Association Between Plasma Levels Of Soluble CD40/CD40 Ligand And Kidney Damage In Preeclamptic Patients

Objective To investigate the variance levels of plasma soluble CD40 (sCD40) and soluble CD40 ligand (sCD40L) in preeclamptic patients with renal damage and its relationship.Methods A total of 63 pregnant women delivered in the Department of Obstetrics, Affiliated Hospital of Qingdao University Medical College from August 2008 to June 2010 were included in the study. Among these women,28 cases were mild (group of mild preeclampsia), and 35 cases were severe (group of severe preeclampsia).30 normotesive pregnant women were enrolled in the study as the control group during the same study period. Expression of sCD40 and sCD40L were determined by Enzyme-linked immunosorbent assay (ELISA) in the pregnant women of the 3 groups. At the same time, the blood routine, C reaction protein (CRP), urine routine,24h urine protein excretion, and serum uric acid (UA), creatinine (Cr), blood urea nitrogen (BUN) were measured to investigate the correlation between the sCD40/CD40L and the blood biochemical indexes in 3 groups of recruited women.Results(1) The concentration of sCD40 and sCD40L was significantly higher in women with severe preeclampsia compared with mild preeclampsia and control groups. The plasma level of sCD40 and sCD40L was 133.6(105.7-189.9)pg/ml and 12.5(8.3-17.9) ng/ml,26.5(84.1-157.8) pg/ml and 10.4 (5.6-15.1) ng/ml,90.7 (62.3-122.4) pg/ml and 4.4 (1.5-8.7) ng/ml, respectively, in severe preeclampsia, mild preeclampsia, and control group. Significant statistics difference was found in multiple comparison P＜0.01).(2) The correlation analysis indicated that the level of sCD40 has a positive correlation with 24h urine protein excretion (r=0.434, P<0.05), also significant positive correlation (r=0.536,0.528, P<0.01) between the level of sCD40 and UA, CRP was found in women with preeclampsia. There was no significant correlation between the level of sCD40 and systolic blood pressure, diastolic blood pressure, delivery gestational age, Cr, BUN, and PLT (r=0.135,0.183,-0.133,0.190,0.167, -0.221,P>0.05).(3) The correlation analysis indicated that the level of sCD40L has a positive correlation with 24h urine protein excretion, UA, and CRP (r=0.591,0.445,0.539, P<0.01). There was no significant correlation between the level of sCD40L and systolic blood pressure, diastolic blood pressure, delivery gestational age, Cr, BUN, and PLT (r=0.178,0.212,-0.292,0.144,0.135,-0.273, P>0.05).(4) There was significant positive correlation between serum sCD40 and sCD40L (r=0.707, P<0.01).(5) There was no correlation between the level of sCD40, sCD40L and the Blood Biochemical Indexes in normotesive pregnant women (P>0.05)ConclusionThe plasma concentration of sCD40/CD40L is significantly higher in pregnant women with preeclampsia compared with the control ones, which may contribute to the development of endothelial cell dysfunction found in preeclampsia and lead to the kidney damage.