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Association between enhanced soluble CD40 ligand and prothrombotic state in inflammatory bowel disease
Ioannis E Koutroubakis1, Angeliki Theodoropoulou, Costas Xidakis
1Department of Gastroenterology University Hospital Heraklion; and Regional Blood Bank Center Venizelion Hospital Heraklion, Crete, Greece.
Insights
Elevated soluble CD40 ligand (sCD40L) levels in inflammatory bowel disease patients, particularly those with active Crohn's disease, correlate with markers of blood clotting. This suggests sCD40L may link IBD to a prothrombotic state.
Area of Science:
- Gastroenterology
- Hematology
- Immunology
Background:
- Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), is linked to increased thromboembolic events.
- Soluble CD40 ligand (sCD40L) is a molecule with known prothrombotic properties.
Purpose of the Study:
- To investigate the role of sCD40L in patients with UC and CD.
- To compare sCD40L levels in IBD patients with those in inflammatory and healthy controls.
Main Methods:
- Plasma levels of sCD40L, prothrombin fragment 1+2 (F1+2), thrombin-antithrombin (TAT) complex, and soluble P-selectin were measured using ELISA.
- 104 IBD patients (54 UC, 50 CD), 18 non-IBD inflammatory controls, and 80 healthy controls were included.
- sCD40L levels were correlated with disease activity, type, localization, treatment, and thrombophilic parameters.
Main Results:
- Crohn's disease patients exhibited significantly higher sCD40L levels compared to both control groups.
- Ulcerative colitis patients showed higher, though not statistically significant, sCD40L levels than controls.
- Active disease in both UC and CD patients was associated with significantly elevated sCD40L levels.
- sCD40L levels correlated positively with platelet count, prothrombin F1+2, TAT complex, and soluble P-selectin.
Conclusions:
- Increased plasma sCD40L levels in IBD patients may contribute to the observed procoagulant state.
- sCD40L could represent a molecular link between inflammatory bowel disease and thrombosis.
Background:
Inflammatory bowel disease is associated with an increased incidence of thromboembolic complications. The aim of this study was to investigate the role of the soluble CD40 ligand (sCD40L), which displays prothrombotic properties, in patients with ulcerative colitis (UC) and Crohn's disease (CD) in comparison with inflammatory and healthy controls.
Methods:
Plasma levels of sCD40L, prothrombin fragment 1+2 (F1+2), thrombin-antithrombin (TAT) complex and soluble P-selectin were measured in 104 inflammatory bowel disease patients (54 ulcerative colitis and 50 Crohn's disease), in 18 cases with other causes of intestinal inflammation and in 80 healthy controls using commercially available enzyme-linked immunosorbent assays. Plasma levels of sCD40L were correlated with disease activity, type, localization and treatment as well as with the measured thrombophilic parameters.
Results:
CD patients had significantly higher sCD40L levels than both groups of controls (CD vs HC P < 0.001; CD vs non-IBD P < 0.05). UC patients had higher but not significantly different sCD40L levels compared with the controls. Both UC and CD patients with active disease had significantly higher sCD40L levels in comparison with patients with inactive disease. Plasma levels of sCD40L were correlated with platelet count (r = 0.27, P = 0.001). They also showed a correlation with prothrombin F1+2 (r = 0.16, r = 0.03) and TAT (r = 0.15, r = 0.04) as well as with P-selectin (r = 0.19, P = 0.01).
Conclusions:
The increased sCD40L plasma levels may represent, at least in some degree, a molecular link between inflammatory bowel disease and the procoagualant state.
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