A High Level of Soluble CD40L Is Associated with P. aeruginosa Infection in Patients with Cystic Fibrosis

作者：Ester Bustamante Adriana; Carlos Jaime Perez Jose; Cordero Perez Paula; Galindo Rodriguez Gabriela; Elsa Munoz Espinosa Linda; Daniel Villarreal Villarreal Cesar; Mercado Longoria Roberto

来源：PLos One, 2016, 11(12): e0168819.

DOI：10.1371/journal.pone.0168819

Objective
The aim of this study was to evaluate whether the concentration of sCD40L, a product of platelet activation, correlates with the presence of Pseudomonas aeruginosa in the airway of patients with cystic fibrosis (CF) and to determine its possible clinical association.
Methods
Sixty patients with CF, ranging in age from 2 months to 36 years, were studied. The demographics, cystic fibrosis transmembrane conductance regulator (CFTR) genotype, spirometry measurements, radiographic and tomographic scans, platelet count in peripheral blood, sCD40L, IL-6, TNF-alpha and ICAM1 data were collected. Infection-colonization of the airway was evaluated using sputum and throat swab cultures; the levels of anti-Pseudomonas aeruginosa antibodies (Anti-PaAb) were evaluated.
Results
Patients with CF and chronic colonization had anti-PaAb values of 11.6 +/- 2.1 ELISA units (EU) and sCD40L in plasma of 1530.9 +/- 1162.3 pg/mL; those with intermittent infection had 5.7 +/- 2.7 EU and 2243.6 +/- 1475.9 pg/mL; and those who were never infected had 3.46 +/- 1.8 EU (p <= 0.001) and 1008.1 +/- 746.8 pg/ mL (p <= 0.01), respectively. The cutoff value of sCD40L of 1255 pg/ mL was associated with an area under the ROC (receiver operating characteristic curve) of 0.84 (95% CI, 0.71 to 0.97), reflecting P. aeruginosa infection with a sensitivity of 73% and a specificity of 89%. Lung damage was determined using the Brasfield Score, the Bhalla Score, and spirometry (FVC%, FEV1%) and found to be significantly different among the groups (p <= 0.001).
Conclusion
Circulating sCD40L levels are increased in patients with cystic fibrosis and P. aeruginosa infection. Soluble CD40L appears to reflect infection and provides a tool for monitoring the evolution of lung deterioration.

• 出版日期2016-12-28