Enhanced soluble CD40 ligand and Alzheimer's disease: Evidence of a possible pathogenetic role

Desideri, Giovambattista; Cipollone, Francesco; Necozione, Stefano; Marini, Carmine; Lechiara, Maria Carmela; Taglieri, Guglielmo; Zuliani, Giovanni; Fellin, Renato; Mezzetti, Andrea; di Orio, Ferdinando; Ferri, Claudio

doi:10.1016/j.neurobiolaging.2006.10.019

« Previous Next »Neurobiology of Aging
Volume 29, Issue 3 , Pages 348-356, March 2008

Enhanced soluble CD40 ligand and Alzheimer's disease: Evidence of a possible pathogenetic role

Giovambattista Desideri
- Department of Internal Medicine and Public Health, University of L’Aquila, L’Aquila, Italy
- These authors contributed equally to this work.
- Corresponding author. Tel.: +39 862 434746; fax: +39 862 434749.
Francesco Cipollone
- Atherosclerosis Prevention Center and Clinical Research Center, University of Chieti “G. D’Annunzio”, Chieti, Italy
- These authors contributed equally to this work.
Stefano Necozione
- Department of Internal Medicine and Public Health, University of L’Aquila, L’Aquila, Italy
Carmine Marini
- Department of Internal Medicine and Public Health, University of L’Aquila, L’Aquila, Italy
Maria Carmela Lechiara
- Serafino Rinaldi Hospital, L’Aquila, Italy
Guglielmo Taglieri
- Department of Internal Medicine and Public Health, University of L’Aquila, L’Aquila, Italy
Giovanni Zuliani
- Section of Internal Medicine, Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy
Renato Fellin
- Section of Internal Medicine, Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy
Andrea Mezzetti
- Atherosclerosis Prevention Center and Clinical Research Center, University of Chieti “G. D’Annunzio”, Chieti, Italy
Ferdinando di Orio
- Department of Internal Medicine and Public Health, University of L’Aquila, L’Aquila, Italy
Claudio Ferri
- Department of Internal Medicine and Public Health, University of L’Aquila, L’Aquila, Italy

Received 22 July 2006; received in revised form 4 October 2006; accepted 18 October 2006. published online 24 November 2006.

Abstract

It has been suggested that cerebrovascular factors contribute to Alzheimer's disease. Soluble CD40 ligand (sCD40L) is directly involved in the development of vascular damage. We tested the hypothesis that sCD40L may be enhanced in Alzheimer's disease and predictive of its clinical course.

Plasma sCD40L levels were evaluated in three groups of 40 consecutive patients each referring for mild or moderate or severe Alzheimer's disease, as assessed by the Clinical Dementia Rating (CDR), and in 40 healthy subjects. Seventy-seven patients with mild or moderate disease were re-evaluated after 2 years. Cross-sectional comparisons revealed higher plasma sCD40L levels in Alzheimer's disease patients than in controls (9.3±4.7ng/mL versus 3.4±1.3ng/mL, p<0.0001). Circulating sCD40L levels significantly increased through the three CDR stages (p=0.0011 or less) and were correlated with MMSE (r=−0.574, p<0.0001) and ADAS-cog subscale (r=0.538, p<0.0001) scores. Longitudinal evaluation identified sCD40L as an independent predictor of MMSE (β=−0.157, t=−3.650, p=0.0005) and ADAS-cog subscale (β=0.484, t=3.890, p=0.0002) score changes after 2 years. Patients with plasma sCD40L level≥6.0ng/mL, identified by ROC curve analysis as the best discriminating value for disease progression, had a three-fold increase in the risk of progression toward a worse CDR stage (odd ratio: 3.0, C.I. 95% 1.2–8.1).

In conclusion, circulating sCD40L is enhanced in patients with Alzheimer's disease and independently associated with the severity and progression of the disease. These data might suggest a pathogenetic role for sCD40L in Alzheimer's disease.

Keywords: Alzheimer's disease, CD40 ligand, Lipid peroxidation, Platelet activation, Inflammation