Authors: David P Inwald Saul N Faust Paula Lister Mark J Peters Michael Levin Robert Heyderman Nigel J Klein
Publish Date: 2006/06/30
Volume: 32, Issue: 9, Pages: 1432-1437
Abstract
a sCD40L ELISA of plasma from patients with meningococcal sepsis n = 49 and age matched controls n = 10 This demonstrated higher sCD40L levels in patients median 029 ng/ml IQR 02–041 than controls 009 ng/ml 008–012 However there was no relationship between plasma sCD40L level and platelet count or disease severity b Flow cytometry of fresh blood from patients with meningococcal sepsis n = 11 and agematched controls n = 10 for membrane bound CD40L and CD62P on circulating platelets This demonstrated low levels of CD40L and CD62P in patients and controls CD40L+ platelets were 35 30–48 in patients and 49 35–43 in controls CD62P+ platelets were 107 64–128 in patients and 79 59–130 in controls c Immunohistochemistry of skin biopsy specimens from six patients staining for endothelial CD40 expression at sites of microthrombus formation which demonstrated preserved CD40 expression in vascular endothelium at sites of microthrombus formationThe elevated sCD40L level in meningococcal sepsis implies release of sCD40L from platelets However there was no relationship between plasma sCD40L level and the degree of thrombocytopenia or disease severity Furthermore platelet surface bound CD40L was similar in controls and patients Thus further investigation is needed to determine whether platelet CD40L contributes to inflammation and thrombosis in MCSThis work was jointly undertaken in Great Ormond Street Hospital for Children NHS Trust which received a proportion of its funding from the NHS Executive The views expressed in this publication are those of the authors and not necessarily those of the NHS executive
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