OBJECTIVETo investigate the therapeutic effects of Qingre Quyu Granule (QQG) on the patients with severe carotid stenosis, and to explore the mechanism of it.

METHODSNinety-six patients with severe carotid stenosis were enrolled in the study and were classified into a QQG group (n=48) and a control group (n=48) randomly using consecutively numbered envelopes. The patients in the QQG group were given QQG and Western medicine, those in the control group were given Western medicine merely, the course of treatment was 16 weeks. All patients went through endarterectomy after treatment. Plaques were subjected to the analysis of CD3, CD68, soluble intercellular adhesion molecule 1 (ICAM-1), matrix metalloprotease-9 (MMP-9), CD40L, tenascin-C, and collagen content lipid content by immunohistochemistry or polarized light analysis.

RESULTSBy the end of experiment, the expressions of CD3, CD68, ICAM-1, MMP9, CD40L and tenascin-C on the plaques were statistically significant lower in the QQG group compared with the control group(P<0.01). The lipid content of the plaque was also significantly lower in the QQG group compared with the control group (P<0.01). The interstitial collagen in the tissue sections of the plaques was also significantly higher in the QQG group in comparison with the control group (P<0.01).

CONCLUSIONQQG could stabilize carotid artery plaques through inhibiting pro-inflammation factors and restraining the tenascin-C and MMP9 pathway.

Aged ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; CD3 Complex ; metabolism ; CD40 Ligand ; metabolism ; Carotid Arteries ; metabolism ; pathology ; Carotid Stenosis ; blood ; complications ; drug therapy ; Collagen ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Humans ; Immunohistochemistry ; Inflammation ; complications ; pathology ; Intercellular Adhesion Molecule-1 ; metabolism ; Lipids ; blood ; Male ; Matrix Metalloproteinase 9 ; metabolism ; Plaque, Atherosclerotic ; blood ; complications ; drug therapy ; Tenascin ; metabolism

BACKGROUND: Anti-Gal is a major antibody induced in non-human primates (NHPs) after xenotransplantation. To understand the mechanism of graft rejection, we investigated the association between anti-Gal responses and graft failure in NHP recipients of porcine islet transplantation (PITx). METHODS: Intraportal PITx was performed in 35 diabetic NHPs, and graft function was monitored. Early graft failure (EGF) was defined as loss of graft function within a month after PITx. Seven, 19, nine NHPs received immunosuppression (IS) without CD40 pathway blockade (Group I), with anti-CD154 (Group II), and with anti-CD40 (Group III), respectively. The anti-Gal levels on day 0 and day 7 of PITx were measured by ELISA. RESULTS: The frequency of EGF was significantly lower in Group II (26.3%) than in Group I (100%, P=0.0012) and Group III (77.8%, P=0.0166). While levels of anti-Gal IgG in Group I and anti-Gal IgM in Group III increased on day 7 compared with day 0 (P=0.0156 and 0.0273), there was no increase in either on day 7 in Group II. The ratio of anti-Gal IgM or IgG level on day 7 to that on day 0 (Ratio7/0) was significantly higher in recipients with EGF than without EGF (P=0.0009 and 0.0027). ROC curve analysis of anti-Gal IgM Ratio7/0 revealed an area under the curve of 0.789 (P=0.0003). CONCLUSIONS: IS with anti-CD154 suppressed anti-Gal responses and prevented EGF in PITx. Anti-Gal IgM Ratio7/0, being associated with EGF, is a predictive marker for EGF.
Animals ; Antibodies/blood/immunology ; Antigens, CD40/immunology ; Area Under Curve ; CD40 Ligand/immunology ; Disaccharides/*immunology ; Epidermal Growth Factor/blood ; Graft Rejection/*immunology ; Immunoglobulin G/blood ; Immunoglobulin M/*blood ; Immunosuppressive Agents/therapeutic use ; *Islets of Langerhans Transplantation ; Macaca mulatta ; ROC Curve ; Swine ; Transplantation, Heterologous

BACKGROUNDRecently, studies have disclosed soluble CD40 ligand (sCD40L) during atherosclerosis development and plaque destabilization. The objective of the present study was to test the hypothesis that sCD40L levels are higher in acute coronary syndrome (ACS) patients with a greater extent of angiographic coronary involvement.

METHODSThis cross-sectional study examined ACS patients who underwent coronary angiography by measuring their sCD40L levels. In order to estimate the serum levels of sCD40L, 10 ml of peripheral venous blood was drawn within 24 hours of admission. sCD40L levels were measured using an enzyme-linked immunosorbent assay (ELISA, RapidBio, West Hills, CA, USA). Demographic data, presence of concomitant diseases, ACS characteristics, and angiographic findings were evaluated. A review of medical records and patient interviews were conducted to assess coronary risk factors. And the severity of coronary artery disease was evaluated using the Gensini score index.

RESULTSTwo hundred and eighty-nine patients were included in the study, of whom 186 were male, with an average age of 64.1 ± 10.0 years. Median sCD40L levels were 1.7 ng/ml (0.3-7.3 ng/ml) and Gensini scores were 50 (0-228). After adjusting for demographic variables and cardiovascular risk factors, the Gensini score was associated with the natural logarithm of the sCD40L level (Coefficient b = 0.002, 95% CI 0.000-0.003, P = 0.029).

CONCLUSIONsCD40L levels were independently associated with angiographic severity of coronary artery disease in patients with ACS.

Acute Coronary Syndrome ; diagnostic imaging ; pathology ; Aged ; CD40 Ligand ; blood ; Coronary Angiography ; Coronary Artery Disease ; diagnostic imaging ; pathology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Severity of Illness Index

OBJECTIVETo explore effects and action mechanism of warm moxibustion on regulation of blood lipids and anti-atherosclerosis.

METHODSForty-one male Japanese big-ear white rabbits were randomly divided into a blank group (10 rabbits), a model group (10 rabbits), a moxibustion group (10 rabbits) and a medication group (11 rabbits). Normal diet was applied in the blank group while high-cholesterol diet combined with injection of bovine serum albumin were applied in the rest groups to establish rabbit model of atherosclerosis. After establishment, the model group was not intervened and warm moxibustion was applied in the moxibustion group at "Zusan-li" (ST 36) and "Shenque" (CV 8), 10 min per acupoint per day for continuous 4 weeks. The medication group was treated with intragastric administration of lovastatin capsule (3.6 mg/kg) for continuous 4 weeks. The level of blood lipids, such as total cholesterol (TC), triglyceride (TG), and content of CD40 ligand (CD40L), soluble CD40 ligand (sCD40L) and expression of nuclear factor NF-kappaB were tested after 4 weeks.

RESULTSCompared with the model group, the moxibustion group and medication group could effectively reduce the contents of TC and low density lipoprotein (all P < 0.05), lower the level of sCD40L [(8.310 +/- 1.221) ng/mL in the model group, (7.097 +/- 0.846) ng/mL in the moxibustion group and (7.354 +/- 0.631) ng/mL in the medication group], reduce expression of CD40L [(0.235 +/- 0.179) mm2 in the model group, (0.072 +/- 0.079) mm2 in the moxibustion group and (0.039 +/- 0.015) mm2 in the medication group] and NF-kappaB [(0.145 +/- 0.052)mm2 in the model group, (0.052 +/- 0.012) mm2 in the moxibustion group and (0.036 +/- 0.013) mm2 in the medication group], indicating the significant difference (P < 0.05, P < 0.001). There was no statistical difference between the moxibustion group and medication group (all P > 0.05).

CONCLUSIONThe warm moxibustion has great effect on regulation of blood lipids and anti-atherosclerosis, in which lowering expression of CD40-CD40L could be one of possible mechanisms to take effect of anti-atherosclerosis.

Animals ; Atherosclerosis ; blood ; therapy ; CD40 Antigens ; blood ; CD40 Ligand ; blood ; Humans ; Lipids ; blood ; Male ; Moxibustion ; methods ; Rabbits

PURPOSE: We investigated correlations of coronary plaque composition determined by virtual histology (VH) intravascular ultrasound (IVUS) and blood levels of biomarkers that represent the vulnerability of coronary plaques. MATERIALS AND METHODS: Pre- and postprocedural blood levels of high sensitivity C-reactive protein, soluble CD40 ligand (sCD40L), matrix metalloproteinase-9, and neopterin were measured in 70 patients with stable angina (SA) or unstable angina (UA) who were undergoing percutaneous coronary intervention (PCI) for single lesions. We evaluated the data for correlations between these biomarkers and necrotic core contents in PCI target lesions analyzed by VH. RESULTS: Clinical characteristics, IVUS, VH, and biomarker blood levels were not different between the SA and the UA group except for more frequent previous statin use (52.3% vs. 23.1%, p=0.017) and lower remodeling index in the SA group (0.98+/-0.09 vs. 1.10+/-0.070, p<0.001). Among the biomarkers evaluated, only pre-PCI neopterin level showed a weakly significant correlation with the absolute volume of the necrotic core (r=0.320, p=0.008). Pre- and post-PCI blood levels of sCD40L (r=0.220, p=0.072; r=0.231, p=0.062) and post-PCI blood level of neopterin (r=0.238, p=0.051) showed trends toward weakly positive correlations with the absolute volume of necrotic core. CONCLUSION: We found a weakly positive correlation between the pre-PCI neopterin level and necrotic core volume in the PCI-target lesion. The clinical implications of our findings need to be investigated in further studies.
Aged ; Angina Pectoris/blood ; Angina, Stable/blood ; Angina, Unstable/blood ; Angioplasty, Balloon, Coronary ; Biological Markers/blood ; C-Reactive Protein/metabolism ; CD40 Ligand/blood ; Coronary Artery Disease/*blood/*metabolism/ultrasonography ; Female ; Humans ; Male ; Matrix Metalloproteinase 9/blood ; Middle Aged ; Neopterin/blood ; Plaque, Atherosclerotic/*blood/*metabolism/ultrasonography ; Ultrasonography, Interventional

PURPOSE: To investigate the changes and correlations of the serum inflammation factors levels and left ventricular (LV) structure and function in patients with acute ST segment elevation myocardial infarction (STEMI). MATERIALS AND METHODS: A prospective study was performed on 70 STEMI patients and 70 control subjects. Serum levels of interleukin-6 (IL-6), soluble CD40 ligand (sCD40L), metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were measured by sandwich enzyme-linked immunosorbent assay (ELISA), and cardiac structure and function were assessed by echocardiography at admission and 3-year follow-up. RESULTS: We found that the levels of serum IL-6, sCD40L and MMP-9 increased steadily among control subjects, remote myocardial infarction and acute STEMI patients, and the level of TIMP-1 elevated remarkly at 3-year follow-up visit in STEMI. The admission level of serum MMP-9 positively correlated with LV end-diastolic and end-diastole volume (r=0.294, p=0.022; r=0.269, p=0.036, respectively), and TIMP-1 positively correlated with E/A ratio (r=0.278, p=0.044) at 3-year follow-up. CONCLUSION: The study indicates that admission levels of serum MMP-9 and TIMP-1 closely correlated with left ventricular structure and function, which may be involved in the process of post-infarction remodeling of myocardium.
Aged ; CD40 Ligand/blood ; Female ; Humans ; Interleukin-6/blood ; Male ; Matrix Metalloproteinase 9/blood ; Middle Aged ; Myocardial Infarction/*blood/*physiopathology ; Prospective Studies ; Tissue Inhibitor of Metalloproteinase-1/blood ; Ventricular Remodeling/*physiology

OBJECTIVETo observe the effects of Modified Liangge Powder (MLP) on the expressions of platelet toll like receptor 4 (TLR4) and the release of platelet-derived cytokines interleukin 8 (IL-8), beta platelet globulin (beta-TG), soluble CD40 ligand (sCD40L).

METHODSThe modulating effects on the release of cytokines from mice platelets by TLR4 ligand through monoclonal antibody blocking TLR4 on platelet were compared. The stimulated platelet by LPS was incubated with low (0.94 g/mL), medium (1.89 g/mL), and high (2.84 g/mL) dose of MLP contained serum. The changes of the platelet TLR4 expression and platelet-derived cytokines were observed.

RESULTSThe positive expression rate of platelet TLR4 obviously decreased (P < 0.01) and the release of sCD40L and beta-TG from platelets significantly increased (P < 0.01) after stimulated by LPS. However, the release of sCD40L and beta-TG from platelets obviously decreased by TLR4 monoclonal antibody (P < 0.05, P < 0.01). There was no statistical difference in IL-8 between before and after LPS stimulation (P > 0.05). Platelet TLR4 positive expression rate was significantly higher after incubated by medium and high doses of MLP contained serum (P < 0.01), and the releasing of sCD40L and beta-TG was lower in the serum contained groups. The inhibitory effects were enhanced in a dose-dependent manner.

CONCLUSIONSLPS induced platelet activation by TLR4 and released sCD40L and beta-TG, while the release of platelet IL-8 was not dependent on platelet TLR4-LPS pathway. MLP could inhibit LPS-stimulated sCD40L and beta-TG, inhibit the binding of platelet TLR4 and LPS in a dose-dependent manner, thus reducing the release of platelet cytokines.

Animals ; Beta-Globulins ; metabolism ; Blood Platelets ; drug effects ; metabolism ; CD40 Ligand ; metabolism ; Cytokines ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Interleukin-8 ; metabolism ; Lipopolysaccharides ; adverse effects ; Male ; Mice ; Mice, Inbred ICR ; Serum ; Toll-Like Receptor 4 ; metabolism

OBJECTIVESTo study the relationship between serum levels of some inflammatory markers and stability of carotid plaques in the patients with carotid plaques and evaluate the ability of each serum marker in identifying vulnerable carotid plaques.

METHODSThe study included 65 consecutive patients with carotid plaques confirmed by imaging examinations from March 2008 to March 2010. All the patients were classified as stable plaques group (n = 21) and unstable plaques group (n = 44) according to the characteristic findings of the plaques in MRI such as the thickness of fibrous cap, the existence of large lipid core and the intra-plaque hemorrhage. The patients of unstable plaques group were further classified as unruptured plaques group (n = 29) and rupture plaques group (n = 15) according to the integrity of fibrous cap. Serum levels of soluble cluster of differentiation 40 ligand (sCD40L), matrix metalloproteinase 9 (MMP-9) and pregnancy-associated plasma protein A (PAPP-A) were determined by ELISA.

RESULTSSerum levels of sCD40L and MMP-9 in patients of unstable plaques group, unruptured plaques group and rupture plaques group were all significantly enhanced compared to individuals of stable plaques group (SCD40L: χ(2) = 6.45, 12.04 and 16.23, P < 0.01; MMP-9; F = 2.55, 5.10 and 4.69, P < 0.05). Serum levels of PAPP-A in patients of unstable plaques group and rupture plaques group were all significantly enhanced compared to individuals of stable plaques group (χ(2) = 11.71 and 13.55, P < 0.05). Serum levels of PAPP-A in patients of rupture plaques group were significantly enhanced compared to individuals of unruptured plaques group (χ(2) = 13.19, P = 0.000). sCD40L ≥ 673.22 ng/L (OR = 22.47, 95%CI: 2.11 - 239.81, P = 0.010), MMP-9 ≥ 84.09 µg/L (OR = 10.01, 95%CI: 1.74 - 57.78, P = 0.010) and PAPP-A ≥ 0.101 µg/L (OR = 14.29, 95%CI: 2.69 - 75.90, P = 0.002) were all significantly correlated with the vulnerability of carotid plaques.

CONCLUSIONSThere appear to be a relationship between the serum levels of sCD40L, MMP-9 and PAPP-A and the stability of carotid plaques in patients with carotid plaques. High serum levels of the above-mentioned markers may indicate that the plaques were vulnerable or ruptured.

Aged ; Aged, 80 and over ; CD40 Ligand ; blood ; Carotid Stenosis ; blood ; Female ; Humans ; Male ; Matrix Metalloproteinase 9 ; blood ; Middle Aged ; Pregnancy-Associated Plasma Protein-A ; metabolism

OBJECTIVETo observe changes of soluble CD40 ligand (sCD40L) in patients with hyperlipidemia of blood stasis syndrome and its correlation with blood stasis syndrome integral, P-selectin, and high sensitive creatine reactive protein (hs-CRP), to investigate the roles of platelet activation and inflammation in the physiopathologic process of blood-stasis type hyperlipidemia, and to explore the pathogenetic mechanism of blood-stasis syndrome (BSS).

METHODSSeventy hyperlipidemia patients were assigned to two groups, 39 in the BSS group and 31 in the non-BSS group. Meanwhile, thirty healthy subjects were grouped as the control. Main physiochemical indices, blood levels of sCD40L, P-selectin, hs-CRP were detected in all. The correlations of the aforesaid indices were analyzed.

RESULTSBSS score in the BSS group was higher than that in the non-BSS group and in the control group. Higher blood levels of P-selectin and sCD40L were shown in the BSS group than in the non-BSS group [(25.13 +/- 5.49) ng/L vs. (21.37 +/- 3.56) ng/L and (2.45 +/- 0.48) ng/L vs. (2.07 +/- 0. 41) ng/L] respectively, and the two indices were higher in hyperlipidemia patients than in healthy persons [(14.91 +/- 2.48) ng/L and (1.63 +/- 0.25) ng/L, P < 0.01]. Correlation analysis showed that in patients with hyperlipidemia, blood level of sCD40L was positively correlated with low-density lipoprotein cholesterol (LDL-C) level (r = 0.503, P < 0.01), P-selectin (r = 0.897, P < 0.01), and the BSS score (r = 0.603, P < 0.01).

CONCLUSIONSThe over-expressed sCD40L indicated persistent inflammatory state in patients with hyperlipidemia of BSS. BSS would further accelerate the chronic inflammation process of hyperlipidemia.

Adult ; Aged ; C-Reactive Protein ; metabolism ; CD40 Ligand ; blood ; Case-Control Studies ; Female ; Humans ; Hyperlipidemias ; blood ; diagnosis ; pathology ; Inflammation ; blood ; Male ; Medicine, Chinese Traditional ; Middle Aged ; P-Selectin ; blood

Chemokine is a class of soluble active peptides that attract white blood cells to the inflammatory site. CD40 ligand (CD40L) involves in synthesis of proinflammatory mediators. Accumulation of chemokine and CD40L can induce non-hemolytic reaction after transfusion, transfusion-related acute lung injury (TRALI) and autoimmune disease during blood component storage. Pre-storage leucocyte deletion can prevent the release of leucocyte-derived chemokines, but not prevent the accumulation of platelet-derived chemokines. γ-irradiation or ultraviolet β irradiation is effective in preventing the increase of chemokines in the storage of platelet, thus prevents non-hemolytic febrile reaction after platelet transfusion. In this review, the recent advance in research of accumulation of chemokines and CD40L during blood component storage, and its effect on blood transfusion, as well as preventive measures are summarized.
Blood Platelets ; metabolism ; Blood Preservation ; Blood Transfusion ; CD40 Ligand ; blood ; Chemokines ; blood ; Humans