Circulating CD40 and sCD40L Predict Changes in Renal Function in Subjects with Chronic Kidney Disease.
Circulating CD40 and sCD40L Predict Changes in Renal Function in Subjects with Chronic Kidney Disease.
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循环 CD40 和 sCD40L 可预测慢性肾病患者肾功能的变化。
DOI：
10.1038/s41598-017-08426-8
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发表时间：
2017
影响因子：
4.6
通讯作者：
Haller,StevenT
中科院分区：
文献类型：
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作者：
Xie,JeffreyX;Alderson,Helen;Ritchie,James;Kalra,PhilipA;Xie,Yanmei;Ren,Kaili;Nguyen,Hanh;Chen,Tian;Brewster,Pamela;Gupta,Rajesh;Dworkin,LanceD;Malhotra,Deepak;Cooper,ChristopherJ;Tian,Jiang;Haller,StevenT
可溶性CD 40配体（sCD 40 L）与肾损伤的发生有关。CD 40受体以可溶性形式sCD 40 R存在，并已显示作为CD 40活化的竞争性拮抗剂发挥作用。我们分析了血浆sCD 40 L和sCD 40 R水平是否可预测全因慢性肾脏病（CKD）队列的肾功能变化。基于sCD 40 L和sCD 40 R单独以及组合对受试者进行分层，证明sCD 40 L与估计肾小球滤过率（eGFR）下降直接相关。sCD 40 R与eGFR下降呈负相关。分层后的基线特征，包括收缩压、糖尿病或外周血管疾病史、原发性肾脏疾病分类和血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂的使用无显著差异。高sCD 40 L和低sCD 40 R均被发现是1年随访时eGFR下降的独立预测因素（− 7.57%，p = 0.014; − 6.39%，p = 0.044）。我们的数据表明，sCD 40 L和sCD 40 R的循环水平与CKD患者的肾功能变化相关。CD 40诱骗受体sCD 40 R可能是减轻肾功能下降的潜在治疗靶点。
Soluble CD40 ligand (sCD40L) has been implicated in the development of renal injury. The CD40 receptor exists in a soluble form, sCD40R, and has been shown to function as a competitive antagonist against CD40 activation. We analyzed whether plasma levels of sCD40L and sCD40R predict changes in renal function in an all-cause chronic kidney disease (CKD) cohort. Stratification of subjects based on sCD40L and sCD40R individually, as well as in combination, demonstrated that sCD40L was directly associated with declines in estimated glomerular filtration rate (eGFR). sCD40R was negatively associated with declines in eGFR. Baseline characteristics following stratification, including systolic blood pressure, history of diabetes mellitus or peripheral vascular disease, primary renal disease classification, and angiotensin converting enzyme inhibitor or angiotensin receptor blocker usage were not significantly different. High sCD40L and low sCD40R were both found to be independent predictors of a decline in eGFR at 1-year follow-up (−7.57%, p = 0.014; −6.39%, p = 0.044). Our data suggest that circulating levels of sCD40L and sCD40R are associated with changes in renal function in patients with CKD. The CD40 decoy receptor, sCD40R, may serve as a potential therapeutic target to attenuate renal function decline.