Abstract
Background: CD154 and its soluble counterpart (sCD154) are proteins of the tumor necrosis factor (TNF) family and exhibit proinflamatory and procoagulant properties. Higher circulating sCD154 levels have been found in ischemic stroke patients than in controls. However, the association between circulating sCD154 levels and mortality in ischemic stroke patients has not been reported, and was the focus of this study. Methods: This was a multicenter, observational and prospective study carried out in six Spanish Intensive Care Units. We measured serum sCD154 from 50 patients with severe malignant middle cerebral artery infarction (MMCAI), defined as Glasgow Coma Scale (GCS) lower than 9, at the moment of the severe MMCAI diagnosis and from 50 healthy controls. The end-point of the study was 30-day mortality. Results: We found higher serum sCD154 levels in patients with severe MMCAI than in healthy controls (p < 0.001). We found higher serum sCD154 levels (p < 0.001) in non-surviving (n = 26) than in surviving MMCAI patients (n = 24). Multiple binomial logistic regression analysis showed that serum sCD154 levels >1.41 ng/mmL were associated with 30-day mortality (OR = 10.25; 95% CI = 2.34–44.95; p = 0.002). Conclusions: The new more important finding of our study was that serum sCD154 levels in MMCAI patients were associated with mortality.
Highlights
Ischemic stroke is an important cause of disability, mortality and resources consumption [1].CD154 is a protein of the tumor necrosis factor (TNF) family, and is expressed by platelets, B cells, monocytic cells, natural killer cells, mast cells, and basophils
There were no significant differences between patients with severe malignant middle cerebral artery infarction (MMCAI) and healthy controls groups on age and sex
We found that patients with serum sCD154 levels higher than 1.41 ng/mmL showed higher mortality at 30 days than patients with lower levels (Hazard ratio = 3.4; 95% CI = 1.58–7.39; p = 0.006)
Summary
CD154 is a protein of the tumor necrosis factor (TNF) family, and is expressed by platelets, B cells, monocytic cells, natural killer cells, mast cells, and basophils. CD154 and its soluble counterpart (sCD154) are proteins that exhibit proinflammatory and procoagulant properties when binding to their cell surface receptor CD154 [3]. CD154 is a member of the TNF receptor family that is expressed on the surface of many cells, such as endothelial cells, smooth muscle cells, B cells, monocytes, and microglia. CD154 and its soluble counterpart (sCD154) are proteins of the tumor necrosis factor (TNF) family and exhibit proinflamatory and procoagulant properties. Higher circulating sCD154 levels have been found in ischemic stroke patients than in controls. The association between circulating sCD154 levels and mortality in ischemic stroke patients has not been reported, and was the focus of this study.
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