Persistently Higher Serum sCD40L Levels Are Associated With Outcome in Septic Patients

Yingjian Liang; Chengrui Zhu; Yini Sun; Zhiliang Li; Liang Wang; Yina Liu; Xin Li; Xiaochun Ma


BMC Anesthesiol. 2021;21(26) 

In This Article


Sepsis is the overwhelming inflammatory host response to the infectious agent causing the overexpression of inflammatory mediators.[1] Moreover, sepsis is also generally associated with coagulation abnormalities and presents as thromboembolic disease or clinically less apparent microvascular fibrin deposition.[2] In sepsis, inflammation and coagulation are cross-linked, and inflammation causes coagulation activation. In contrast, coagulation also affects the activation of inflammation, which promotes disease progression and leads to organ dysfunction.[3]

CD40 ligand (CD40L) and the soluble form of CD40L (sCD40L) are members of the tumor necrosis factor (TNF) family and are expressed in a variety of cell types, including B cells, epithelial cells, fibroblasts, endothelial cells (ECs), and platelets. CD40L and sCD40L exhibit proinflammatory and procoagulant effects.[4,5] Previous studies have found that serum CD40L levels are elevated in patients with sepsis and are associated with mortality in these patients.[6–9]

In surgical patients, endothelial cell damage, inflammation, and coagulation changes occurred after surgery. Therefore, the purpose of this study was to determine sCD40L changes in surgical patients without sepsis (SWS) and in surgical sepsis patients (SS) during the first 3 days after ICU admission and to observe the relationship between sCD40L and mortality.