The binding of CD40 ligand (CD40L) to CD40 stimulates inflammatory
processes including the release of proinflammatory cytokines and the
expression of adhesion molecules implying a role in atherosclerosis.
Patients exhibiting hypercholesterolemia, unstable angina, or acute
myocardial infarction present with increased CD40L levels. Novel data
suggest that elevated soluble CD40L levels not only represent a risk
factor for cardiovascular disease but also predict future adverse
events, especially in patients with acute coronary syndromes (ACS).
Examination of the potential role of the genetic variability on
CD40/CD40L genes in ACS, as regards the regulation of CD40L, appears to
be of great interest. Moreover, several therapeutic approaches such as
statins, antihypertensive agents, and antiplatelet agents have been
suggested as potential modulators of CD40L levels anticipating a
positive impact on the outcomes of patients with ACS. Whether specific
agents target the CD40/CD40L system as well as its pathogenic role in
ACS remains to be elucidated by large-scale studies in the future.
(Trends Cardiovasc Med 2010;20:153-164) (C) 2010, Elsevier Inc. All
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