Soluble CD40 ligand is not solely related to the presence and severity of sepsis 英文参考文献.docVIP

Chew and Thorlacius Critical Care 2011, 15:438 /content/15/4/438 LET TER Soluble CD40 ligand is not solely related to the presence and severity of sepsis Michelle S Chew* and Henrik Thorlacius See related research by Lorente et al., /content/15/2/R97 We read with interest the recently published paper by logy and Chronic Health Evaluation scores, Sequential Lorente and colleagues reporting that levels of soluble Organ Failure Assessment scores, and TNF? and IL-10 CD40 ligand (CD40L) are increased in septic patients levels [1], which is in agreement with previous ? ndings compared with healthy controls and that increased [3,4]. Further, although the study was conducted in patients with sepsis, we suggest that soluble CD40L is a common e relation ship denominator for patients with shock, rather than with sepsis per se us, in a study of critically ill patients circulating CD40L levels may be an independent predic tor of mortality in patients with sep between platelets and soluble CD40L seen in this study is consistent with previous data showing that soluble admitted to the intensive care unit with shock due to di? er- CD40L is mainly released from activated platelets and ent aetiologies, we found no di? erences in the levels of mediates neutrophil-induced lung injury in sepsis [2]. We believe that the functional role of soluble CD40L is complex, however, and not solely related to the presence of soluble CD40L between septic and nonseptic shock patients e relevance of soluble CD40L as a potential thera- peutic target for sepsis therefore remains to be explored. We suggest that targeting CD40L in order to ameliorate sepsis or its severity is is indicated in the study by Lorente and colleagues, in which no associations were pathological in? ammatory responses is not limited to found between