Soluble CD40 Ligand, High Sensitive C-Reactive Protein and Fetuin-A Levels in Patients with Essential Thrombocythemia

Background: CD40 ligand (CD40L) is expressed on the surface of activated platelets and activated T lymphocytes. Circulating soluble CD40 ligand (sCD40L) is formed from these molecules proteolytically. Fetuin-A is a potent antiinflammatory cytokine. Aim of the study: In this study, we aim to investigate sCD40L levels to determine whether there is platelet activation and to measure high sensitive C-reactive protein (hs-CRP) levels to demonstrate if this leads to an inflammatory process and also to study fetuin-A levels to see if there is any concomitant antiinflammatory event in patients with essential thrombocythemia (ET). Methods: We compared 30 patients with essential thrombocythemia with 30 control subjects and in these patients we measured levels of sCD40L, hs-CRP and fetuin-A. Results: sCD40L levels were significantly higher in the Er group compared to the control group (30.6 +/- 14.4 vs. 18.5 +/- 8.9, p = 0.001). Although fetuin-A levels showed a slight trend to be increased in ET patients, the difference did not reach significance (4.5 +/- 4.2 vs. 3.2 +/- 2.1, p = 0.158). There were no statistically significant differences in hs-CRP levels (24.6 +/- 4.9 vs. 25.0 +/- 5.2, p = 0.750). Conclusion: sCD40L was significantly higher in patients with an ET without any association with an inflammatory process and we believe this may be a marker of platelet regeneration.