Platelet membrane CD154 and sCD154 in progressive peripheral arterial disease: A pilot study

Abstract Objective The expression and potential role of platelet membrane CD154 and sCD154 in atherosclerosis was investigated in patients with peripheral arterial disease. Methods This prospective observational study measured the expression of platelet-bound CD154 and soluble CD154 (sCD154) in 39 patients with critical limb ischaemia (CLI, n  = 15), stable intermittent claudication (SIC, n  = 12) and age-matched controls (AMC, n  = 12). Basal and agonist-stimulated CD154, P-selectin expression and fibrinogen binding was measured by whole blood flow cytometry, while sCD154 was measured in paired plasma samples by ELISA. Results Basal expression of CD154 on the platelet surface was enhanced in both groups of patients with peripheral arterial disease. However, the critical limb ischaemics showed the highest level of basal expression 0.7 ± 0.3 [median ± IQR] and was significantly increased compared to both stable intermittent claudicants and age-matched controls ( P P P Conclusions Enhanced basal platelet expression and increased propensity to express CD154 and sCD154 in critical limb ischaemics compared to both controls and patients with stable intermittent claudication support evidence for the role of CD154 in atherogenesis and suggest a novel function in progressive and acute peripheral arterial disease.