The role of CD40 receptor-ligand system in the development of diabetes mellitus and its complications

Abstract

The CD40 receptor-CD40 ligand system, along with other signal molecules, plays an important role in the development of immune and inflammatoryreactions. CD40R and CD40L are expressed in lymphocytes, monocytes, platelets, endothelial and smooth muscle cells, pancreatic beta-cells, adipocytes,and other cells. The CD40-CD40L system participates in the formation of immune and inflammatory reactions in the cardiovascular system,platelet production and development of autoimmune diseases. Signals mediated through CD40 receptors are involved in the autoimmune process intype 1 diabetes, inflammation of adipose tissue in DM2, development of atherosclerosis and diabetic nephropathy. Therefore, the CD40-CD40Lsystem can be regarded as a universal pathogenetic factor responsible for immune and inflammatory processes, hyperglycemia, and vascular complications.Measurement of CD40 expression in lymphocytes, monocytes, and adipocytes and sCD40L in blood and urine can be used to diagnose andforetell immune and inflammatory processes associated with diabetes mellitus. HMG-CoA reductase inhibitors (statins) and disaggregants (aspirin,clopidogrel) inhibit activity of the CD40-CD40L system. Further studies of possibilities of pharmacological correction of this system may provide abasis for the development of new therapeutic modalities for the management of diabetes and its complications.