Atherosclerosis is a systemic disease of the large arteries, and activation
of inflammatory pathways is important in its pathogenesis(1). Increasing e
vidence supports the importance of CD40-CD154 interactions in atheroscleros
is(2,3), interactions originally known to be essential in major immune reac
tions(4) and autoimmune diseases(5). CD40 is present on atheroma-derived ce
lls in vitro and in human atheromata in situ(6). Ligation of CD40 on athero
ma-associated cells in vitro activates the production of chemokines(6), cyt
okines(6), matrix metalloproteinases(7,8), adhesion molecules(9,10) and tis
sue factor: substances responsible for lesion progression and plaque destab
ilization(1). Administration of antibody against CD154 to low-density lipop
rotein receptor-deficient mice has been shown to reduce atherosclerosis and
decrease T-lymphocyte and macrophage content; however, only initial lesion
s were studied(3). Here, we determined the effect of genetic disruption of
CD154 in ApoE(-/-) mice in both initial and advanced atherosclerotic lesion
s. Plaque area was reduced 550%. In contrast to previous reports, initial l
esion development was not affected. Advanced plaques in CD154(-/-)ApoE(-/-)
mice had a less-lipid-containing, collagen-rich, stable plaque phenotype,
with a reduced T-lymphocyte/macrophage content. These data indicate that CD
40-CD154 signaling is important in late atherosclerotic changes, such as li
pid core formation and plaque destabilization.