Objective: To evaluate the significance of changes in the serum levels of soluble Fas (sFas) and soluble Fas ligand (sFasL) in patients with multiple organ dysfunction syndrome (MODS) regarding its diagnosis and judgement of severity and outcome, and to investigate the correlations between the levels of tumor necrosis factor-alpha (TNF-alpha), sFas and sFasL.
Methods: Enzyme linked immunoadsorbent assay (ELISA) was used in the determination of serum sFas, sFasL and TNF-alpha in 36 patients with MODS. Thirty-two non SIRS patients and 20 healthy individuals comprised the control groups. The acute physiology and chronic health evaluation III (APACHE III) scoring system and modified MODS scoring system were used to assess patients' clinical severity. The differences of sFas and sFasL levels between MODS group and control groups and between survival and dead patients were observed. The correlations between sFas, sFasL and TNF-alpha levels and severity of MODS and the correlations between the TNF-alpha levels and the levels of sFas and sFasL were also observed.
Results: The serum levels of sFas, sFasL and TNF-alpha in patients with MODS were significantly higher than those in controls (P<0.05 or P<0.01), and were associated with severity of the disease (all P<0.01) . The sFas and sFasL levels were found to be significantly higher in the patients who eventually died as compared to those in the patients who survived (both P<0.05). Positive correlations were noted between the TNF-alpha levels and the levels of sFas and sFasL(both P<0.01). The serum levels of sFas and sFasL were elevated with the increase of the number of failure organs in MODS patients.
Conclusion: The serum levels of sFas and sFasL may serve as diagnostic and prognostic indicators for MODS. TNF-alpha may help enhance the expression of Fas/FasL system.
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