Increased serum soluble Fas in patients with acute liver failure due to paracetamol overdose

Background/Aims: Experimental studies have suggested that apoptosis via the Fas/Fas Ligand signaling system may play an important role in the development of acute liver failure. The aim of the study was to investigate the soluble form of Fas in patients with acute liver failure. Methodology: Serum levels of sFas (soluble Fas) were measured by ELISA in 24 patients with acute liver failure and 10 normal control subjects. Serum levels of tumor necrosis factor-a and interferon-y were also determined by ELISA. Results: Serum sFas was significantly increased in patients with acute liver failure (median, 26.8 U/mL; range, 6.9-52.7 U/mL) compared to the normal controls (median, 8.6 U/mL; range, 6.5-12.0 U/mL, P<0.0001). Levels were significantly greater it patients with acute liver failure due to paracetamo overdose (median, 28.7 U/mL; range, 12.8-52.7 U/mL, n=17) than those due to non-A to E hepatitis (median, 12.5 U/mL; range, 6.9-46.0 U/mL, n=7 P<0.01). There was no relationship of sFas to even tual outcome in the patients. A significant correla tion was observed between serum sFas levels anc aspartate aminotransferase (r=0.613, P<0.01). Conclusions: The increased concentration of sFas in serum of patients with acute liver failure may reflect activation of Fas-mediated apoptosis in the liver and this together with increased tumor necrosis factor-a may be an important factor in liver cell loss.