[Soluble Fas in acute rejection in patients with liver transplantation. Response to treatment].
It has been suggested that in the cellular rejection of hepatic graft, the lesion provoked by cytotoxic T-lymphocytes might be mediated by the Fas antigen/Fas ligand system, producing cell death by apoptosis.


OBJECTIVE
To determine whether soluble Fas (sFas) is increased during treatment and to evaluate response to treatment.


METHODS
Fourteen patients with orthotopic liver transplantation who presented an episode of acute cellular rejection were studied. Serum levels of sFas were detected by enzyme-immunoanalysis at diagnosis and again 5 days after treatment was completed. As control groups, sFas was analyzed in 12 patients with liver transplantation without rejection and in 10 healthy subjects.


RESULTS
sFas levels were found to be significantly higher in patients with rejection than in those without rejection and in healthy subjects (24.2 +/- 39.1 vs. 2.8 +/- 4.0 vs. 0.6 +/- 1.5 UI/ml; p = 0.03). In patients with acute cellular rejection, immunosuppressive treatment significantly decreased sFas levels compared with basal values (24.2 +/- 39.1 vs. 9.9 +/- 30.2 UI/ml; p = 0.005). A clear correlation between the serum levels of sFas, glutamate oxaloacetate transaminase (GOT), glutamate-pyruvate transaminase/glutamic-pyruvic transaminase (GPT) and gamma-glutamyl transferase (GGT).


CONCLUSIONS
a) The increase of sFas during rejection and the decrease in patients with a good evolution suggests that the Fas system may play an important role in the hepatocyte lesion produced by an apoptosis mechanism in these patients. b) Monitoring sFas could be useful in diagnosing rejection and in evaluating response to treatment.
Rivero
M
M
Servicio Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander.
Crespo
J
J
Mayorga
M
M
Fábrega
E
E
de las Heras
B
B
Almohalla
C
C
Pons-Romero
F
F
D000208:Acute Disease; D000328:Adult; D005260:Female; D006084:Graft Rejection / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D019014:fas Receptor / Q000097:blood*
D007166:Immunosuppressive Agents; D019014:fas Receptor