title: Increased soluble FAS suggests delayed apoptosis in familial Mediterranean fever complicated with amyloidosis.
abstract: OBJECTIVE
  Interactions of the FAS with FAS ligand have been proposed as a major regulatory mechanism of immune homeostasis. Soluble FAS (sFAS) acts as a competitive antagonist to FAS, thereby inhibiting FAS mediated apoptosis. sFAS concentrations have been studied in various autoimmune diseases, with controversial results. In this cross sectional study, we investigated the role of sFAS protein in attack-free patients with familial Mediterranean fever (FMF) with and without amyloidosis.
  
  
  METHODS
  Twelve FMF patients without amyloidosis (male/female: 7/5; median age 23.5 yrs, range 17-38), 10 FMF patients with amyloidosis (male/female: 5/5; median age 41.5 yrs, range 33-51), and 14 controls (male/female: 6/8; median age 46 yrs, range 38-57) were enrolled in the study. Serum sFAS concentrations were studied by ELISA.
  
  
  RESULTS
  Median serum sFAS concentrations were 4630 (2580-12,270), 1338 (453-3240), and 3430 (2110-5960) pg/ml in FMF patients without amyloidosis, FMF patients with amyloidosis, and controls, respectively. Intergroup differences were all statistically significant (p < 0.05).
  
  
  CONCLUSIONS
  Elevated serum sFAS concentrations in attack-free FMF patients might be due to dysregulated apoptosis of polymorphonuclear leukocytes together with the ongoing subclinical inflammatory activity. On the other hand, decreased sFAS concentrations could contribute to the augmented apoptosis together with the alterations in immune response leading to the amyloidosis.
authors.affiliation: Department of Rheumatology, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Sedat
authors.initials: S
authors.lastname: Kiraz
authors.forename: Ihsan
authors.initials: I
authors.lastname: Ertenli
authors.forename: M Akif
authors.initials: MA
authors.lastname: Oztürk
authors.forename: Ibrahim C
authors.initials: IC
authors.lastname: Haznedaroglu
authors.forename: Meral
authors.initials: M
authors.lastname: Calgüneri
authors.forename: Enver
authors.initials: E
authors.lastname: Atalar
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Ozbalkan
authors.forename: Serafettin
authors.initials: S
authors.lastname: Kirazli
authors.forename: Ismail
authors.initials: I
authors.lastname: Celik
mesh_terms: D000293:Adolescent; D000328:Adult; D000686:Amyloidosis / Q000097:blood* / Q000150:complications*; D017209:Apoptosis; D003430:Cross-Sectional Studies; D010505:Familial Mediterranean Fever / Q000097:blood* / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012995:Solubility; D019014:fas Receptor / Q000097:blood*
chemical_list: D019014:fas Receptor