title: Increased serum soluble Fas in patients with acute liver failure due to paracetamol overdose.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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-alpha and interferon-gamma 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 in patients with acute liver failure due to paracetamol 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 eventual outcome in the patients. A significant correlation was observed between serum sFas levels and 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-alpha may be an important factor in liver cell loss.
authors.affiliation: First Department of Internal Medicine, Gifu University School of Medicine, 40 Tsukasa-machi, Gifu, 500-8705, Japan. atagami@cc.gifu-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tagami
authors.forename: Hiroo
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Robin D
authors.initials: RD
authors.lastname: Hughes
mesh_terms: D000082:Acetaminophen / Q000506:poisoning*; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000506:poisoning*; D062787:Drug Overdose / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D017093:Liver Failure / Q000097:blood / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D019014:fas Receptor / Q000097:blood*
chemical_list: D018712:Analgesics, Non-Narcotic; D014409:Tumor Necrosis Factor-alpha; D019014:fas Receptor; D000082:Acetaminophen; D007371:Interferon-gamma