title: Evaluation of serum perforin, caspase-3, sFasL and M-30 levels as apoptotic markers in children with Crimean-Congo hemorrhagic fever.
abstract: BACKGROUND
  Apoptosis is a main regulator in responses of cellular immunity throughout systemic viral infections. Perforin, soluble Fas ligand, caspase-3 and caspase-cleaved cytokeratin-18 (M-30) are mediators of apoptosis. The aim of this study is the evaluation of Crimean-Congo hemorrhagic fever (CCHF) disease changes in the levels of these apoptotic markers and the relation of these changes with disease severity.
  
  
  METHODS
  Forty-nine hospitalized children with CCHF and 36 healthy controls were enrolled in this prospective study. The CCHF patients were classified into 2 groups based on disease severity (severe group and nonsevere group). Demographic characteristics and clinical and laboratory findings of all patients were recorded on admission.
  
  
  RESULTS
  Serum perforin, caspase-3 and soluble Fas ligand levels were found to be significantly higher both in the severe and nonsevere CCHF groups than the healthy control group (P < 0.05), but there was no significant difference in these apoptotic markers between severe and nonsevere CCHF groups (P > 0.05). In addition, serum M-30 levels did not differ significantly among all groups (P > 0.05). There was a positive correlation between serum values for perforin, caspase-3 and M-30 and the disease's severity criteria such as aspartate aminotransferase and/or alanine aminotransferase. The serum levels of all these markers were negatively correlated with disease severity criteria such as the platelet count.
  
  
  CONCLUSIONS
  In this study, we concluded that the interactions of cytolytic granules containing perforin and caspase cascade and Fas-FasL may play an important role in the pathogenesis of CCHF in children.
authors.affiliation: From the *Department of Pediatrics; †Department of Biochemistry; ‡Department of Microbiology; §Department of Cardiology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey; and ¶Department of Pharmaceutical Microbiology, Cumhuriyet University Faculty of Pharmacy, Sivas, Turkey.
authors.forename: Ahmet S
authors.initials: AS
authors.lastname: Güven
authors.forename: Enver
authors.initials: E
authors.lastname: Sancakdar
authors.forename: Elif B
authors.initials: EB
authors.lastname: Uysal
authors.forename: Ali
authors.initials: A
authors.lastname: Kaya
authors.forename: Mehmet B
authors.initials: MB
authors.lastname: Oflaz
authors.forename: Hekim
authors.initials: H
authors.lastname: Karapınar
authors.forename: Fatih
authors.initials: F
authors.lastname: Bolat
authors.forename: Nevin
authors.initials: N
authors.lastname: Tuzcu
authors.forename: Köksal
authors.initials: K
authors.lastname: Deveci
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Cevit
authors.forename: Füsun D
authors.initials: FD
authors.lastname: İcagasioglu
mesh_terms: D017209:Apoptosis; D015415:Biomarkers / Q000097:blood; D053148:Caspase 3 / Q000097:blood*; D002648:Child; D053222:Fas Ligand Protein / Q000097:blood*; D006479:Hemorrhagic Fever, Crimean / Q000276:immunology* / Q000473:pathology*; D006801:Humans; D053538:Keratin-18 / Q000097:blood*; D054353:Perforin / Q000097:blood*; D044967:Serum / Q000737:chemistry; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; C505661:FASLG protein, human; D053222:Fas Ligand Protein; D053538:Keratin-18; D054353:Perforin; D053148:Caspase 3