Apoptosis markers soluble Fas (sFas), Fas Ligand (FasL) and sFas/FasL ratio in patients with bacteremia: A prospective cohort study

作者：Huttunen Reetta^*; Syrjanen Jaana; Vuento Risto; Laine Janne; Hurme Mikko; Aittoniemi Janne

来源：Journal of Infection, 2012, 64(3): 276-281.

DOI：10.1016/j.jinf.2011.12.006

• Bacteremia
• Soluble Fas
• Fas ligand
• sFas/FasL
• Sepsis
• Case fatality
• Disease severity
• Outcome
• Bacteremia
• Apoptosis

Background: Recent studies have shown that immunoparalysis and lymphocyte apoptosis play a critical role in severe bacteremia. Monitoring apoptosis on a routine basis in septic patients has proved challenging. We here studied the prognostic value of apoptosis markers human soluble Fas (sFas), Fas ligand (FasL) and sFas/FasL ratio in patients with bacteremia. %26lt;br%26gt;Methods: sFas (ng/ml) and FasL (ng/ml) concentrations in plasma were determined using commercial quantitative enzyme immunoassays (Quantikine (R), R%26D Systems Inc., Minneapolis, MN, USA) in 132 patients with bacteremia caused by Staphylococcus aureus, Streptococcus pneumoniae, beta-hemolytic streptococcae or Escherichia coli. %26lt;br%26gt;Results: Maximum sFas, minimum FasL and high sFas/FasL ratio predicted high SOFA score in bacteremic patients (p %26lt; 0.001, p = 0.003 and p %26lt; 0.001, respectively). AUC(ROC)%26apos;s in the prediction of high SOFA score for sFas, FasL and sFas/FasL ratio were 0.70 (CI 0.61-0.79), 0.65 (CI 0.56-0.75) and 0.72 (CI 0.63-0.80), respectively. High sFas concentrations and sFas/aFasL ratio, assessed using ROC curve as regards high SOFA (%26gt;= 4) score, were associated with hypotension (p = 0.001 and p = 0.039, respectively). All of these markers predicted a high SOFA score independently in a logistic regression model. Maximum sFas, sFas/FasL ratio or minimum FasL during days 1-4 after blood culture were not associated with increased case fatality. %26lt;br%26gt;Conclusions: Apoptosis markers sFas, FasL or sFas/FasL ratio are associated with high SOFA score in bacteremia.

• 出版日期2012-3