The role of the CD95, CD38 and TGFbeta1 during active human cytomegalovirus infection in liver transplantation

AIM

Human cytomegalovirus (HCMV) has highly evolved mechanisms for avoiding detection by the host immune system. The aim of this study was to analyze the expression levels of TGFbeta1, soluble form of CD95, CD95 ligand (sCD95 and sCD95L, respectively) in plasma and CD95 expression on CD3(+) cells, CD38 expression on CD8(+) cells in liver transplanted recipients with active HCMV infection.

METHODS

Blood samples were collected from 15 liver transplanted recipients with active HCMV infection and 15 recipients without HCMV infection. CD95 expression on CD3(+) cells and CD38 expression on CD8(+) cells were quantitatively detected with two-color fluorescence activated cell sorter (FACS) analysis. Lymphocyte surface phenotypes of CD4 and CD8 were detected with FACS analysis. Plasma sCD95, sCD95L and TGFbeta1 levels were determined with enzyme linked-immuno-sorbent assay (ELISA). The results were compared with that from 15 healthy individuals.

RESULTS

CD95 expression on CD3(+) T-cells and CD38 expression on CD8(+) cells were significantly increased in active HCMV infection group compared with that in stable group or healthy group (P<0.01). No significant difference was seen between stable group and healthy group (P>0.05). The percentages of CD4(+) T-cell and CD4/CD8 ratio in active HCMV infection group were significantly lower than the values in stable group and healthy group (P<0.05). Plasma levels of TGFbeta1 and sCD95 were significantly increased in active HCMV infection group compared to stable group and healthy group (P<0.05). In contrast, plasma levels of sCD95L in healthy group were not significantly different from that expressed in active HCMV infection group and stable group (P>0.05).

CONCLUSION

HCMV suppress proliferation of activated T cells by apoptosis and by releasing immunosuppressive cytokine TGFbeta1. This may provide an important clue to a better understanding of the pathogenesis in liver transplanted recipients with active HCMV infection.

HBV and HCV infections and acute rejection differentially modulate CD95 and CD28 expression on peripheral blood lymphocytes after liver transplantation

Hepatitis B virus (HBV) and hepatitis C virus (HCV) generally reinfect liver graft early posttransplantation and lead to poorer graft and patient survivals. In the present study the influence of acute rejection (AR), HBV and HCV infections, and human leukocyte antigen (HLA) class-I compatibility on the expression of CD28 (in 237 liver recipients) and CD95 (in 114 liver recipients) on peripheral blood cells were evaluated by flow cytometry during the first month after transplantation. HBV/HCV infections induced strong CD95 upregulation on CD3+ lymphocytes. Maximal CD95 upmodulation was found in infected recipients showing partial HLA class-I compatibility. AR and virus reinfection could be distinguished because CD28 was upregulated on CD4+ lymphocytes only in recipients with AR, irrespective of their status regarding HBV/HCV infections. In conclusion, cytometric co-evaluation of CD95 and CD28 expression on peripheral blood lymphocytes could be useful to discriminate AR from cellular activation induced by viral reinfection of the liver graft.

Evaluation of sICAM-1, sVCAM-1, and sE-Selectin levels in patients with metastatic breast cancer receiving high-dose chemotherapy

Soluble forms of some cell adhesion molecules (CAM), sICAM-1, sVCAM-1, and sE-selectin, are elevated in the sera and plasma of patients with inflammation, arthritis, diabetes, and cancer. Increased levels of these soluble molecules in patients with cancer have been shown to correlate with disease progression and survival. This suggests that increased expression of the soluble forms of CAMs may play an important role in cancer cell growth and metastasis and may be prognostic and/or predictive of malignant disease. In this retrospective study, we assessed the clinical significance of sICAM-1, sVCAM-1, and sE-selectin in 95 patients with metastatic breast cancer enrolled in clinical trials of high-dose chemotherapy (HDC) and autologous stem cell transplantation (ASCT). The significance of soluble HER-2 (sHER-2) and sFAS status, determined in previous studies for this group of patients, was also included in this analysis. Univariate analysis showed that sICAM-1, sVCAM-1, sFas, sHER-2 positive status, and the presence of liver metastases were significant prognostic factors for both progression-free survival (PFS) and overall survival (OS) in the total patient group. In multivariable analysis, HER-2 and sFAS were shown to be independent prognostic factors for PFS and OS. Within the various treatment groups examined, sICAM-1 was a prognostic factor for clinical outcome for patients with metastatic breast cancer enrolled in trials with cyclophosphamide- and carboplatin-based or vinblastine-based HDC, but not in trials with paclitaxeland cyclophosphamide-based HDC.

Evaluation of the maternal and umbilical vein serum sFas/sFasL system in pregnancies complicated by preeclampsia with intrauterine growth retardation

OBJECTIVE

The aim of this study was to determine the maternal and umbilical vein soluble Fas and its ligand (sFasL) serum levels in pregnancies complicated by preeclampsia with intrauterine growth retardation (IUGR).

PATIENTS AND METHODS

The study was carried out on 11 preeclamptic delivering patients in the third trimester of pregnancy with severe preeclampsia complicated by intrauterine growth retardation. The control group consisted of 12 healthy normotensive delivering patients with singleton uncomplicated pregnancies, without any renal, heart and vascular diseases and with normal laboratory tests. Maternal and umbilical serum soluble Fas and FasL concentrations were estimated using a sandwich ELISA assay.

RESULTS AND CONCLUSIONS

Increased maternal and umbilical vein serum sFas and increased umbilical vein serum sFasL levels were found in the study group in comparison with the control group. In our study in both groups of patient higher maternal sFas values were observed in comparison with the umbilical cord blood. Further studies are necessary to evaluate the role of Fas/FasL pathway in pregnancies complicated by preeclampsia and intrauterine growth retardation.

Variations of soluble fas and cytokeratin 18-Asp 396 neo-epitope in different cancers during chemotherapy

Soluble Fas (sFas) and cytokeratin 18-Asp396 neoepitope (CK18-NE) were measured by ELISA in serial samples from 42 patients with different cancers under chemotherapy and were compared with pharmacokinetic results. Baseline sFas (median 6146 pg/ml, range 3123-16294 pg/ml) was higher in cancer patients than in normal subjects (median 4954 pglml, range 2595-10565 pg/ml, n =95) (p <0.01) and increased with the number of previous chemotherapy lines (p =0.008). During pharmacokinetics, the median sFas response differed significantly with tumour histology (p<0.001) and was correlated to 5-Fluorouracil (rho=0.366, p=0.015, n=45) or cisplatin (rho=0.509, p=0.025, n=21) concentrations but not to anthracyclines or oxazaphosphorine. By Kaplan-Meier analysis, patients with baseline sFas <6146 pg/ml had a longer survival probability (p=0.002). The median baseline CK18-NE did not differ from normal subjects, but its maximum increase differed according to histology (p=0.007) and to drug type (p=0.028). Patients with a maximum increase >67.5% (median) during chemotherapy had a better univariate overall survival (p=0.021). As measured by sFas concentration, chemotherapy induces an anti-apoptotic response of differing intensity according to tumour types and drugs, which has a prognostic value for survival. A CK18-NE elevation, indicative of chemotherapy-induced apoptosis, is linked to good prognosis.

Serum Fas and Bcl-2 in patients with epilepsy

OBJECTIVES

The present study aimed to investigate the levels of the biochemical markers of apoptosis (soluble Fas and Bcl-2) in the sera of children and adolescents with idiopathic epilepsy.

MATERIALS AND METHODS

The study included 30 children and adolescents (mean age 8.03 +/- 4.49 years) with idiopathic epilepsy, 16 of them were newly diagnosed, and 15 clinically healthy control subjects. Of the included patients, 22 had focal seizures and eight had generalized seizures. In addition to laboratory and radiological investigations needed for diagnosis and follow-up, soluble Fas (s.Fas) and Bcl-2 were assayed in sera of patients and controls by enzyme-linked immunosorbent assay technique.

RESULTS

Serum levels of s.Fas and Bcl-2 were significantly higher in the patients group than in the control group; however, their levels were comparable in patients with different seizure types. Levels of s.Fas correlated positively with seizure severity and negatively with the duration from the last attack. Bcl-2 levels were positively correlated to each of the duration of epilepsy, the severity of seizures and its frequency. There was a significant positive correlation between serum levels of s.Fas and that of Bcl-2 and both were significantly increased in patients with uncontrolled epilepsy.

CONCLUSION

The present data demonstrate that markers of apoptosis, both the proapoptotic Fas and the anti-apoptotic Bcl-2, were proportionately elevated in sera of patients with idiopathic epilepsy, and their levels were related to the seizure severity and frequency.

Modulation of the anti-inflammatory interleukin 10 and of proapoptotic IL-18 in patients with chronic hepatitis C treated with interferon alpha and ribavirin

The aim of this work was to analyse apoptosis rate, measured by the serum levels of proapoptotic interleukin (IL)-18 and of soluble Fas (sFas), as well as of anti-inflammatory IL-10, in patients with chronic hepatitis C, at baseline and after treatment with interferon alpha and ribavirin. Twenty-seven patients with biopsy-proven chronic hepatitis C were studied, at baseline and after treatment with interferon alpha (21 cases) or pegylated interferon (6 cases) plus ribavirin. A group of 15 healthy sex- and age-matched individuals was selected as control. Serum concentrations of sFas, IL-10 and IL-18 were determined by ELISA in sandwich. The relationship of these molecules to necro-inflammatory and fibrotic activity was evaluated. Evolution of the serum concentrations of these molecules was analysed after treatment. Significantly increased serum concentrations of sFas were detected in patients with chronic hepatitis, compared with controls. Levels of this molecule were significantly correlated with necroinflammatory activity. Likewise, concentrations of IL-10 were significantly increased in the group of patients, compared with controls. Treatment with interferon and ribavirin induced a significant decrease of IL-18 concentration independently of the viral response. In contrast, levels of sFas decreased only in those patients with sustained response to therapy. Finally, baseline levels of IL-10 were significantly increased in patients without response to treatment, compared with those with sustained response, but the concentration did not change with the treatment. Increased serum levels of IL-10 are a negative prognostic marker of response to hepatitis C treatment. A significant decrease of apoptotic rate, as determined by sFas, can be expected in patients with a response to therapy.

[Expression of soluble GM-CSF-Ralpha in patients with acute myeloid leukemia]

To evaluate soluble GM-CSF-Ralpha expression in patients with acute myeloid leukemia (AML) and its clinic significance, plasma concentration of solGM-Ralpha in de novo 66 patients with AML was detected by enzyme-linked immuno-sorbent assay, and the relationship between solGM-Ralpha levels and various clinical parameters was analyzed. The result showed that the levels of solGM-Ralpha in plasma of patients with AML were significantly higher than that in plasma of normal controls; the lowest level of solGM-Ralpha was found in plasma of patients with AML-M3 (3897.75 +/- 2651.43 pg/ml), the highest level of solGM-Ralpha was observed in plasma of patients with AML-M5 (9990.92 +/- 6325.43 pg/ml). Patients with high level of solGM-Ralpha were generally accompanied with a distinct clinical picture, including higher counts of white blood cell and myeloid precursors, as well as higher expression of CD34, CD95 and CD116 antigen. It is concluded that the high level of solGM-Ralpha in plasma of patients may suggest AML poor prognosis and play a role in pathogenesis of leukemia, the GM-CSF and its receptor solGM-Ralpha needs further study.

Serum-soluble Fas antigen level in patients with allergic rhinitis: its relation to specific immunotherapy

There have been conflicting reports on the relationship between Fas/Fas ligand-mediated apoptosis and allergic response. Specific immunotherapy (SIT) is widely used for treatment of allergic diseases. It has long been apparent that SIT results in a reduction in antigen-specific lymphoproliferation, but it is unclear by what mechanism T-cell responses are inhibited by SIT in vivo. In this study, we examined serum-soluble Fas (sFas) levels in patients with allergic rhinitis and healthy subjects. We also examined the effect of SIT on sFas level. Seventy-two patients with allergic rhinitis and 20 healthy subjects were included in this study. Twenty-eight patients were newly diagnosed and 44 patients were treated with SIT for a 5-year or 7-year duration. Serum sFas levels were measured by a sandwich enzyme-linked immunoassay. Mean serum sFas level was 7931 +/- 2861 pg/mL in newly diagnosed patients with allergic rhinitis during the pollen season, 8426 +/- 2846 pg/mL in patients with allergic rhinitis treated by SIT for a 5-year duration, 8490 +/- 2256 pg/mL in patients with allergic rhinitis treated by SIT for a 7-year duration, and 7493 +/- 3450 pg/mL in healthy subjects. Serum sFas level was not found to be significantly different among the study groups (p > 0.05). These findings suggest that there is no relation between sFas level and the etiopathogenesis of allergic inflammation in patients with allergic rhinitis and mechanism of action of SIT.

[Changes and clinical significance of serum soluble Apo-1/Fas in pancreatic cancer]

OBJECTIVE

To detect changes of serum soluble Apo-1/Fas (sApo-1/Fas) in pancreatic cancer patients and to investigate its clinical value in assessing the effect of chemotherapy.

METHODS

The serum level of sApo-1/Fas in 30 normal control subjects and 58 pancreatic cancer patients were detected using enzyme-linked immunosorbent assay (ELISA), and the sApo-1/Fas level of 48 pancreatic cancer patients, before and after chemotherapy was compared.

RESULTS

Compared with the level of the control group, the level of serum soluble Apo-1/Fas was significantly correlated with clinical stage but not with age, sex or pathologic type of pancreatic cancer. It was elevated gradually from stage II to IV (P < 0.01). However, it would obviously decrease in pancreatic cancer patients after chemotherapy (P < 0.01).

CONCLUSION

The serum soluble Apo-1/Fas may be involved in the development of pancreatic cancer, and it may be used as one parameter to assess the disease status and prognosis of pancreatic cancer patient.

Serum and follicular fluid levels of soluble Fas and soluble Fas ligand in IVF cycles

OBJECTIVE

To determine follicular fluid (FF) and serum levels of soluble Fas (sFas) and soluble Fas ligand (sFasL) in patients undergoing IVF cycles.

STUDY DESIGN

A prospective comparative study among patients with endometriosis (n=12), infertility due to male factor (n=12) and poor responders (n=32) undergoing IVF cycles in Centrum IVF Clinic. Individual FF and serum samples were collected from patients during transvaginal ultrasonography-guided follicle aspiration. Patients were classified as poor responder patients undergoing IVF cycles with GnRHa, triptorelin and GnRH antagonist, cetrotide, patients with endometriosis and patients with infertility due to male factor. sFas, sFasL levels in both FF and serum samples and their correlations with clinical outcomes of IVF were measured in each study group.

RESULTS

Serum and FF levels of sFas, sFasL were similar in the poor responder and male factor groups. There were no differences between the serum and FF levels of both sFas and sFasL among poor responder patients receiving either GnRH agonist or antagonist therapies. Serum levels of sFas were significantly lower in the endometriosis group compared to the male factor group. Serum and FF levels of sFas, sFasL were similar among patients with or without clinical pregnancy.

CONCLUSION

sFas and sFasL are detected in both serum and follicular fluid samples from IVF cycles, their levels are similar between poor responder and male factor groups as well as between GnRH agonist and antagonist treatment groups. These soluble apoptotic factors may not be predictive for the outcomes of IVF. Decreased serum levels of sFas, suggests increased apoptosis in endometriosis.

[Levels and clinic significance of serum soluble Fas and soluble Fas ligand in coal workers' pneumoconiosis]

OBJECTIVE

To investigate the changes of levels and clinic significance of serum soluble Fas (sFas) and soluble FasL (sFasL) in coal workers' pneumonoconiosis.

METHODS

Serum levels of sFas and sFasL were determined in 52 patients with silicosis, 57 coal workers' pneumonoconiosis, 46 healthy underground coal workers' (the underground control group) and 40 healthy volunteers working on the ground (the ground control group) with a sandwich ELISA.

RESULTS

Compared to the underground control and the ground control group, the serum levels of sFas and sFasL in the patients with silicosis and the coal workers' pneumonoconiosis were significantly higher (P < 0.01). Serum levels of sFas and sFasL in the underground control group were significantly higher than those in the ground control group (P < 0.01); Serum sFas levels in coal workers' pneumonoconiosis was significantly higher than those in the patients with silicosis (P < 0.01). Although the serum sFasL levels was also increased, there was no significant difference (P > 0.05). In the patients with silicosis and the coal workers' pneumonoconiosis patients, the serum sFas levels in Phase I patients combined with emphysema and simple Phase II + III patients were significantly higher than those in simple Phase I patients (P < 0.01). There was no significant difference in the serum sFasL levels among various groups with different parameters of pneumonoconiosis. In the patients with silicosis and the coal workers' pneumonoconiosis, serum levels of sFas and sFasL were not significantly altered among different duration of exposure to dusts. There was no correlation between serum levels of sFas and sFasL in the patients with silicosis while there was a slightly positive correlation between sFas and sFasL levels in the coal workers' pneumonoconiosis (r = 0.479, P < 0.05).

CONCLUSION

In the patients with silicosis and the coal workers' pneumonoconiosis, the serum levels of sFas and sFasL are abnormal and associated with the development of the pneumonoconiosis. The changes of serum sFas levels may indicate the development and progression of the pneumonoconiosis. The detection of the serum sFas level may be used in the differential diagnosis for the silicosis and the coal worker's pneumonoconiosis.

Soluble Fas receptor and soluble Fas ligand in the serum of women with uterine tumors

It is commonly accepted that apoptosis plays an important role in the death of normal and neoplastic cells. Related proteins and their receptors on cell surfaces regulate apoptosis. One of the best-characterized systems is the Fas-Fas ligand system. The aim of the study was to examine the concentrations of soluble Fas receptor (sFas) and the soluble ligand for the Fas receptor (sFasL) in serum of women with uterine tumors. The study included 42 women with uterine tumors. As a normal control, sera were obtained from 20 healthy female volunteers. The concentrations of sFas and sFasL in serum were measured by enzyme-linked immunosorbent assay ELISA. Significant increases of the mean value of sFas and sFasL were found in the serum of women with uterine tumor compared to the control group (p < 0.0001). The mean levels of these parameters increased in consecutive stages of the clinical extent of the uterine cancer (I-III). The lowest concentration was observed in women with stage I and the highest in women with stage III of clinical extent according to FIGO. Apoptosis that appears to occur in the cancerous cells of malignant uterine tumors is associated with high levels of sFas and sFasL in serum.

Levels of HBV-DNA, sFas and sFasL among healthy HBsAg carriers in period of three years

PURPOSE

The object of the study was the usefulness of sFas and sFasL concentration in the prognosis of disease development in healthy HBsAg carriers.

PATIENTS

34 healthy HBsAg carriers were examined over a three-years period.

MATERIAL AND METHODS

HBV-DNA was extracted using the Gene Elute Mammalian Genomic DNA Miniprep Kit (Sigma, USA). HBV-DNA concentration and YMDD mutations were measured by RT-PCR based on TaqMan Universal Master Mix (Applied Biosystems, USA). HBeAg and anti-HBe in serum were detected by MEIA method (ABBOTT, Germany). The concentration of sFas and sFasL in serum was estimated by ELISA method (Bender MedSystems, Austria).

RESULTS

Within three year observation period the number of carriers with absent HBV-DNA increased from 19% to 33%. HBV-DNA above 105 copies/ml, which was detected in 63% of carriers, decreased to 11% (p < 0.05). After 3 years, a reduction of HBV-DNA levels was observed in 89% of carriers (p < 0.05). The occurrence of sFasL decreased from 56% to 48%. sFasL correlated with HBV-DNA (p < 0.05). The concentration of sFas decreased (p < 0.01). Chronic hepatitis B developed in 11% of men carriers, and 11% eliminated HBeAg, anti-HBe and HBV-DNA. YMDD mutant was not detected in any of the HBsAg carriers.

CONCLUSIONS

High concentration of sFasL in serum may suggest the development of chronic hepatitis and it seems that sFasL detection is never a good prognostic factor.

[Apoptosis of immunocompetent cells in patients with depressive disorders]

A comprehensive evaluation of biological indices has been carried out in 26 patients with depressive disorders and in 20 age- and sex-matched controls. Indices of programmed cell death (apoptosis) in subpopulations of blood lymphocytes and concentration of cortisone in blood serum were determined. Significantly enhanced apoptosis was observed in the lymphocytes of depressive patients as shown by increased percentage of lymphocytes expressing FAS-receptor and cells with morphological changes characteristic of apoptosis (nuclear condensation, vacuolation. Clinical symptoms of depression were concomitant with alterations of cellular link of immunity expressing in the decrease of the total T-lymphocytes (CD3+) number, T-helpers (CD4+) and natural killers (CD16+) as compared to healthy persons. The level of blood serum cortisone was increased in patients with depression. High cortisone values correlated with suppression of cellular CD4+ population and an increase of FAS-receptors expression in patients with depression.

Soluble Fas, Fas ligand and Bcl-2 in autoimmune thyroid diseases: relation to humoral immune response markers

PURPOSE

To compare soluble Fas, FasL and Bcl-2 in Graves' disease (GD) and Hashimoto's thyroiditis (HT) to the markers of humoral response: aTPO, aTG and aTSHR.

MATERIAL AND METHODS

5 groups of subjects: 1) 14 patients with GD in euthyreosis on methimazol (euGD); 2) 20 patients with hyperthyroid GD (hrGD); 3) 15 patients with HT in euthyreosis on levothyroxine (euHT); 4) 16 patients with hypothyroid HT (hoHT); 5) 12 healthy volunteers age and sex-matched to group 1-4. Serum concentrations of Fas, FasL, Bcl-2, aTPO and aTG were determined by ELISA and aTSHR by RIA.

RESULTS

Levels of sFas were the highest in hoHT: 8.7 (7.2-9.8) ng/ml as compared to the controls (p < 0.01) and euHT (p < 0.05). We found positive correlations between sFas and aTPO in all studied groups (r = 0.25, p < 0.05) and between sFas and TSH in HT (r = 0.4, p < 0.05). In GD there was a positive correlation between sFasL and aTG (r = 0.5, p < 0.01) and negative correlations between sFasL and Fas (r = -0.39, p < 0.01) and between sFasL and period of methimazol administration (r = -0.32, p < 0.05). Levels of sBcl-2 were significantly increased in euHT: 31.0 (13.5-44.1) ng/ml as compared to the controls (p < 0.05) and euGD (p < 0.05).

CONCLUSIONS

Fas/FasL mediated apoptosis plays an important role in the active stage of the autoimmune process of both Hashimoto's thyroiditis and Graves' disease, however, in Hashimoto's thyroiditis they contribute to irreversible damage of thyreocytes. Early detection of Hashimoto's and Graves' diseases allows for the initiation of the proper treatment that probably leads to the reduction of the autoimmune process intensity.

Apoptosis-specific activation markers in on- versus off-pump coronary artery bypass graft (CABG) patients

BACKGROUND

The relation of epithelial/endothelial apoptosis and secretion of death-inducing receptors (DIR) in comparison to vascular adhesion molecules is not known in patients undergoing the On- versus Off-pump coronary artery bypass graft (CABG) procedure.

METHODS

30 patients were prospectively included in the study (On- vs. Off-pump CABG, each n = 15). Serum samples were obtained prior to, and 30 minutes, 60 minutes and 24 hours after CABG operation. ELISA was utilized to detect caspase-cleaved cytokeratin-18 (CK18) by means of M30 antibody, soluble VCAM-1, soluble ICAM-1, and soluble DIR TNFR-1 and CD95.

RESULTS

Soluble caspase-cleaved CK18 was increased and leveled to initial values at 24 hrs. sICAM-1 showed a significant decrease at 30 minutes and 60 minutes in comparison to preoperative values. sTNFR-1/sCD95 showed a rise that was not significant to preoperative values.

CONCLUSION

These results indicate for the first time that epithelial/endothelial apoptosis is occurring in patients undergoing bypass operation, irrespective of the CABG procedure selected.

Apoptotic markers on lymphocytes and monocytes are unchanged during single hemodialysis sessions using either regenerated cellulose or polysulfone membranes

BACKGROUND

There is an increased rate of apoptosis of peripheral blood mononuclear cells (PBMCs) in patients undergoing hemodialysis (HD), but little is known about how different dialysis membranes may contribute to the process. We, therefore, studied the influence of two different dialysis membranes on apoptotic markers during HD.

METHODS

8 healthy controls and 8 patients on regular HD 3 times per week were enrolled in this cross-controlled study. Patients received HD using polysulfone and then regenerated cellulose dialysis membranes for one week each, sequentially. Serum was collected for C-reactive protein (CRP) detection; flow cytometry with dual antibody staining was used to measure the apoptotic markers Fas (CD95), FasL (CD 178) and TNF-R2 (CD120b) in T cells (CD3+), B cells (CD19+), and monocytes (CD14+) at 0, 15, 120 and 240 min after starting HD. We also measured total leukocyte numbers and differential white cell counts.

RESULTS

Hemodialysis patients revealed lymphocytopenia, monocytopenia, higher CRP levels and higher Fas and TNF-R2 expression on lymphocytes and monocytes at baseline when compared with normal controls. Leukocyte numbers, including neutrophils, lymphocytes and monocytes, dropped significantly after 15 min of dialysis. There were no significant differences in Fas levels during hemodialysis on T and B lymphocytes or on monocytes. T lymphocyte FasL (CD 178) levels remained unchanged throughout the process. There was a significantly lower overall level of CD120b at 15 min of HD, whereas this marker was higher on monocytes after dialysis. There were no significant differences in the levels of apoptotic markers between the two membranes.

CONCLUSION

Our results suggest that uremia itself contributes to PBMC apoptosis. The two different dialysis membranes used in this study did not influence apoptotic markers on PBMCs significantly, but increased TNF-R2 expression on monocytes during a single dialysis session.

Characterization of soluble FAS, FAS ligand and tumour necrosis factor-alpha in patients with chronic HCV infection

BACKGROUND

There are limited reports on the role of the cell surface receptor Fas and its ligand molecule in mediating apoptosis during infection with the hepatitis C virus (HCV).

OBJECTIVES

The aims of this study were (1) to assess the susceptibility of the Fas antigen expressed on peripheral blood mononuclear cells to Fas ligand-induced-death in patients with chronic HCV infection and (2) to investigate the correlation between the plasma levels of soluble Fas (sFas), soluble Fas ligand (sFasL), tumour necrosis factor-alpha (TNF-alpha), alanine amino transferase (ALT), and HCV viral load.

STUDY DESIGN

The susceptibility of peripheral blood mononuclear cells from 17 subjects with chronic HCV infection to Fas ligand induced cell death was assessed using a water soluble tetrazolium assay. The plasma levels of associated markers such as sFas, sFasL, and TNF-alpha were quantified using immunoassays. ALT values were obtained from hospital records. Viral loads were quantified using a commercially available quantitative assay--the Amplicor Monitor (version 2.0). Controls for comparison included a group of healthy individuals and individuals infected with the human immunodeficiency virus 1.

RESULTS

The percentage of cell death induced in hepatitis C virus infected individuals was lower than that seen in the healthy control group. Patients infected with HCV had higher average values of sFas and TNF-alpha as compared to both control groups. Plasma levels of sFas in patients with chronic HCV infection showed significant positive correlations to ALT and TNF-alpha levels. TNF-alpha levels also showed a significant positive correlation with ALT levels.

CONCLUSIONS

PBMC in HCV infection exhibit decreased susceptibility to Fas ligand induced cell death. This may signify a means by which HCV escapes immune surveillance. This phenomenon merits further investigation. The strong correlations observed between plasma sFas, ALT and TNF-alpha suggest a potential role for these markers as an alternative to an invasive liver biopsy.

[The inhibition pathway of the EBV-immortalized cells in children with infectious mononucleosis]

OBJECTIVE

To explore the inhibition pathway of the EBV-immortalized cells (CD23(+)) in children with infectious mononucleosis (IM) caused by Epstein-Barr virus.

METHODS

The expressions of CD23, CD19, CD95, Bcl-2 and the co-expressions of CD23CD95, CD19CD23 on peripheral blood mononuclear cell (PBMC) were analyzed by flow cytometry (FCM) during acute phase, early convalescent phase and convalescent phase of 34 EBV-IM children and compared with that of 24 healthy donors.

RESULTS

(1) The levels of CD23(+) and CD23(+)CD19(+) cells decreased and CD95(+), CD95(+)CD23(+), Bcl-2(+) cells increased markedly in IM patients in acute phase [CD95(+) cells (19.43 +/- 8.46)%; CD95(+)CD23(+) cells (1.81 +/- 1.71)%; Bcl-2(+) cells (23.41 +/- 26.47)%] and early convalescent phase [CD95(+) cells (12.94 +/- 5.05)%; CD95(+)CD23(+) (1.05 +/- 1.20)%; Bcl-2(+) cells (10.54 +/- 9.68)%], as compared with those of healthy controls [CD95(+) cells (10.39 +/- 2.90)%; CD95(+)CD23(+) cells (0.50 +/- 0.46)%; Bcl-2(+) cells (7.25 +/- 2.88)%]. The earlier the course of IM, the more abnormal the expressive levels. All the abnormal results returned to normal in convalescent phase. (2) Positive relationships were observed between the expressions of CD95(+)CD23(+) cells and that of CD23(+) cells, CD23(+)CD19(+) cells during acute and early convalescent phase, the expressions of Bcl-2(+), CD3(+) cells and CD23(+), CD23(+)CD19(+) cells during acute phase, the expressions of CD95(+)CD23(+) cells and Bcl-2(+) cells during acute phase, and the expressions of CD95(+)CD23(+) cells and CD95(+) cells during convalescent phase.

CONCLUSION

The results indicate that CD95L-CD95 mediated apoptosis plays an important role in eliminating EBV-immortalized cells, which is counteracted partly by Bcl-2.

Elevated levels of serum soluble Fas are associated with organ and tissue damage in systemic lupus erythematosus among Chinese

The aims of the present study are to evaluate the difference of the levels of soluble Fas (sFas) antigen between patients with systemic lupus erythematosus (SLE) and healthy controls and to explore whether sFas has a role in either the disease activity or the organ damage in SLE. Serum levels of sFas were measured in 40 Chinese patients with SLE and 15 age-, gender-, and race-matched healthy controls using double antibody ELISA. SLEDAI scores for disease activity were determined. Data of organ and tissue damage was obtained from clinical records. Serum sFas levels were significantly increased in both more active (mean=8043.8 pg/ml, P<0.001) and less active SLE patients (mean=4820.2 pg/ml, P<0.001) comparing to the healthy controls (mean=3253.4 pg/ml). There was also a significant difference in serum sFas levels between the more active SLE patients and less active SLE patients (P=0.04). But, the levels of sFas didn't correlate with SLEDAI. There was a significant difference in the serum sFas levels between patients with and without CNS disease (mean=9582.6, 6634.5 pg/ml; P=0.007). The same was true when patients with and without renal disease (mean=10972.7, 6520.1 pg/ml; P=0.019), as well as serositis (mean=10385.3, 6709.1 pg/ml; P=0.005) were analyzed. sFas is elevated in sera of SLE patients, especially in patients with active SLE. The elevated levels of sFas in the sera of patients with SLE may be closely associated with damage to the kidneys, central nervous system and serosa. Serum sFas may serve as a predictor of some organ and tissue damage in SLE.

[Expression of Fas and FasL in serum and placenta of preeclamptic pregnancy and its significance]

OBJECTIVE

To observe the serum and placental levels of FAS and FASL in preeclampsia (PE) and to study its relationship with the disease.

METHODS

Forty women with preeclampsia and 39 healthy pregnant women were recruited and samples of serum and placentas were collected. The expression of Fas and FasL in placentas was detected with Western blot and the concentration of soluble Fas and FasL in serum was detected with ELISA method.

RESULT

Serum levels of soluble Fas in PE group were significantly higher than those of healthy pregnant women (2.11+/-0.95 mg/L compared with 1.57+/-0.60 mg/L, P<0.05), and serum levels of soluble FasL in PE group were also significantly higher than those in controls (4.43+/-1.90 g/L compared with 3.48+/-1.53 g/L, P<0.01). There were no significant differences in Fas and FasL levels in placentas between PE group and healthy pregnant women (P>0.05 for both).

CONCLUSION

The elevated serum Fas and FasL levels are closely associated with preeclampsia, which may play an important role in the pathogenesis of the disease.

[Effect of interferon alpha on liver fibrosis in patients with chronic hepatitis B]

OBJECTIVE

To observe the histological changes in the fibrotic and inflammatory tissues in response to interferon alpha treatment in patients with chronic viral hepatitis B.

METHODS

Sixteen patients with chronic viral hepatitis B in S3-S4 stages established by pathological examination were treated with interferon alpha for 6-9 months, and the degree of liver fibrosis and inflammation were examined 3 times during the treatment. The expression of Fas, transforming growth factor beta1 (TGFbeta1) and HBcAg in the liver tissues were detected by immunohistochemistry, and DNA fragmentation was examined by TUNEL assay. The levels of the serum markers for liver fibrosis and liver function were also measured.

RESULTS

Patients with liver fibrosis in S3-S4 stages had high pathological expression of Fas and TGFbeta1 with severe DNA damage in the liver tissues. After 3 months of interferon therapy, the expression of Fas and TGFbeta1 were lowered (P<0.05), and further treatment till 3-9 months resulted in gradual decrease in the degree of hepatic fibrosis and cell apoptosis (P<0.05), with improved serum liver fibrosis indices and liver function.

CONCLUSION

Interferon alpha may alleviate liver fibrosis and suppress cell apoptosis in patients in S3-S4 stages after a 6- to 9-month continuous treatment.