Detection Of The Soluble Form Of The Fas Molecule In Patients With Herpes Simplex Encephalitis

ObjectiveTo assess the role of Fas/FasL in the mechanism of HSE through the level of sFAS in cerebral spinal fluid samples from patients with HSE and debate the relationship between the level of sFAS with the severity and sustained brain damage.MethodsCSF samples from 59 patients with enphathitis and 10 healthy individuals, that were divided to three groups:HSE group, non-HSE group and healthy control group, were enrolled for quantitative measurement of soluble FAS (sFAS) by ELISA.Results1. High level of sFAS were expressed in CSF samples collected between days 0-45 after neurological onset in 81.4%(44/54) HSE patients, whereas only 10/30(33%) of non-HSE patients and none of 10 healthy controls demonstrated measurable levels of sFAS. Also HSE patients had significantly higher levels of changes of CSF sFAS compared to non-HSE patients(P<0.05).2. The HSE patients with CSF samples collected at day 0-7 after onset of neurological symptoms were classified to the state of consciousness at admission by the use of the Glasgow coma level scale, and as to the outcome at 12 months by the use of the Glasgow prognosis score, We did not observe any significant differences in the CSF sFAS levels during the first 7 days of neurological symptoms.3. We observes that HSE patients with severe neurological sequels revealed an increase in changes of CSF sFAS as compared to patients with mild or moderate neurological outcome (57.6±55.6pg/ml,n=8 versus 26.3±97.5pg/ml,n=13;p=0.008). Patients with coma or half-coma status had higher logic indexes than those with somnolence, but no statistical differences(39.3±53.4 pg/ml, n=9 versus 39.3±115.5 pg/ml, n=12;P=0.291).Conclusions1. The apoptosis through the Fas/Fas ligand pathway play an important role in the process of HSE.2. The dynamics of sFas level state throughout the course of the disease could be an index of the diagnosis and prognosis of patients with HSE.