The Change And Its Significance Of Plasma Levels Of SFas And SFasL In Patients With Congestive Heart Failure

OBJECTIVES:The study sought to evaluate plasma levels in patients with congestive heart failure (CHF) of soluble Fas / APO-1 receptor (sFas),an inhibitor of apoptosis,and soluble Fas ligand (sFasL),an inducer of apoptosis,and their relation to each other,which may be significant in the development of heart failure.METHODS:The study included 67 patients (mean age 66 years,range 30 to 90)with New York Heart Association(NYHA) classified II - IV chronic CHF(coronary artery disease in 24,dilated cardiomyopathy in 3,valvular heart disease in 25,hypertensive heart disease in 15 and 20 age- and gender-matched normal control subjects. Plasma levels of sFas,sFasL,TNF-a and IL-6 were measured by enzyme-linked immunosorbent assays using monoclonal anti-human antibodies.RESULTS:There were significant differences in sFas interleukin-6(IL-6) and tumor necrosis factor alpha(TNF- a ) levels between normal subjects and patients in functional classes II toIV(p<0.01);Independent of the underlying diseases,plasma levels of sFas and TNF- a increased with severity of functional classification and had significant correlation with heart functional classification(p<0.01). Increase of sFasL only found inplasma of serious CHF patients(p<0.01). Levels of TNF-a and IL-6 in plasma of all CHF patients,between which obvious correlation were found(p<0.01),also,had an explicit correlation with that of sFas(p<0.05 and 0.01). Such relation was not found in sFasL.CONCLUSIONS:Compared with controls,we found elevated levels of plasma sFas and sFasL increased clearly,in patients with serious CHF which suggests the increase of sFas and sFasL levels in human CHF ,even whole Fas/APO system may play an important role in the pathophysiologic mechanism of CHF.The relation of sFas TNF- a and IL-6 show that they play a similar role in the development of CHF. The two pairs of factors of inducing apoptosis ,sFas-sFasL and mFas-mFasL,can interact each other and build up a complicated immunal network.Once the balance is broken,CHF will be triggered.