Measurement of soluble fas antigen and ligand in circulating serum and intra-abdominal or cerebrospinal fluid during gastrointestinal or cerebrovascular surgery

Purpose: Soluble Fas antigen (sFas) and ligand (sFasL), which are associate d with apoptosis, have not been evaluated in gastrointestinal or cerebrovas cular surgery. The aim of this study was to measure these substances in ser um, intra-abdominal fluid, or cerebrospinal fluid, and to speculate a patho physiologic role for Fas-FasL apoptosis in surgery. Materials and Methods: Arterial blood and intraabdominal or cerebrospinal f luid were collected at intervals from 27 gastrointestinal surgical patients , 10 cerebrovascular surgical patients, and 10 spinal anesthesia patients. Results: Serum sFas levels did not change during and after surgery Intra-ab dominal and cerebrospinal sFas levels were identical to and lower than thos e in serum. Serum sFasL levels did not change during surgery, but decreased after surgery. Intra-abdominal and cerebrospinal sFasL levels were higher than and identical to those in serum. In spinal anesthesia, cerebrospinal s Fas and sFasL levels were lower than those in serum. Conclusions: Serum sFasL decreases after surgery, whereas intra-abdominal o r cerebrospinal sFasL increases, although sFas in each site does not change , suggesting redistribution of activated lymphocytes into local surgical wo unds and induction of apoptosis in this site. Copyright (C) 2000 by W.B. Sa unders Company.