Soluble fas and soluble Fas-ligand in children with Escherichia coli O157 : H7-associated hemolytic uremic syndrome

We measured soluble Fas-ligand (sFas-L) and soluble Fas (sFas) revels by sa ndwich enzyme-linked immunosorbeny assay and compared them among (1) health y controls (n = 11), (2) children with hemorrhagic colitis (HC) caused by a non-verotoxin-producing pathogen (n = 23), (3) patients with uncomplicated Escherichia coil O157: H7 HC (n = 14), and (4) children with O157:H7-assoc iated hemolytic uremic syndrome (HUS) (n = 24), Children with uncomplicated E coil O157:H7 HC and HUS were matched for duration of enteric prodrome be fore blood sample collection. We also compared sFas-L and sFas levels among patients with HUS according to severity of renal dysfunction; abnormally i ncreased sFas-L levels were noted in only 4% of the children (n = 3), Abnor mally high concentrations of sFas were noted in 9% of the children with HC caused by a non-verotoxin-producing pathogen, 29% of the patients with unco mplicated E coli O157:H7 MC, and 69% of the children with O157:H7-associate d HUS. Compared with healthy controls, patients with HUS had twofold greate r concentrations of sFas (P < 0.0001). Levels of sFas were not statisticall y different between 14 patients with uncomplicated O157:H7 HC and 14 childr en with HUS (8.2 +/- 4.7 versus 11.0 +/- 4.6 U/mL, respectively; P < 0.07) when matched for time after onset of enteritis (7.0 +/- 3.7 versus 7.3 +/- 3.8 days, respectively). Greater concentrations of sFas were noted in patie nts with HUS who developed oligoanuria (n = 10; P < 0.007), required perito neal dialysis (n = 10; P < 0.007), or had a decreased glomerular filtration rate (n = 5; P < 0.002) 1 year later, Our data show that plasma concentrat ions of sFas but not sFas-L are abnormally increased in children with O157: H7 infections, Levels of sFas are associated with severity of renal dysfunc tion during HUS, Further studies are needed to clearly determine the role a nd origin of circulating sFas among children with infections caused by E co li O157:H7. (C) 2000 by the National Kidney Foundation, Inc.