Abstract:

Objective  To assess the role of Fas/FasL in the mechanism of herpes simplex encephalitis (HSE) through soluble FAS (sFas) content in cerebral spinal fluid samples from patients with HSE and explore the association between sFas level and the severity of sustained brain damage. Methods  Fifty-nine patients with encephalitis were divided into the HSE group and non-HSE group, and 10 healthy individuals served as the control group. The HSE group was subdivided into drowsiness group and coma group according to the state of consciousness at admission by the Glasgow coma level scale. With reference to the outcome  at discharge, these patients were subdivided into mild-moderate neurological syndrome group and severe neurological syndrome or dead group. ELISA was used to detect the sFas content in cerebrospinal fluid; t test was used to compare the sFas levels of each group at the onset of disease; linear regression coefficient was adopted to observe changes of sFas in the HSE group. Results  HSE patients had significantly higher level of sFas compared to non-HSE patients (P<0.05). No significant difference was observed in the sFas levels during the first 7 days of neurological symptoms in HSE patients (P=0.40). Patients with severe neurological syndrome revealed higher regression coefficient compared to patients with mild or moderate neurological outcome (P=0.008). Conclusion  The apoptosis through the Fas/FasL pathway played an important role in the process of HSE. The dynamics of sFas level stated throughout the course of the disease could be an index for the diagnosis and prognosis of HSE.

Key words: Encephalitis; Herpes simplex; Cerebrospinal fluid; Soluble Fas