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Elevation of the Serum Fas Ligand in Patients With Hemophagocytic
Syndrome and Diamond-Blackfan Anemia
Daiichiro Hasegawa,
Seiji Kojima,
Eiji Tatsumi,
Akira Hayakawa,
Yoshiyuki Kosaka,
Hajime Nakamura,
Masahiro Sako,
Yuko Osugi,
Shigekazu Nagata, and
Kimihiko Sano
From the Departments of Pediatrics and of Tumor Genetics, Kobe
University School of Medicine, Kobe, Japan; the Division of Hematology
and Oncology, Children's Medical Center, Japanese Red Cross Nagoya
First Hospital, Nagoya, Japan; the Department of Pediatrics, Osaka City
General Hospital, Osaka, Japan; the Department of Pediatrics, Osaka
University Hospital, Osaka, Japan; and the Department of Genetics,
Osaka University Medical School, Osaka, Japan.
Fas ligand (FasL) is a membrane protein that is expressed in
activated T cells and natural killer cells. FasL binds to Fas on target
cells and induces apoptosis. There exists a soluble form of FasL
(sFasL), and sFasL also induces apoptosis of Fas-bearing cells. The
serum sFasL concentrations were reported to be elevated in patients
with large granular lymphocytic leukemia and natural killer cell
lymphoma. In this study, we have measured serum sFasL concentrations in
other hematological disorders, including severe aplastic anemia (SAA),
hemophagocytic lymphohistiocytosis (HLH), and Diamond-Blackfan anemia
(DBA). The serum sFasL concentration of age-matched healthy controls
was 0.16 ± 0.11 ng/mL (mean ± SD, n = 22). The serum sFasL levels
in the patients with HLH and DBA were 3.75 ± 3.82 (n = 19;
P < .0001, HLH v control) and 2.76 ± 2.43 ng/mL (n
= 6; P = .012, DBA v control), respectively. Serum interferon- concentration was elevated in the patients with HLH (1.61 ± 2.62 ng/mL) but not in those with DBA (below the detectable level). These results suggest that the Fas-FasL system plays a role, at
least in part, in the pathophysiology of HLH and DBA.
Blood, Vol. 91 No. 8 (April 15), 1998:
pp. 2793-2799
© 1998 by The American Society of Hematology.

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