Prognostic value of Fas ligand in patients with sepsis and septic shock

Background: Recent studies have discovered that necroptosis, a programmed necrosis mechanism, is involved in the pathogenesis and outcomes of sepsis. Fas ligand, a trigger of apoptosis, has been identified to also induce necroptosis. However, little is known on the association between Fas ligand and sepsis. Objectives: The aim of this study was to assess the plasma level of Fas ligand in patients with sepsis and septic shock and to determine the correlation between the level of Fas ligand and severity of illness and mortality. Methods: We retrospective analyzed the data of 256 patients with sepsis or septic shock admitted to the intensive care unit (ICU) registry of Samsung Medical Center. Fas ligand was measured from plasma of each patient collected on the day of ICU admission. Results: Of 256 critically ill patients, 172 (67.2%) and 84 (32.8%) patients were diagnosed with sepsis and septic shock, respectively. Plasma level of Fas ligand was significantly higher in patients with sepsis shock compared to that of sepsis (102.5 pg/mL vs. 48.4 pg/mL, P < 0.001). When patients were classified into groups of high and low plasma level of Fas ligand based on median level of Fas ligand, SAPS 3 score, APCHE II score, and SOFA score were significantly higher in the group of high plasma level of Fas ligand. However, there was no difference in 28-day ICU mortality between the two groups. The area under the receiver operating characteristics curve for 28-day ICU mortality according to plasma Fas ligand were 0.517 (0.453 – 0.594). Conclusions: Plasma level of Fas ligand was associated with severity of sepsis in patients with sepsis and septic shock, however, was not predictive of mortality.