Cerebrospinal fluid soluble Fas and Fas ligand levels after aneurysmal subarachnoid haemorrhage

Background. The aim of the present study was to show the CSF release of soluble Fas (sFas) and Fas Ligand (FasL) and their serum levels after subarachnoid haemorrhage (SAH) as potentially regulatory factors of programmed cell death (PCD). Method. Twelve SAH patients were studied prospectively on days 1 to 3, 5 and 7, with clinical evaluation and analysis of CSF and serum levels of sFas, FasL, IL-1, IL-6 and TNF-alpha. The control group consisted of eight patients with hydrocephalus. Findings. The CSF levels of sFas and FasL increased significantly, with a maximal increase at day 7 (p < 0.001) in SAH patients compared to control group. Serum sFas and FasL levels did not elevate significantly until day 7 (p < 0.05). In addition, CSF and serum levels of IL-1, IL-6 and TNF-a increased significantly. However, there was no correlation between CSF levels of sFas and FasL and IL-1, IL-6 and TNF-alpha. Conclusions. Our preliminary study demonstrates that sFas and FasL are present in higher amounts in CSF after aneurysmal SAH, suggesting that activation of the extrisic pathway of PCD may be initiated as a direct result of SAH independently from the posthaemorrhagic inflammatory response.