Abstract: Objective To investigate serum soluble Fas (sFas), soluble Fas ligand (sFasL)concentration and its correlation with known markers of inflammation, nutritional status and carotid arterial intima- media thickness(IMT) in uremic patients with cardiovascular disease. Methods One hundred and sixty-three subjects were enraolled in this study including 103 hemodialysis patients (HD group), 30 chronic kidney disease patients(CKD group, defined as 15＜GFR＜50ml/min/1.73m2) with and 30 healthy subjects as a control group. The serum level of sFas，sFasL, c-reactive protein (CRP) and albumin (ALB) were measured with enzyme-linked immunosorbent assay(ELISA). The expression of Fas and FasL on radial arterial endothelial cells were determined by immunohistochemical method and their mRNA expression were analyzed with reverse transcription-polymerase chain reaction(RT-PCR). The carotid arterial IMTs in uremic patients were evaluated using color doppler ultrasonography. Results Compared with control group, the level of serum sFasL in HD group and CKD group increased significantly, sFas decreased significantly，and the expression of Fas and FasL on radial arterial endothelial cells in HD group rose significantly too. In additon, Fluorescent RT-PCR showed expressions of Fas and FasL mRNA were 50.00% higher than that in control group. In HD group, 63.49% (40/63) patients presented increase of IMT. Bivariate correlation analysis showed sFasL was positively associationated with CRP and IMT (r = 0.58 and 0.64 respectively, P ＜0.01), but negatively correlationed with serum albumin and GFR (r=-0.53 and -0.62 respectively, P＜0.01), opposite for sFas. Conclusion Serum sFasL concentration increases extremely in uremic patients with CVD, so serum sFasL is likely to be a novel risk factor of cardiovascular disease in uremic patients.

Key words: Soluble Fas ligand, ? Uremia, Cardiovascular disease, Inflammation