Functional reserve of oxygen-dependent metabolism of phagocytes in blood of patients with severe hemorrhagic fever with renal syndrome complicated by acute renal failure

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INTRODUCTION: Hemorrhagic fever with renal syndrome (HFRS) is one of the most common zoonotic infections, and acute renal failure (ARF) is a serious complication of HFRS. A mechanism inalienable from the pathogenesis of HFRS is activation of oxygen-dependent metabolism of phagocytes and the generation of reactive oxygen species (ROS) by them. Overactivation of oxygen-dependent processes induces oxidative damage to molecular structures and underlies the development of ARF leading to marked alterations of reserve capacities of phagocytes.

AIM: Evaluation of the functional reserve of oxygen-dependent metabolism of phagocytes in the blood of patients with severe HFRS complicated by ARF.

MATERIALS AND METHODS: The study included 140 patients who underwent treatment at the Republican Clinical Infectious Diseases Hospital in Ufa. Thirty-two patients had mild form of HFRS, 35 patients had moderately severe form, 35 patients had severe HFRS and 38 patients had severe HFRS complicated by ARF. The comparison group consisted of 46 healthy individuals. Parameters of spontaneous and induced oxygen-dependent metabolism of phagocytes, generation by them of ROS, were evaluated by registration of luminol-dependent chemiluminescence (LDCL). On the basis of these parameters, the functional reserve of oxygen-dependent metabolism of phagocytes was calculated using the formula that estimated the multiplicity of the difference between spontaneous and induced LDCL to spontaneous LDCL.

RESULTS: The functional reserve did not change in mild HFRS, but decreased in moderate and severe forms. The reserve was better preserved in patients with moderately severe disease (2.8) compared to severe form (2.0; р < 0.05). The greatest drop in the functional reserve (0.7) was recorded in patients with severe HFRS complicated by ARF, which was accompanied by increased spontaneous oxygen-dependent metabolism (5.1 times the control) and twice reduction of induced metabolism from the control (р < 0.05). Thus, the drop of the functional reserve of phagocytes increased with increase in severity of HFRS: in patients with moderate and severe HFRS without ARF, the drop was up to 30.0%, while with ARF complication — 65.0% (р < 0.05).

CONCLUSION: A decrease in the reserve of functional activity of phagocytes in patients with HFRS with clinical symptoms of ARF indicates a breakdown of adaptive capacities of an organism, a decrease in its protective immunoregulatory capacities. The parameters of the functional reserve can be considered a marker of severe LFRS complicated by ARF.

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作者简介

Saida Galimova

Bashkir State Medical University

Email: saida9319@mail.ru
ORCID iD: 0000-0002-7865-8326
SPIN 代码: 9986-5929
俄罗斯联邦, Ufa

Nuriya Abdrakhmanova

Republican Clinical Infectious Diseases Hospital

Email: nuria.abdrahmanova@mail.ru
ORCID iD: 0009-0007-7573-7196

MD.

俄罗斯联邦, Ufa

Konstantin Mochalov

Bashkir State Medical University

编辑信件的主要联系方式.
Email: ksmochalov@yandex.ru
ORCID iD: 0000-0002-8010-3338
SPIN 代码: 3348-2362

Cand. Sci. (Biol.), Associate Professor

俄罗斯联邦, Ufa

Shamil’ Galimov

Bashkir State Medical University

Email: sngalim@mail.ru
ORCID iD: 0000-0002-5871-5151
SPIN 代码: 6096-1910

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Ufa

Aleksandra Kufterina

Central State Medical Academy of Department of Presidential Affairs

Email: sasha.kufterina@yandex.ru
ORCID iD: 0000-0003-3852-1605
SPIN 代码: 6486-8802
俄罗斯联邦, Moscow

Ernst Khisamov

Bashkir State Medical University

Email: hisamov7958@yandex.ru
ORCID iD: 0009-0005-0141-770X
SPIN 代码: 3495-3746

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Ufa

Elmira Galimova

Bashkir State Medical University

Email: efgalimova@mail.ru
ORCID iD: 0000-0002-3351-7669
SPIN 代码: 1651-0055

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Ufa

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2. Fig. 1. Percentage of the functional reserve of phagocytes in HFRS of different severity from the baseline control values. Notes: * — statistically significant difference from the control, p < 0.05; ** — statistically significant differences between groups of patients with HFRS of different severity, p < 0.05; HFRS — hemorrhagic fever with renal syndrome, ARF — acute renal failure.

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3. Fig. 1. Percentage of the functional reserve of phagocytes in HFRS of different severity from the baseline control values.

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