Роль матриксной металлопротеиназы-2 и альфа-субъединицы рецептора интерлейкина-2 в развитии критического состояния у больных пневмонией при гриппе A/H1N1

Abstract

The aim of the research. To assess the role of matrix metalloproteinase-2 (MMP-2) and the alpha subunit of the interleukin-2 receptor (IL-2 Ra) in development of critical illness in pneumonia patients with underlying influenza A (H1N1). Material and methods. A total of 85 patients with pneumonia associated with influenza A (H1N1) were examined. Among them, 30 patients suffered from severe pneumonia while 55 had non-severe pneumonia. Th e mean age of the patients amounted to 52 [38; 67]. Th e group was constituted by 48 % male and 52 % female patients. Th e diagnosis of infl uenza A / H1N1 was confirmed by positive PCR test results. Th e CURB / CRB-65 scales were used to diagnose and assess the severity of pneumonia; this was also performed using SMART-COP, the Federal Clinical Guidelines of the Ministry of Health of the Russian Federation “Community-acquired pneumonia in adults”, 2019 and the IDSA / ATS criteria (pneumonia was considered severe in presence of one major or three minor criteria). Plasma concentration of MMP-2 and IL-2 Ra molecules (sCD25) was measured through flow cytometry with the Beckman Coulter analyser (USA) using LEGENDplex™ HU Immune Checkpoint Panel 1 and Human Vascular Inflammation Panel 1 Beckman Coulter (USA) multiplex assay kits. Results. It was established that patients with severe pneumonia and underlying influenza A (H1N1) had plasma concentration of MMP-2 and sCD25 increased 2-fold and 2.5-fold, respectively. Conclusion. Statistically signifi cant increase in the concentration of MMP-2 and IL-2 Ra in pneumonia patients with underlying influenza A (H1N1) indicates the occurrence of proinflammatory conditions for the development of a critical state, as well as the involvement of negative regulation components of the T-cell response into the cascade of adaptive immune responses, which is associated with severity of the condition.