Endothelin-1 indices in patients with leptospirosis of various severity degrees and their changes under the influence of seven-day treatment

Abstract

Introduction. Leptospirosis is one of the most common zoonoses in the world, pathogenesis of which is based on the damage of vascular endothelium. Violation of endothelial functions leads to damage of these cells plasma membranes, loss of vascular integrity, ischemia, necrosis, and, finally, the development of organ dysfunction. In current literature there is sparce information concerning endothelial dysfunction in patients with leptospirosis, therefore the development and standardization of methods for the assessment of vascular endothelium imbalance in patients with leptospirosis of different severity degrees is an urgent task. Detection of endothelin-1 (ET-1) one of the best markers of endothelial dysfunction, can become an important tool for predicting the severity of the disease. The aim of the study. To investigate ET-1 indices in patients with leptospirosis of different severity degrees and to estimate their changes after the seven-day treatment. Materials and methods. ET-1 content in the blood serum of patients with diagnosed leptospirosis was detected by ELISA method. Absolute values were compared using Mann-Whitney test (U-test); the results were statistically processed using Fisher’s bilateral test (F-test). Correlation analysis was carried out according to Spearman’s method. The difference was considered statistically significant with p less than 0.05. Results. ET-1 content was detected at time of hospitalization and after 7 days of leptospirosis treatment. Patients (n = 43) were divided into two groups depending on the severity of leptospirosis course: the first group with a moderate course included 21 patients; second group with a severe course included 22 patients; the control group consisted of 20 healthy individuals. Both groups of leptospirosis affected patients demonstrated significantly higher ET-1 concentration in comparison with the control group (p less than 0.01). Moreover, the proportion of patients with high (more than 5.5 pg/ml) concentration of ET-1 in the blood post the 7 days treatment was documented in 13.3% patients of the first group, and 43.8 % patients of the second group (p less than 0.05). It was also estimated that in both groups patients 7 days treatment of leptospirosis induced a credible increase in the concentration of ET-1 (p less than 0.05). Conclusions. Our results claim that at time of hospitalization and after 7 days treatment both groups of leptospirosis affected patients demonstrated significantly higher level of ET-1 in comparison to control group individuals (p less than 0.01). 7 days of leptospirosis treatment caused a credible enhancement of ET-1 content (p less than 0.05). Patients with a severe course of leptospirosis after 7 days treatment exposed significantly higher ET-1 concentration compared to patients with moderate course (p less than 0.05).