INFLUENCE OF INTERLEUKIN-1β, INTERFERON-GAMMA ON THE DEVELOPMENT OF ANEMIA OF CHRONIC DISEASES IN PATIENTS WITH MALIGNANT TUMORS

Abstract

Relevance. Anemia of chronic diseases has a significant impact on the quality of life of patients with malignant neoplasms, as well as on the course of the underlying disease and prognosis. Aim. To study the characteristics of the secretion of interleukin-1β (IL-1β), interferon-γ (INF-γ) in patients with malignant neoplasms with and without anemia of chronic diseases. To study the effect of these cytokines on hemoglobin synthesis, erythropoiesis and some indicators of iron metabolism. To propose a working version of the classification of anemia of chronic diseases based on the leading pathogenetic factor in the development of anemia. Material and methods. The study involved 42 (27 patients with anemia - 19 men, 8 women, average age 65.1 ± 8.1 years, 15 without it, 10 men, 5 women, average age 61.1 ± 10.1 years) patients with II- Stage IV malignant neoplasm. A comparative analysis was carried out between groups with and without anemia and a correlation analysis between IL-1β, INF-γ and indicators of hemogram, iron metabolism, C-reactive protein (CRP), hepcidin. Results. In patients with malignant neoplasms and ACD, in comparison with patients in the control group, a more pronounced inflammation was proved, accompanied by an increase in the synthesis of ferritin, CRP and IL-1β, INF-γ (p <0.05). For IL-1β, a moderate correlation was found with the concentration of iron (r = 0.46), CST (r = 0.48), hemoglobin (r = -0.61) and a strong correlation with the concentrations of hepcidin (r = 0.8), ferritin (r = 0.78), CRP (r = 0.87). A weak correlation was found between IL-1β and the number of erythrocytes, TIBC and transferrin. For IFN-γ, a moderate correlation was established with erythrocytes (r = -0.68), hemoglobin (r = -0.57), CST (r = -0.57), ferritin (r = 0.57) and a strong correlation connection with CRP (r = 0.83), hepcidin (r = 0.9), transferrin (r = -0.83). A weak correlation has been established between INF-γ and the concentration of iron, TIBC. Conclusions. In patients with malignant neoplasms and ACD, a more pronounced inflammation was proved, accompanied by an increase in the synthesis of ferritin, CRP and IL-1β, INF-γ. The influence of the investigated cytokines on erythropoiesis, synthesis of hemoglobin and hepcidin, and iron metabolism has been proved. This reflects the pleiotropic effect of these cytokines and the complex pathogenesis of ACD in patients with malignant neoplasms, including erythropoiesis disorders, changes in iron metabolism, and increased synthesis of proinflammatory cytokines. A working version of the classification of ACD (with a predominant iron deficiency, with impaired regulatory mechanisms of erythropoiesis, with insufficient production of erythropoietin) has been proposed.