Participation of iron in the formation of nutritional immunity in patients with tick-borne rickettsiosis in the South of Khabarovsk krai
Objective. Determination of the relationship between iron (Fe) levels and cytokine status in patients with tick-borne rickettsiosis (TBR) caused by R. heilongjiangensis in the dynamics of the disease for a better understanding of the pathogenesis of this pathology.Mokretsova E.V., Tomilka G.S., Shchupak A.Yu., Kovalsky Yu.G., Maleev V.V.
Materials and methods. The serum Fe and some proinflammatory cytokines (IL-6, IL-8, TNF-α) levels were analyzed in patients with moderate TBR taking into account a two-time examination: during hospitalization (at the height of the disease (4-5 days of illness)) and in the early convalescence period (8–10 days from the onset of the disease).
Results. It was found that at the height of the disease, a statistically significant decrease in the serum Fe level (by 4.7 times) was observed, which was combined with a reliably expressed activation of the endogenous mediators studied (IL-6 – by 56.1 times, IL-8 – by 4.8 times, TNF-α – by 9.5 times). However, already in the early convalescence period, against the background of a further decrease in the serum Fe concentration (by 5.6 times), the level of the studied interleukins significantly decreased (IL-6 and TNF-α by 7 and 2.6 times, respectively), remaining higher relative to the comparison group. When conducting a correlation analysis, a moderate unidirectional relationship between the level of Fe and the cytokine IL-6 was found.
Conclusion. The results obtained indicate an inductive effect of cytokine status elements on the unbound Fe level. IL-6, apparently, is a necessary cytokine for iron inhibition during inflammation and is involved in the development of protective hypoferremia in the formation of nutritional immunity in patients with TBR caused by R. heilongjiangensis.
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References
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About the Authors
Evgenia V. Mokretsova, Cand. Med. Sci., Associate Professor; Associate Professor, Department of Infectious Diseases and Epidemiology, Far Eastern State Medical University, Ministry of Health of Russia, Khabarovsk, Russia; bremer68@mail.ru; https://orcid.org/0000-0001-9492-2660Professor Gennady S. Tomilka, MD, Head, Department of Infectious Diseases and Epidemiology, Far Eastern State Medical University, Ministry of Health of Russia, Khabarovsk, Russia; genntom@mail.fesmu.ru; https://orcid.org/0000-0002-8785-2147
Alexander Yu. Shchupak, Cand. Med. Sci., Associate Professor, Head, Department of Clinical Toxicology and Extreme Medicine, Far Eastern State Medical University, Ministry of Health of Russia, Khabarovsk, Russia; schupakalex@mail.ru; https://orcid.org/0000-0001-6255-7638
Professor Yuri G. Kovalsky, MD, Head, Department of Biological Chemistry and Clinical Laboratory Diagnostics, Far Eastern State Medical University, Ministry of Health of Russia, Khabarovsk, Russia; kovalyura@mail.ru; https://orcid.org/0000-0001-7433-6285
Professor Viktor V. Maleev, Academician of the Russian Academy of Sciences, MD, Advisor to the Director for Scientific Work, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; maleyev@pcr.ru; https://orcid.org/0000-0001-5748-178X