Siberian State Medical University, Tomsk, Russia.
Siberian State Medical University, Tomsk, Russia; Cancer Research Institute, Tomsk National Research Medical Center, Tomsk, Russia.
Biomed Khim. 2023 Sep;69(4):240-247. doi: 10.18097/PBMC20236904240.
The universal proteinase inhibitor α2-macroglobulin (α₂-MG) exhibiting antiviral and immunomodulatory activities, is considered as an important participant in the infectious process. The activity of α₂-MG in the new coronavirus infection and post-covid syndrome (long COVID) has not been studied yet. We examined 85 patients diagnosed with community-acquired bilateral polysegmental pneumonia developed under conditions of a new coronavirus infection SARS-CoV-2. For assessment of the post-COVID period, 60 patients were examined 5.0±3.6 months after the coronavirus infection. Among these patients, 40 people had complications, manifested in the form of neurological, cardiological, gastroenterological, dermatological, bronchopulmonary symptoms. The control group included 30 conditionally healthy individuals with a negative PCR result for SARS-CoV-2 RNA and lack of antibodies to the SARS-CoV-2 virus. The α₂-MG activity in serum samples of patients with coronavirus infection dramatically decreased, up to 2.5% of the physiological level. This was accompanied by an increase in the activity of the α₁-proteinase inhibitor, elastase- and trypsin-like proteinases by 2.0-, 4.4- and 2.6-fold respectively as compared with these parameters in conditionally healthy individuals of the control. In the post-COVID period, despite the trend towards normalization of the activity of inhibitors, the activity of elastase-like and especially trypsin-like proteinases in serum remained elevated. In overweight individuals, the increase in the activity of trypsin-like proteinases was most pronounced and correlated with an increase in the antibody titer to the SARS-CoV-2 virus. In the post-COVID period, the α₂-MG activity not only normalized, but also exceeded the control level, especially in patients with dermatological and neurological symptoms. In patients with neurological symptoms or with dermatological symptoms, the α₂-MG activity was 1.3 times and 2.1 times higher than in asymptomatic persons. Low α₂-MG activity in the post-COVID period persisted in overweight individuals. The results obtained can be used to monitor the course of the post-COVID period and identify risk groups for complications.
具有抗病毒和免疫调节活性的广谱蛋白酶抑制剂 α2-巨球蛋白（α₂-MG）被认为是感染过程中的重要参与者。α₂-MG 在新型冠状病毒感染和新冠后综合征（长新冠）中的活性尚未得到研究。我们检查了 85 名在 SARS-CoV-2 新型冠状病毒感染下诊断为社区获得性双侧多节段肺炎的患者。为了评估新冠后时期，对 60 名患者在冠状病毒感染后 5.0±3.6 个月进行了检查。其中 40 人有并发症，表现为神经、心脏、胃肠、皮肤、支气管肺部症状。对照组包括 30 名有条件健康的个体，他们的 SARS-CoV-2 RNA PCR 结果为阴性，且缺乏对 SARS-CoV-2 病毒的抗体。冠状病毒感染患者的血清 α₂-MG 活性显著下降，低至生理水平的 2.5%。这伴随着 α₁-蛋白酶抑制剂、弹性蛋白酶和胰蛋白酶样蛋白酶的活性分别增加 2.0 倍、4.4 倍和 2.6 倍，与对照组条件健康个体的这些参数相比。在新冠后时期，尽管抑制剂活性有趋于正常的趋势，但血清中弹性蛋白酶样和特别是胰蛋白酶样蛋白酶的活性仍然升高。在超重个体中，胰蛋白酶样蛋白酶的活性增加最为明显，且与对 SARS-CoV-2 病毒的抗体滴度增加相关。在新冠后时期，α₂-MG 活性不仅恢复正常，而且超过了对照组水平，尤其是在有皮肤和神经症状的患者中。在有神经症状或有皮肤症状的患者中，α₂-MG 活性分别比无症状者高 1.3 倍和 2.1 倍。超重个体的新冠后时期低 α₂-MG 活性持续存在。所得结果可用于监测新冠后时期的病程，并确定并发症的风险群体。
