Objective. Aminothiols (glutathione (GSH), cysteinylglycine (CG)) may play an important role in the pathogenesis of coronavirus disease 2019 (COVID-19), but the possible association of these indicators with the severity of COVID-19 has not yet been investigated. Methods. The total content ( t ) and reduced forms ( r ) of aminothiols were determined in patients with COVID-19 ( n = 59 ) on admission. Lung injury was characterized by computed tomography (CT) findings in accordance with the CT0-4 classification. Results. Low tGSH level was associated with the risk of severe COVID-19 ( tGSH ≤ 1.5   μ M , mild vs. moderate/severe: risk   ratio   RR = 3.09 , p = 0.007 ) and degree of lung damage ( tGSH ≤ 1.8   μ M , CT < 2 vs. CT ≥ 2 : RR = 2.14 , p = 0.0094 ). The rGSH level showed a negative association with D-dimer levels ( ρ = − 0.599 , p = 0.014 ). Low rCG level was also associated with the risk of lung damage ( rCG ≤ 1.3   μ M , CT < 2 vs. CT ≥ 2 : RR = 2.28 , p = 0.001 ). Levels of rCG ( ρ = − 0.339 , p = 0.012 ) and especially tCG ( ρ = − 0.551 , p = 0.004 ) were negatively associated with platelet count. In addition, a significant relationship was found between the advanced oxidation protein product level and tGSH in patients with moderate or severe but not in patients with mild COVID-19. Conclusion. Thus, tGSH and rCG can be seen as potential markers for the risk of severe COVID-19. GSH appears to be an important factor to oxidative damage prevention as infection progresses. This suggests the potential clinical efficacy of correcting glutathione metabolism as an adjunct therapy for COVID-19.

Objective. S-Adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) are indicators of global transmethylation and may play an important role as markers of severity of COVID-19. Methods. The levels of plasma SAM and SAH were determined in patients admitted with COVID-19 ( n = 56 , mean   age = 61 ). Lung injury was identified by computed tomography (CT) in accordance with the CT0-4 classification. Results. SAM was found to be a potential marker of lung damage risk in COVID-19 patients ( SAM > 80   nM ; CT3,4 vs. CT 0-2: relative ratio (RR) was 3.0; p = 0.0029 ). SAM / SAH > 6.0 was also found to be a marker of lung injury (CT2-4 vs. CT0,1: RR = 3.47 , p = 0.0004 ). There was a negative association between SAM and glutathione level ( ρ = − 0.343 , p = 0.011 ). Interleukin-6 (IL-6) levels were associated with SAM ( ρ = 0.44 , p = 0.01 ) and SAH ( ρ = 0.534 , p = 0.001 ) levels. Conclusions. A high SAM level and high methylation index are associated with the risk of lung injury in patients with COVID-19. The association of SAM with IL-6 and glutathione indicates an important role of transmethylation in the development of cytokine imbalance and oxidative stress in patients with COVID-19.

Цель. Изучить влияние гепцидина, растворимого рецептора трансферрина (sTfR), цитокинов на обмен железа и развитие анемии у пациентов со злокачественными новообразованиями; на основании полученных данных предложить рабочий вариант классификации анемии при хронических заболеваниях (АХЗ) по ведущему патогенетическому фактору. Материалы и методы. В исследование включено 63 пациента со II-IV стадией злокачественных новообразований. Больных с анемией было 41 (34 мужчины, 7 женщин, средний возраст 67,1 ± 9,9 года), без анемии-22 (17 мужчин, 5 женщин, средний возраст 60,2 ± 14,9 года). Выполнен сравнительный анализ показателей обмена железа, С-реактивного белка (СРБ), гепцидина, sTfR, а также провоспалительных (интерлейкин-6 [ИЛ-6], фактор некроза опухолей α [ФНО-α]) и противовоспалительных (ИЛ-10) цитокинов у больных со злокачественными (солидными) новообразованиями с анемией и без нее. Проведен корреляционный анализ между ИЛ-6, ИЛ-10, ФНО-α, гепцидином, sTfR и показателями гемограммы. Результаты. У больных с анемией в сравнении с контрольной группой выявлены более низкие концентрации железа, общей железосвязывающей способности (ОЖСС), коэффициента насыщения трансферрина железом (КНТ) и более высокие концентрации СРБ,

В обзоре приведены данные, касающиеся новых важных аспектов патогенеза и лечения анемии хронических заболеваний. Продемонстрирован сложный мнококомпонентный генез этой анемии, в основе которого лежат нарушения обмена железа, повреждение пролиферации и дифференцировки клеток эритропоэза, уменьшение синтеза и биологической активности эритропоэтина. Показано значение гемотрансфузий, препаратов железа и эритропоэз-стимулирующих агентов в лечении пациентов с анемией хронических заболеваний. Установлено, что данные по безопасности этих методик достаточно противоречивы, необходимы дальнейшие исследования в этом направлении с целью разработки единых принципов диагностики и лечения этой анемии. Представлены собственные результаты сравнительного анализа концентрации интерлейкина (ИЛ) 6, 10, фактора некроза опухоли альфа (ФНО-α) у пациентов со злокачественными новообразованиями с анемией и без таковой, а также корреляционного анализа для оценки их влияния на число эритроцитов и концентрацию гемоглобина.

Objective: to study the importance of cytokines, hepcidin, a soluble transferrin receptor, iron metabolism in the development of anemia of chronic diseases in patients with malignant neoplasms and rheumatic pathology, to identify the leading factors in the development of anemia for each of the studied groups and to develop a working classification of anemia of chronic diseases.Materials and methods. 63 patients with rheumatic pathology were examined. The study group included 41 (17 men/24 women, average age 53.4 ± 4 years) patients with anemia, the control group included 22 (9 men/13 women, age 49.3 ± 1.78 years) patients without anemia. The patients (n = 63) with stage II–IV malignant neoplasms were examined. The study group included 41 patients with anemia (34 men/7 women, age 67.1 ± 9.9 years), in the control group 22 patients without it (17 men/5 women, age 60.2 ± 14.9 years). The number of red blood cells, the hemoglobin level, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, concentrations of serum iron, total iron binding capacity (TIBC), ferritin, transferrin, C-reactive protein (CRP), transferrin saturation index (TSI), and soluble transferrin receptor (sTfR), hepcidin, interleukin (IL) – 6, – 10, tumor necrosis factor-α (TNF-α) were determined. Mann – Whitney U Test was applied to check for statistically significant differences in study samples.Results. Compared with the control group, elevated concentrations of ferritin, CRP, hepcidin, sTfR and IL-6 (p <0.05) were found for patients with rheumatic pathology and anemia and no differences were found in the concentrations of iron, TIBC, TSI, transferrin. For patients with solid malignant neoplasms and anemia, lower concentrations of iron, TIBC, TSI and higher concentrations of CRP, hepcidin, sTfR, IL-6, IL-10, TNF-α (p <0.05) are shown in comparison with the control group and there were no differences in the concentrations of ferritin, transferrin (p >0.05).Conclusion. The multicomponent anemia genesis in patients with cancer and rheumatic pathology is shown. The contribution of each mechanism to the development of anemia may vary depending on the specific nosological form. In patients with cancer, functional iron deficiency, activation of IL-6, IL-10, TNF-α synthesis and an increase in hepcidin synthesis lead to the development of anemia of chronic diseases. In patients with a rheumatic profile and anemia, a more pronounced synthesis of hepcidin and an increase IL-6 concentration are indicated. A working version of the classification of anemia of chronic diseases based on the leading pathogenetic factor is proposed (with a predominant iron deficiency, with impaired regulatory mechanisms of erythropoiesis, with insufficient production of erythropoietin).