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Abstract
Abstract. To explain the causes of acute respiratory distress syndrome, which occurs as a result of SARS-CoV-2 (severe acute respiratory syndrome-related coronavirus 2) infection, two main hypotheses are proposed: a cytokine storm theory and a bradykinin (BK) storm theory. From a cytokine storm perspective, elevated levels of cytokines, primarily interleukin-6 (IL-6), cause multisystem pathologic manifestations of COVID-19 (Coronavirus disease 2019), including acute lung injury and respiratory distress syndrome in critically ill patients. The BK storm theory emphasizes the importance of decreased angiotensin-converting enzymes in lung epithelial cells, resulting in an inability to break down BK and the BK analog des-Arg9-BK. The aim of the work was a comparative study of BK levels in the blood of patients with diabetes mellitus (DM) and patients with mild and severe forms of COVID-19. Material and methods. Blood was obtained by standard venipuncture and stored in EDTA tubes. Plasma was separated by centrifugation within 10 minutes after blood sampling. The amount of BK was determined using enzyme immunoassay kits ab136936 («Abcam», Great Britain), IL-6 – EH2IL6 («Invitrogen», Austria). Results. It was shown that the BK level increased significantly in patients with DM. Patients with DM and COVID-19 had a slight increase in the amount of BK. At the same time, the amount of IL-6 increased significantly in patients with DM and, especially, in patients with acute COVID-19. Conclusions. The BK level increase in the blood of patients with DM and COVID-19 is caused mainly by DM. In patients with acute COVID-19, the level of the pro-inflammatory cytokine IL-6 increased almost threefold compared to controls.
References
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