Alpha-2 macroglobulin activity in SARS-CoV-2 induced infection and in the post-COVID-19 period

Akbasheva O.E.1, Mitrofanova D.K.1, Spirina L.V.2 , Samoilova Yu.G.1, Matveeva M.V.1, Podchinenova D.V.1, Oleynik O.A.1

1. Siberian State Medical University, Tomsk, Russia
2. Siberian State Medical University, Tomsk, Russia; Cancer Research Institute, Tomsk National Research Medical Center, Tomsk, Russia
Section: Clinical and Diagnostic Research
DOI: 10.18097/PBMC20236904240      PubMed Id: 37705485
Year: 2023  Volume: 69  Issue: 4  Pages: 240-247
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.
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Keywords: alpha-2-macroglobulin, alpha-1-proteinase inhibitor, trypsin-like proteases, elastase-like proteases, post-COVID period
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Akbasheva, O. E., Mitrofanova, D. K., Spirina, L. V., Samoilova, Yu. G., Matveeva, M. V., Podchinenova, D. V., Oleynik, O. A. (2023). Alpha-2 macroglobulin activity in SARS-CoV-2 induced infection and in the post-COVID-19 period. Biomeditsinskaya Khimiya, 69(4), 240-247.
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