Vasomodulating function of the endothelium in hemorrhagic fever with renal syndrome

Aim. To study the content of endothelin-1, nitric oxide (II) and the activity of angiotensin-converting enzyme in the blood of patients with hemorrhagic fever with renal syndrome, depending on the period and the severity of the disease in order to assess their role in the pathogenesis and to develop a pathogenetically substantiated correction of the changes in the systemic vascular tone. Methods. The group of dynamic study included 114 patients (102 male and 12 female) with serologically confirmed hemorrhagic fever with renal syndrome aged 22-55 years. The moderately severe form was diagnosed in 66 patients, severe uncomplicated form - in 27, severe form with complications - in 21 patients. The control group comprised 23 practically healthy volunteers. The concentration of endothelin-1 in blood plasma, the contents of metabolic products of nitric oxide (II) and the activity of the angiotensin-converting enzyme in the blood serum were determined. Results. The concentration of endothelin-1 in the blood in the dynamics of the disease significantly decreased, the content of the final stable metabolites of nitric oxide (II) and the activity of the angiotensin-converting enzyme increased with statistical significance in all periods of the disease. These changes were most pronounced during severe forms of the disease with complications. Conclusion. In moderately severe and severe uncomplicated forms of the disease the endothelium is able to maintain the systemic vascular tone and tissue perfusion at a physiological level, however in severe form with complications the changes in the synthesis of vasomodulating substances may be involved in the development of complications.

endothelin-1, nitric oxide (II), angiotensin-converting enzyme, hemorrhagic fever with renal syndrome