Določanje napovedne vrednosti indeksa oksidativnega stresa pri pacientih s potrjeno okužbo z virusom SARS-CoV-2

Pucko, Sara (avtor), Osredkar, Joško (mentor), Božnar Alič, Elizabeta (komentor)

Izbruh virusa SARS-CoV-2 (ang. Severe acute respiratory syndrome coronavirus 2) je popolnoma spremenil ustaljen način življenja in zaznamoval leto 2020 kot leto, v katerem je bila s strani Svetovne zdravstvene organizacije 11. marca razglašena pandemija, prvič v sodobnem času smo zaprli državne meje, se bili primorani izolirati od svojcev, prijateljev in se naučili živeti z maskami. Simptomi in znaki bolezni COVID-19 se razlikujejo od pacienta do pacienta, od asimptomatskih znakov do sprememb v klinični sliki in laboratorijskem izvidu, ki nakazujejo na značilnosti citokinske nevihte. Osrednji dejavnik teh stanj pa je oksidativni stres. Čedalje več študij poudarja vpliv oksidativnega stresa in prevelikih količin reaktivnih kisikovih spojin na potek okužbe. V magistrski nalogi smo se dotaknili problematike oksidativnega stresa in njegove povezave s potekom bolezni. Namen raziskave je bil ugotoviti, ali lahko s pomočjo indeksa oksidativnega stresa, ki smo ga določili na podlagi d-ROMs (ang. determination of reactive oxygen metabolites), testa za merjenje prooksidantov, in PAT (ang. plasma antioxidant capacity test), testa za merjenje antioksidantov, napovemo potek bolezni pacienta. Nadalje smo s pomočjo rezultatov d-ROMs, PAT in indeksa oksidativnega stresa (OSI, ang. oxidative stress index), opredelili stanje posameznih skupin in jih vnesli v koordinatni sistem. Na koncu smo primerjali rezultate indeksa oksidativnega stresa dveh pacientov iz intenzivne nege z biokemičnimi in hematološkimi parametri, ki so bili izmerjeni na isti dan, kot je bil odvzet vzorec za analizo oksidativnega stresa. Meritve smo izvedli na vzorcih seruma, ki smo jih razdelili v tri skupine. Prva skupina je bila kontrolna skupina, sestavljali so jo posamezniki z negativnim rezultatom RT-PCR na okužbo s SARS-CoV-2 (UKC-negativni), v drugi skupini so bili pacienti, pozitivni na SARS-CoV-2, z lažjim potekom bolezni, ki ni zahteval hospitalizacije (UKC-pozitivni), v tretji skupini pa so bili pacienti, pozitivni na SARS-CoV-2, ki so zaradi težjega poteka bolezni bili hospitalizirani na intenzivni negi (UKC-intenzivna). Postavili smo šest hipotez. Predpostavili smo, da se indeks oksidativnega stresa razlikuje med posameznimi skupinami in da lahko na podlagi tega parametra predvidevamo potek bolezni. Predpostavili smo tudi, da se stanje posamezne skupine razlikuje po rezultatih d-ROMs, PAT in OSI ter da so rezultati slednjega primerljivi z rezultati hematoloških in biokemičnih parametrov. Dokazali smo, da se indeks oksidativnega stresa statistično značilno razlikuje med kontrolno skupino in UKC-intenzivna (p = 0,024), medtem ko med skupinami UKC-pozitivni in kontrolno skupino (p = 0,272) ter UKC-pozitivni in UKC-intenzivna (p = 0,471) tega nismo dokazali. Nadalje smo s pomočjo koordinatnega sistema ugotovili, da se posamezne skupine grupirajo v različnih kvadrantih in s pomočjo rezultatov d-ROMs, PAT in OSI opisali njihovo stanje. Primerjave hematoloških in biokemičnih parametrov s parametri oksidativnega stresa so pokazale zelo dobro korelacijo. Na koncu smo prišli do zaključka, da vrednosti OSI zelo dobro napovejo potek bolezni COVID-19 in jih lahko uporabimo kot napovedni dejavnik.

• Jezik: Slovenski jezik
• Ključne besede: indeks oksidativnega stresa, prooksidanti, antioksidanti, SARS-CoV-2, oksidativni stres
• Vrsta gradiva: Magistrsko delo/naloga
• Organizacija: FFA - Fakulteta za farmacijo
• Leto izida: 2020
• PID: 20.500.12556/RUL-122411
• Datum objave v RUL: 10.12.2020

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Determining the predictive value of oxidative stress index in patients with confirmed SARS-CoV-2 infection

Izvleček

The SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) virus outbreak has completely changed our lives and marked 2020 as the year in which a pandemic was declared on March 11th by the World Health Organization. Borders were closed for the first time in modern world, we were isolated from our relatives, friends and learnt to live with masks. Symptoms and signs differ from patient to patient; some are asymptomatic and some contain important changes in clinical and laboratory examinations, indicating the presence of cytokine storm characteristics. One common factor connecting all these conditions is oxidative stress. More and more studies suggest the involvement of oxidative stress and the excessive amount of reactive oxygen species in the progression of the infection. In this master thesis, we focused on the association of oxidative stress with the severity of the disease. The aim of this research was to discover whether we can predict the outcome of the disease with the help of the oxidative stress index. The latter one was determined based on the d-ROMS (determination of reactive oxygen metabolites) test for measuring prooxidants and the PAT (plasma antioxidant capacity test) test for measuring antioxidants. In addition, we examined the conditions of each group with the d-ROM, PAT, and OSI (oxidative stress index) test results and inserted them into the coordinative system. In the end, we took a closer look at the OSI results of two patients in the intensive care and compared them with measured results of biochemical and hematological parameters. All tests were performed on the same day. Measurements were performed on the samples of a serum, while the patients were divided into three different groups: the first one was a control group consisting of individuals who were tested negative for SARS-CoV-2 (UMCL negative); in the second group we had patients with a confirmed SARS-CoV-2 infection with mild symptoms and were not hospitalized (UMCL positive); and in the third group we had patients with a confirmed SARS-CoV-2 infection and they were hospitalized in intensive care with a severe course of the COVID-19 disease (UMCL intensive care). We tested 6 hypotheses. We assumed that oxidative stress index differs between groups and that we can predict if the outcome of the disease will be good or poor according to the parameter value. We also hypothesised that the condition of individual groups differs based on the d-ROMs, PAT and OSI test results and that the OSI results correlate with the results of hematological and biochemical parameters. OSI values showed statistically significant differences between the control and UMCL intensive care group (p = 0,024). We did not prove statistical difference between the UMCL positive and control group (p = 0,272) and between UMCL positive and UMCL intensive care group (p = 0,471). Moreover, with the help of the coordinative system we discovered that groups are present in different parts; consequently, we can predict the conditions of each group. The comparisons between hematological and biochemical parameters and oxidative stress parameters correlate very well. Finally, we concluded that oxidative stress index predicts the severity of the disease and it is therefore a very good predictive factor.

• Ključne besede: oxidative stress index, prooxidants, antioxidants, SARS-CoV-2, oxidative stress