Prognostic markers for the course of brucellosis infection

Abstract

Introduction. Studies have shown that hemostatic disorders in brucellosis develop due to the systemic nature of the infection and lead to endothelial dysfunction. The state of the hemostatic system in brucellosis infection remains virtually unstudied, which warrants further research. Identification of diagnostic markers can help assess the prognosis of the disease and early detection of the risk for developing vascular complications. The aim of the study was to determine markers of the anticoagulant hemostatic system and the importance of vascular endothelial factor in assessing the prognosis of brucellosis. Methods. The study included patients diagnosed with acute brucellosis (n = 78) who were admitted to the Brucellosis Department of Stavropol and the hospital for infectious diseases of the Republic of Dagestan. The study material was blood serum/plasma from patients with acute brucellosis. The control group consisted of 34 individuals who had not had brucellosis and were not vaccinated against this infection. The plasma concentration of antithrombin III was measured by the chromogenic method; the concentration of protein C was determined photometrically; the concentration of fibrinogen was measured using an automatic analyzer; soluble fibrin-monomer complexes (SFMC) were assessed by the orthophenanthroline test; and the concentration of vascular endothelial growth factor (VEGF) was determined by the enzyme-linked immunosorbent assay (ELISA). Results. In the acute phase of the disease, patients with brucellosis had decreases in the plasma concentrations of primary anticoagulants (antithrombin III, protein C), an increase in fibrinogen, and, as a consequence, an increase in the concentration of the secondary anticoagulant (SFMC) relative to the control group. The concentration of the endothelial marker, vascular endothelial factor, was increased. Conclusion. Long-term persistence of brucellosis leads to a rather lengthy, but not pronounced inflammation that results in the development of a protective adaptive reaction aimed at maintaining the hemostatic system. The studied indicators (antithrombin III, protein C, fibrinogen, SFMC, VEGF) are diagnostically significant in assessing the prognosis of the course of brucellosis infection.Introduction.