ROLE OF CYTOTOXIC SUBSTANCES OF NEUTROPHILS AND CLARA CELL PROTEIN IN DEVELOPMENT OF ACUTE RESPIRATORY DISTRESS SYNDROME AT VIRUS PNEUMONIA
The study of transmitter interactions of development stages of inflammation caused by A/H1N1 was done from uncomplicated influenza to pneumonia and acute respiratory distress syndrome development. In 52 patients with various forms of influenza A/H1N1, 16 of whom developed acute respiratory distress syndrome, the content of neutrophils mediators (α-defensins, elastase, myeloperoxidase and their local inhibitors - Clara cell protein) was determined in the blood plasma. It is shown that in case of uncomplicated influenza the level of α-defensins, elastase, and myeloperoxidase increases against the unchanging amount of Clara cell protein. With the development of pneumonia, compared with uncomplicated influenza, the concentration of elastase and myeloperoxidase increases while the concentration of α-defensins decreases against the unchanging amount of Clara cell protein. With the development of acute respiratory distress syndrome the amount of Clara cell protein decreases sharply and the number of other mediators remains at the level of patients with pneumonia. Conclusions: one of the mechanisms of pneumonia development is the increased concentration of neutrophil elastase, myeloperoxidase with the formation of the relative Clara cell protein deficiency and decreased α-defensins; the decrease of Clara cell protein concentration can be one of the predictors of acute respiratory distress syndrome development.