Ultrastructural AFM Markers of Endogenous Intoxication in Community-Acquired Pneumonia
The aim of the investigation was to assess the information content of the parameters of atomic force microscopy to characterize the severity of endogenous intoxication in community-acquired pneumonia according to the findings of ultrastructural parameters of red blood cells.
Materials and Methods. Using atomic force microscopy we studied nanoanatomical and micromechanical indices of red blood cells in 71 patients with severe and mild community-acquired pneumonia aged 18–23 (mean age: 20.4±0.6 years) against the background of endogenous intoxication of varying severity. The control group consisted of 20 volunteers. Red blood cell samples were taken on admission, and on days 3, 7 and 14 after hospitalization. To determine their morphological features, a contact mode of nanomechanical mapping was used. Endogenous intoxication severity was assessed according to standard clinical and laboratory parameters including hematological, biochemical and immunological markers.
Results. We obtained the reference values of micromechanical parameters of erythrocyte membranes in healthy young subjects and in patients with community-acquired pneumonia of varying severity of endogenous intoxication. The values can serve as a guide for future researches in similar samplings. Viscoelasticity properties of erythrocyte membranes in the disease were found to be closely related to endotoxemia intensity. In disease progression, the elasticity modulus and adhesion force of erythrocyte membrane decreased by 5.2 and 2.4, respectively, while the strain increased by 2.6. A correlation analysis revealed the presence of strong interrelations between the parameters characterizing endogenous intoxication severity (average-weight molecules, IL-10, tumor necrosis factor, leukocyte, nuclear, hematological indices of intoxication, etc.), and micromechanical parameters of cell membranes. The indices of geometric “portrait” of red blood cells (area, diameter, rim height, etc.) did not differ significantly indicating the stability of their cytoskeleton.
Conclusion. The studies prove the information content of micromechanical parameters of erythrocyte membranes by atomic force microscopy to characterize the severity of endogenous intoxication in community-acquired pneumonia. The findings complement the presentation of pathophysiological sequelae of endogenous intoxication, their effect on the ultrastructure of cells and adaptive nature of the changes in micromechanical properties of membranes.
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