actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.29413/ABS.2026-11.3.2actabiomedica-6170Research ArticleИНФЕКЦИОННЫЕ БОЛЕЗНИINFECTIOUS DISEASESПрогноз риска развития постковидных нарушений с использованием маркеров NLRP3 и GSDMD у пациентов с бронхиальной астмой, перенесших COVID-19Risk prediction of post-COVID conditions using NLRP3 and GSDMD markers in patients with bronchial asthma after COVID-19https://orcid.org/0000-0003-1721-6548ЛобоваТ. Г.LobovaT. G.

 

690105, Владивосток, ул. Русская, 73 г

Tatyana G. Lobova – Graduate Student.

Russkaya str. 73g. Vladivostok 690105

lobova.tg@dvfu.ruhttps://orcid.org/0000-0002-1009-9011ВиткинаТ. И.VitkinaT. I.

690105, Владивосток, ул. Русская, 73 г

Tatyana I. Vitkina – Dr. Sc. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Laboratory of Medical Ecology and Recreational Resources.

Russkaya str. 73g. Vladivostok 690105

Владивостокский филиал Федерального государственного бюджетного научного учреждения «Дальневосточный научный центр физиологии и патологии дыхания – Научно-исследовательский институт медицинской климатологии и восстановительного лечения»РоссияVladivostok Branch of the Far Eastern Scientific Center of Physiology and Pathology of Respiration – Institute of Medical Climatology and Rehabilitative TreatmentRussian Federation2026020820261131218Copyright © Лобова Т.Г., Виткина Т.И., 20262026Лобова Т.Г., Виткина Т.И.Lobova T.G., Vitkina T.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/6170Обоснование

Обоснование. Одним из ключевых факторов запуска каскада гипервоспаления при сочетании бронхиальной астмы и COVID-19 предполагается активация вирусом SARS-CoV-2 цитозольных комплексов NLRP3 и белка GSDMD, являющихся эффекторными молекулами для литической и воспалительной формы пироптоза.

Цель

Цель. Определение прогностических критериев утяжеления течения легкой бронхиальной астмы (БА) на фоне перенесённого инфекционного заболевания, вызванного SARS-CoV-2.

Материалы и методы

Материалы и методы. У пациентов с легкой, частично контролируемой бронхиальной астмой (n = 86), которые были разделены на 2 группы: БА без COVID-19 (n = 34) и БА после легкой формы течения COVID-19 (n = 52) проведена оценка маркеров воспаления в периферической крови. Пациенты были обследованы сразу после выздоровления и подтверждения отрицательного результата теста на SARS-COV-2, и через шесть месяцев после заражения. В контрольную группу вошли условно здоровые добровольцы (n = 15), которые не болели COVID-19. Проводился мониторинг функции внешнего дыхания ФЖЕЛ, ОФВ1, ОФВ1/ФЖЕЛ. Инфламмасомы NLRP3, газдермин D определяли методом иммуноферментного анализа.

Результаты

Результаты. Исследование выявило, что у ряда пациентов с легкой астмой, у которых спустя 6 месяцев после COVID-19 сохраняются постковидные нарушения, отмечено повышение уровней инфламмасомы NLRP3 и газдермина D (GSDMD), а также снижение функции внешнего дыхания, что указывает на гипервоспалительный процесс. Разработан способ прогноза утяжеления лёгкой астмы после COVID-19: одновременное превышение уровней NLRP3 > 0,04 ng/ml и GSDMD > 0,38 ng/ml в периоде реконвалесценции служит маркером высокого риска постковидных осложнений.

Заключение

Заключение. Установлена роль NLRP3, GSDMD в утяжелении течения БА после COVID-19, выделены прогнозные пороговые значения биомаркеров у данного контингента пациентов.

Background

Background. One of the key factors in triggering the hyperinflammation cascade in patients with bronchial asthma and COVID-19 is the activation of NLRP3 cytosolic complexes and the GSDMD proteins by SARS-CoV-2, which are effector molecules for the lytic and inflammatory forms of pyroptosis.

Aim

Aim. To determine prognostic criteria for worsening of mild bronchial asthma following an infectious disease caused by SARS-CoV-2.

Materials and Methods

Materials and Methods. In patients with mild, partially controlled bronchial asthma (n = 86), who were divided into 2 groups: asthma without COVID-19 (n = 34) and asthma following mild COVID-19 (n = 52), peripheral blood inflammatory markers were evaluated. The patients were examined immediately after recovery and confirmation of a negative SARS-COV-2 test result, and six months post-infection. The control group included conditionally healthy volunteers (n = 15) with no history of COVID-19. Pulmonary function was monitored by measuring FVCL, OFV1, and OFV1/FVCL. NLRP3 and gasdermin D inflammasomes were measured by enzyme-linked immunosorbent assay.

Results

Results. The study revealed that in a number of patients with mild asthma, who had post-COVID conditions 6 months after COVID 19, there were elevated levels of NLRP3 inflammasome and gasdermin D (GSDMD), as well as a decreased pulmonary function, indicating a hyperinflammatory process. A predictive model for worsening of mild asthma after COVID-19 was developed: concurrent elevation of NLRP3 > 0.04 ng/ml and GSDMD > 0.38 ng/ml levels during the convalescence period serves as a marker of a high risk of post-COVID complications.

Conclusion

Conclusion. The role of NLRP3 and GSDMD in exacerbating the course of asthma after COVID-19 has been established, and predictive threshold values of biomarkers in this patient population have been identified.

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The authors declare that there are no conflicts of interest present.