dysregulation of nrf2, caspase-1, and survivin in peripheral blood of iranian patients with severe covid-19: a qrt-pcr analysis

Background :sars-cov-2 can lead to both acute and chronic inflammation. objectives :this study aims to investigate the expression levels of nuclear factor erythroid 2-related factor 2 (nrf2, also known as nfe2l2), caspase-1, and birc5 in hospitalized patients with sars-cov-2. methods :the expression levels of nrf2, caspase-1, and birc5 were evaluated in 100 individuals, comprising 70 hospitalized patients infected with sars-cov-2 and 30 uninfected individuals as a control group. all participants were in the initial stages of their illness, within 24 hours of experiencing symptoms, and had not yet received any treatment for sars-cov-2. the mrna was extracted from blood samples, converted to cdna, and analyzed using real-time pcr. gene expression between groups was compared using the mann-whitney u test. correlations between gene expression levels were assessed using spearman's rank correlation coefficient. results :the expression of caspase-1 was significantly higher in patients compared to healthy controls (p = 0.008). the median relative expression of birc5 was significantly lower in patients than in healthy controls (p < 0.001). the nrf2 expression showed a trend towards higher expression in infected patients, although the differences in nrf2 expression between the groups did not reach statistical significance (p = 0.081). correlation analysis revealed statistically significant positive associations between birc5 and nef2l2 (rs = 0.585, p < 0.001), between birc5 and caspase-1 (rs = 0.613, p < 0.001), and between caspase-1 and nef2l2 (rs = 0.618, p < 0.001). conclusions :the positive correlations observed among birc5, nrf2, and caspase-1 underscore the interconnectedness of these pathways in the inflammatory response to severe covid-19. these findings contribute to our understanding of the molecular mechanisms underlying covid-19 and may inform future therapeutic strategies aimed at modulating inflammation in affected patients.