Патогенетические предикторы осложнений новой коронавирусной инфекции SARS-COV-2

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Аннотация

Оценены патологические процессы, способствующие локальным (в месте инвазии) и системным (тромботические и фибротические проявления) осложнениям новой коронавирусной инфекции. Проанализированы особенности интернализации вируса в клетки, S-протеин-зависимые биохимические процессы, формирующие воспалительные и барьерные реакции. При исследовании вариантов уклонения вируса от систем иммунологического контроля обращено внимание на раз- общение фагоцитоза с литическими процессами, компартментализованными в лизосомах, при проникновении SARS-CoV-2 в клетки, а также на разноуровневое подавление интерферонового ответа. COVID-19 выступает мощным стрессогенным фактором, что сопряжено с нарастанием в крови кортизола, катехоламинов и лактата. В условиях гипоксии отмечены отклонения в протекании метаболических процессов и рецепции сигнальных молекул. Прослежено перераспределение ионизированного железа в прогрессии вирусного процесса и формировании его осложнений. Важную роль в формировании клеточных повреждений и перестроек структуры тканей играет системная воспалительная реакция и иммунотромбоз, сопряженный с формированием внеклеточных нейтрофильных ловушек, как формы апоптотической гибели клеток. Оценено значение метилирования ДНК, появления мобильных генетических элементов и некодирующих РНК. Формирование структурных изменений во многом сопряжено с фиброзированием, реализуемым, в частности, посредством активируемого вирусом эпителиально-мезенхимального перехода, локальная и системная коррекция которого снизит риск осложнений инфекционного процесса.

Об авторах

С. В. Чепур

Государственный научно-исследовательский испытательный институт военной медицины Минобороны России

Email: gniiivm_2@mil.ru
Санкт-Петербург, Россия

Н. Н. Плужников

Государственный научно-исследовательский испытательный институт военной медицины Минобороны России

Email: gniiivm_2@mil.ru
Санкт-Петербург, Россия

О. В. Чубарь

Государственный научно-исследовательский испытательный институт военной медицины Минобороны России

Email: gniiivm_2@mil.ru
Санкт-Петербург, Россия

Л. С. Бакулина

Воронежская государственная медицинская академия им. академика Н.Н. Бурденко Минздрава России

Email: gniiivm_2@mil.ru
Воронеж, Россия

И. В. Литвиненко

Военно-медицинская академия им. С.М. Кирова Минобороны России

Email: gniiivm_2@mil.ru
Санкт-Петербург, Россия

М. А. Тюнин

Государственный научно-исследовательский испытательный институт военной медицины Минобороны России

Email: gniiivm_2@mil.ru
Санкт-Петербург, Россия

И. А. Мясникова

Государственный научно-исследовательский испытательный институт военной медицины Минобороны России

Email: gniiivm_2@mil.ru
Санкт-Петербург, Россия

В. А. Пугач

Государственный научно-исследовательский испытательный институт военной медицины Минобороны России

Автор, ответственный за переписку.
Email: gniiivm_2@mil.ru
Санкт-Петербург, Россия

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