Патологическое воспаление у пациентов с COVID-19: ключевая роль моноцитов и макрофагов
Оригинал: Nature Reviews Immunology
Специальность: Иммунология
Автор: M. Merad, J.C. Martin
Опубликовано: 06.05.2020
Перевод: Елена Алексеенкова, Фонд профилактики рака
Аннотация
Пандемия COVID-19, вызванная коронавирусом SARS-CoV-2, привела к гибели более 200 000 человек во всем мире. По данным ряда исследований, индуцированное SARS-CoV-2 гипервоспаление выступает ведущей причиной развития тяжелого заболевания и летальных исходов у инфицированных пациентов. Макрофаги являются клеточной популяцией системы врожденного иммунитета, они распознают микробные факторы, в ответ вырабатывают медиаторы воспаления, устраняют патогены и способствуют восстановлению тканей. Тем не менее, для хозяина нарушение деятельности макрофагов может оказаться губительным. Это происходит, например, при синдроме активации макрофагов, который индуцируется некоторыми тяжело протекающими инфекциями, в том числе инфекцией, вызванной вирусом SARS-CoV-2. В данной статье описано потенциальное патологическое воздействие макрофагов на течение вызванной SARS-CoV-2 инфекции, а также рассматриваются существующие и перспективные стратегии лечения, направленные на модуляцию активации макрофагов у пациентов с COVID-19.
Заключение
На сегодняшний день только начинают появляться данные об иммунном и воспалительном статусе пациентов с COVID-19, однако уже очевидно, что гипервоспалительная реакция и коагулопатия усугубляют тяжелое течение заболевания и способствуют летальному исходу у инфицированных SARS-CoV-2 пациентов. Для разработки обоснованной стратегии терапии необходимо более четкое представление о том, какие группы пациентов являются уязвимыми с точки зрения развития патологического воспаления и какие именно воспалительные пути оказываются задействованы в развитии заболевания. Крайне важно начать детальное исследование в текущем времени параметров системной и, в перспективе, локальной воспалительной реакции, индуцируемой SARS-CoV-2, а также воздействие на воспаление методами лечения, которые применяются в качестве стандарта терапии или изучаются в клинических исследованиях. В разгар пандемии крайне трудно заниматься научной деятельностью, однако на клинические центры, располагающие ресурсами для проведения подобных исследований, теперь возложена ответственность инициировать такие исследования и делиться полученными результатами с научным сообществом.
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