Клеточный иммунитет у больных COVID-19: молекулярная биология, патофизиология и клиническое значение

Клеточный иммунитет у больных COVID-19: молекулярная биология, патофизиология и клиническое значение

Автор: Щербак Сергей Григорьевич, Вологжанин Дмитрий Александрович, Голота Александр Сергеевич, Камилова Татьяна Аскаровна, Макаренко Станислав Вячеславович

Журнал: Клиническая практика @clinpractice

Рубрика: Обзоры

Статья в выпуске: 2 т.13, 2022 года.

Бесплатный доступ

Пандемия COVID-19 вызвана коронавирусом SARS-CoV-2. С точки зрения того, что имеет значение для сдерживания вируса, наибольшее внимание привлекают нейтрализующие антитела к SARS-CoV-2, однако важно признать значение вирусспецифичного Т-клеточного ответа, который закладывает основу для эффективной выработки нейтрализующих антител. Большинство людей с инфекцией SARS-CoV-2 выживают и избавляются от вируса. Т-клеточные ответы развиваются рано, но относительно ослаблены при тяжелом течении заболевания, отчасти по причине лимфопении. Понимание роли различных субпопуляций Т-клеток в защите или патогенезе COVID-19 имеет решающее значение для профилактики и лечения. Профиль экспрессии различных Т-клеточных субпопуляций различается при COVID-19 различной степени тяжести и ассоциирован с величиной ответов Т-клеток и исходом заболевания. Структурные изменения генома, транскриптома и протеома SARS-CoV-2 способствуют появлению новых вариантов вируса, могут уменьшить его взаимодействие с антителами и таким образом помочь избежать нейтрализации. Существует сильная корреляция между количеством вирусспецифичных Т-клеток CD4 и титрами нейтрализующих антител IgG против SARS-CoV-2. Во время первичной вирусной инфекции наблюдается широкий разброс клеточных и гуморальных иммунных ответов, при этом пациенты с тяжелыми и продолжительными симптомами демонстрируют крайне несбалансированные клеточные и гуморальные иммунные ответы. В этом обзоре внимание уделяется генерации и клиническому значению клеточного иммунитета в защите от тяжелой острой инфекции и реинфекции, а также потенциальному участию перекрестно-реактивных Т-клеток, специфичных к сезонным коронавирусам, в ответе на SARS-CoV-2.

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Covid-19, коронавирус sars-cov-2, клеточный иммунитет, иммунологическая память, нейтрализующие антитела, перекрестно-реактивный иммунитет

Короткий адрес: https://sciup.org/143178798

IDR: 143178798   |   DOI: 10.17816/clinpract106239

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