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Инфекция и иммунитет

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Некоторые возможности иммунотерапии при коронавирусной инфекции

https://doi.org/10.15789/2220-7619-SPO-1470

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Аннотация

Обзор посвящен анализу средств иммуномодулирующей терапии при коронавирусной инфекции, вызванной SARS-CoV-2 (COVID-19). Как известно, существует очень ограниченный арсенал относительно эффективных средств и методов профилактики и лечения COVID-19. Цель подготовленного обзора литературы — проанализировать некоторые терапевтические подходы к терапии COVID-19 с позиций воздействия на систему врожденного иммунитета. Одним из средств с доказанной терапевтической эффективностью является серотерапия плазмой, полученной из крови выздоравливающих больных. Показано, что переливание плазмы сопровождается сокращением вирусной нагрузки и купированием симптомов заболевания. Недостатком серотерапии является ограниченное количество потенциальных доноров плазмы и значительное варьирование содержания в донорской плазме титров специфических антител. Другим подходом к терапии является применение инженерных моноклональных антител против определенных антигенных детерминант вируса, чаще всего против поверхностного спайк-антигена. Антитела, блокирующие этот антиген, способны предотвратить проникновение вируса в клетку и развитие манифестной инфекции. Кроме того, имеются моноклональные антитела, предотвращающие выработку или связывающие избыточное количество провоспалительных цитокинов, таких как IL-6, TNFα и др. Некоторые из подобных антител (тоцилизумаб) уже испытаны при COVID-19, другие пока проходят исследования и испытания. Определенным прорывом в терапии стали хорошо известные препараты хлорохин и дигидрохлорохин, показавшие себя эффективными средствами противовирусной, противовоспалительной и иммуномодулирующей терапии. Наконец, был предложен новый поликомпонентный иммуномодулирующий препарат Цитовир-3, уже прошедший клинические испытания и рекомендованный к применению при профилактике и терапии гриппа и ОРВИ, который может найти свое место при профилактике COVID-19, поскольку возбудитель SARS-CoV-2 также относится к возбудителям острых респираторных вирусных инфекций. Таким образом, в арсенале средств профилактики и лечения COVID-19 имеются препараты для иммуномодулирующей терапии и профилактики иммунных нарушений, развивающихся в ответ на внедрение патогенного вируса и снижающих риск возможного ущерба. Правильное и научно обоснованное их применение позволит повысить эффективность борьбы с пандемией коронавирусной инфекции.

Об авторах

В. С. Смирнов
ФБУН НИИ эпидемиологии и микробиологии им. Пастера; АО МБНПК «Цитомед»
Россия

Смирнов Вячеслав Сергеевич, доктор медицинских наук, профессор, ведущий научный сотрудник лаборатории молекулярной иммунологии ФБУН НИИ эпидемиологии и микробиологии имени Пастера, главный научный сотрудник АО МБНПК «Цитомед»

197101, Санкт-Петербург, ул. Мира, 14

 


Арег А. Тотолян
http://pasteurorg.ru
ФБУН НИИ эпидемиологии и микробиологии им. Пастера
Россия

Тотолян Арег А., академик РАН, доктор медицинских наук, профессор, заведующий кафедрой иммунологии ГБОУ ВПО Первый Санкт-Петербургский Государственный медицинский университет им. акад. И.П. Павлова МЗ РФ; директор ФБУН НИИ эпидемиологии и микробиологии имени Пастера

Санкт-Петербург



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Для цитирования:


Смирнов В.С., Тотолян А.А. Некоторые возможности иммунотерапии при коронавирусной инфекции. Инфекция и иммунитет. 2020;10(3):446-458. https://doi.org/10.15789/2220-7619-SPO-1470

For citation:


Smirnov V.S., Totolian A.A. Some opportunities for immunotherapy in coronavirus infection. Russian Journal of Infection and Immunity. 2020;10(3):446-458. (In Russ.) https://doi.org/10.15789/2220-7619-SPO-1470

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