МЕХАНИЗМЫ РАЗВИТИЯ ЦИТОКИНОВОГО ШТОРМА ПРИ COVID-19 И НОВЫЕ ПОТЕНЦИАЛЬНЫЕ МИШЕНИ ФАРМАКОТЕРАПИИ

Для тяжёлых форм COVID-19 характерно развитие «цитокинового шторма» – состояния неконтролируемого высвобождения большого количества медиаторов воспаления. Присоединение S-гликопротеина SARS-CoV-2 к ангиотензин-превращающему ферменту 2 рассматривается как процесс, запускающий сложные молекулярные взаимодейтсвия, которые приводят к гипервоспалению, которое в свою очередь реализуется через несколько систем: ренин-ангиотензин-альдостероновую, калликреин-кининовую и систему комплемента. Знание данных механизмов позволяет предположить потенциальные точки терапевтического вмешательства, на которые можно воздействовать существующими терапевтическими средствами для противостояния «цитокиновому шторму» и лечения острого респираторного дистресс-синдрома, связанного с COVID-19.

Цель. В обзоре обобщаются известные на сегодняшний день данные по молекулярным процессам, лежащим в основе неконтролируемого «цитокинового шторма» у пациентов с тяжёлой формой COVID-19 и возможные варианты их фармакологической коррекции.

Материалы и методы. В системах Medline, Cochrane Central Register of Controlled Trials, Scopus, Web of Science Core Collection, Cochrane Library, ClinicalTrials.gov, Elibrary, Google-академия был проведен поиск по ключевым словам и комбинации этих слов: COVID-19, ренин-ангиотензин-альдостероновая система, брадикинин, система комплемента, гиалуроновая кислота, фармакотерапия.

Результаты. Развитие «цитокинового шторма» при COVID-19 опосредованно патогенетическими изменениями, происходящими в организме в ответ на проникновения SARS-CoV-2 в клетку. В РААС подавление АПФ2 приводит к снижению его способности расщеплять АТII,

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