Цитокіновий шторм у патогенезі ускладнень при COVID-19
Анотація
Мета – аналіз та узагальнення результатів новітніх досліджень щодо ролі цитокінового шторму в патогенезі ускладнень COVID-19 та визначенні клінічних і патологічних ознак наслідків цитокінового шторму в пацієнтів, які перенесли COVID-19.
У статті розглянуто роль прозапальних і протизапальних чинників цитокінової мережі у формуванні імунної відповіді на COVID-19, наведено характеристику цитокінового шторму, як неадекватної реакції вродженого та адаптивного імунітету при інфекційних хворобах та COVID-19, проаналізовано можливі механізми розвитку цитокінового шторму, його вплив на важкість перебігу COVID-19 та розвиток ускладнень у разі цієї інфекції. Мультифакторний аналіз представлених у світовій практиці результатів досліджень у цьому напрямку підтверджує наукові гіпотези щодо провідного внеску цитокінового шторму в патогенез ускладнень при COVID-19. За даними численних досліджень, цитокіновий шторм та неконтрольоване запалення визнані визначальними чинниками в патогенезі розвитку ускладнень та летального результату в пацієнтів, інфікованих вірусом SARS-CoV-2. Незаперечним є той факт, що тригером для цитокінового шторму є неконтрольована імунна відповідь, яка характеризується безперервною активацією та експансією імунних клітин, що продукують величезну кількість прозапальних цитокінів не лише системно, а й локально, що призводить до ураження органів. Цей каскад патологічних імунних реакцій може відбуватися послідовно або паралельно в різних органах і системах організму, що призводить до мультиорганноїнедостатності та смерті пацієнта.
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