cfpdБюллетень физиологии и патологии дыханияBulletin Physiology and Pathology of Respiration1998-5029Дальневосточный научный центр физиологии и патологии дыхания10.36604/1998-5029-2022-85-143-150cfpd-1049Research ArticleОБЗОРЫREVIEWSНейтрофильные внеклеточные ловушки в патогенезе акушерских осложнений при COVID-19 (краткий обзор литературы)Neutrophil extracellular traps in the pathogenesis of obstetric complications in COVID-19 (brief review)ЖуковскаяО. В.ZhukovskayaO. V.

Ольга Валерьевна Жуковская, аспирант, лаборатория механизмов этиопатогенеза и восстановительных процессов дыхательной системы при неспецифических заболеваниях легких

675000, г. Благовещенск, ул. Калинина, 22

Olga V. Zhukovskaya, Postgraduate Student, Laboratory of Mechanisms of Etiopathogenesis and Recovery Processes of the Respiratory System at Non-Specific Lung Diseases

2 Kalinina Str., Blagoveshchensk, 675000

zhuchka.85@mail.ruФедеральное государственное бюджетное научное учреждение «Дальневосточный научный центр физиологии и патологии дыхания»Far Eastern Scientific Center of Physiology and Pathology of Respiration202223092022085143150Copyright © Жуковская О.В., 20222022Жуковская О.В.Zhukovskaya O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cfpd.elpub.ru/jour/article/view/1049

Введение. В патогенезе новой коронавирусной инфекции (COVID-19) важное значение имеют врожденные клеточные элементы иммунной системы, среди которых особое внимание уделяется нейтрофилам и механизмам их гибели – нетозу, что приводит к образованию внеклеточных ДНК-ловушек. Нейтрофильные внеклеточные ловушки играют важную роль в развитии эндотелиальной дисфункции и тромботических нарушений, что не только осложняет течение COVID-19 инфекции, но и является причиной тяжелых акушерских осложнений, увеличивающих риск материнской и младенческой смертности. В настоящем обзоре описываются возможные механизмы образования нейтрофильных внеклеточных ловушек, а также их роль в патогенезе СOVID-19.Материалы и методы. Проведен анализ российской (eLibrary) и зарубежной (PubMed) литературы с глубиной поиска 2010-2021 гг.Результаты. Патогенез COVID-19 непосредственно связан с неконтролируемым прогрессированием системного воспаления, изменяющим врожденный иммунный ответ в виде функциональной дезадаптации и преждевременной гибели нейтрофилов с образованием нейтрофильных внеклеточных ловушек. Нетозно трансформированные нейтрофилы играют ключевую роль в развитии тромботических нарушений микроциркуляторного русла, что приводит к развитию жизнеугрожающих осложнений в виде острого респираторного дистресс-синдрома и полиорганной недостаточности, повышающей летальность пациентов с COVID-19 инфекцией. При беременности усиленное образование нейтрофильных внеклеточных ловушек является причиной нарушения гемодинамики фетоплацентарного комплекса, плацентарных нарушений и эндотелиальной дисфункции, сопутствующей развитию преждевременных родов и преэклампсии, увеличивающей риск послеродовых кровотечений, материнской заболеваемости и смертности. Следовательно, новые данные о нейтрофильных внеклеточных ловушках и механизмах образования могут привести к пересмотру патогенеза тромботических нарушений у беременных женщин с COVID-19 инфекцией, что имеет значение для дальнейшей тактики ведения беременности.

Introduction. In the pathogenesis of the new coronavirus infection (COVID-19), innate cellular elements of the immune system are of great importance, among which special attention is paid to neutrophils and the mechanisms of their death – netosis, which leads to the formation of extracellular DNA traps. Neutrophil extracellular traps play an important role in the development of endothelial dysfunction and thrombotic disorders, which not only complicates the course of COVID-19 infection, but also causes severe obstetric complications that increase the risk of maternal and infant mortality. This review describes possible mechanisms for the formation of neutrophil extracellular traps, as well as their role in the pathogenesis of COVID-19.Materials and methods. An analysis of Russian (eLibrary) and foreign (PubMed) literature was carried out with a search depth of 2010-2021.Results. The pathogenesis of COVID-19 is directly related to the uncontrolled progression of systemic inflammation, which changes the innate immune response in the form of functional maladaptation and premature death of neutrophils with the formation of neutrophil extracellular traps. The neutrophils that were transformed by netosis play a key role in the development of thrombotic disorders of the microvasculature, which leads to the development of life-threatening complications such as acute respiratory distress syndrome and multiple organ failure, which increases the mortality of patients with COVID-19 infection. During pregnancy, increased formation of neutrophilic extracellular traps is the cause of hemodynamic disturbances of the fetoplacental complex, placental disorders and endothelial dysfunction, concomitant with the development of preterm labor and preeclampsia, which increases the risk of postpartum hemorrhage, maternal morbidity and mortality. Therefore, new data on neutrophil extracellular traps and mechanisms of formation may lead to a reconsideration of the pathogenesis of thrombotic disorders in pregnant women with COVID-19 infection, which is important for further management of pregnancy.

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The authors declare that there are no conflicts of interest present.