cfpdБюллетень физиологии и патологии дыханияBulletin Physiology and Pathology of Respiration1998-5029Дальневосточный научный центр физиологии и патологии дыхания10.36604/1998-5029-2025-95-149-160cfpd-1242Research ArticleОБЗОРЫREVIEWSМеханизмы повреждающего воздействия атипичных возбудителей на респираторный эпителий: инфекционная и постинфекционная гиперреактивность дыхательных путей у детейMechanisms of damaging effects of atypical pathogens on respiratory epithelium: infectious and post-infectious airway hyperresponsiveness in childrenМанукянА. С.ManukyanA. S.

Айкуш Славиковна Манукян, аспирант, младший научный сотрудник, лаборатория механизмов вирус-ассоциированных патологий развития

675000, г. Благовещенск, ул. Калинина, 22

Aykush S. Manukyan, Postgraduate Student, Junior Staff Scientist, Laboratory of Mechanisms of Virus-Associated Developmental Pathologies

22 Kalinina Str., Blagoveshchensk, 675000

ПриходькоА.PrikhodkoA. G.

Анна Григорьевна Приходько, д-р мед. наук, главный научный сотрудник, лаборатория функциональных методов исследования дыхательной системы

675000, г. Благовещенск, ул. Калинина, 22

Аnnа G. Prikhodko, MD, PhD, DSc (Med.), Main Staff Scientist, Laboratory of Functional Research of Respiratory System

22 Kalinina Str., Blagoveshchensk, 675000

prih-anya@ya.ruФедеральное государственное бюджетное научное учреждение «Дальневосточный научный центр физиологии и патологии дыхания»РоссияFar Eastern Scientific Center of Physiology and Pathology of RespirationRussian Federation202520032025095149160Copyright © Манукян А.С., Приходько А.G., 20252025Манукян А.С., Приходько А.Manukyan A.S., Prikhodko A.G.This work is licensed under a Creative Commons Attribution 4.0 License.https://cfpd.elpub.ru/jour/article/view/1242

Цель – проанализировать и обобщить имеющиеся на сегодняшнем этапе данные литературы о роли атипичных респираторных патогенов (Mycoplasma pneumoniae и Chlamydia pneumoniae) в развитии гиперреактивности дыхательных путей у детей. В статье представлены основные механизмы, посредством которых M. pneumoniae и Ch. pneumoniae могут повреждать клетки респираторного эпителия и способствовать формированию гиперреактивности бронхов. Показано, что повреждение эпителия происходит как напрямую, за счет истощения питательных ресурсов, окислительного стресса и нарушения механизмов восстановления, так и опосредованно, через иммунные механизмы, включая выработку специфических иммуноглобулин E-антител и дисбаланс цитокинов. Выделены особенности атипичных патогенов, приводящие к развитию тяжелых осложнений: продукция токсина внебольничного респираторного дистресс-синдрома (CARDS TX) M. pneumoniae, липополисахарида и белка теплового шока 60 Ch. pneumoniae. Отдельный раздел посвящен способности атипичных возбудителей формировать биоплёнки для повышения выживаемости и патогенности. Подчеркнуто, что повреждённый эпителий, в свою очередь, индуцирует продукцию провоспалительных медиаторов, тем самым усугубляя воспаление дыхательных путей и способствуя в ряде случаев формированию бронхиальной гиперреактивности. Раскрытие механизмов повреждающего воздействия атипичных возбудителей на дыхательные пути, по мнению авторов, позволит разработать новые подходы к диагностике, профилактике и лечению респираторных заболеваний у детей.

The aim of this review was to analyze and summarize the current literature on the role of atypical respiratory pathogens (Mycoplasma pneumoniae and Chlamydia pneumoniae) in the development of airway hyperresponsiveness in children. The article presents the main mechanisms through which M. pneumoniae and Ch. pneumoniae can damage respiratory epithelial cells and contribute to the formation of bronchial hyperresponsiveness. It is shown that epithelial damage occurs both directly, through the depletion of nutrient resources, oxidative stress, and disruption of repair mechanisms, and indirectly, through immune mechanisms, including the production of specific immunoglobulin E antibodies and cytokine imbalance. Key characteristics of atypical pathogens leading to severe complications are highlighted, including: the production of the community-acquired respiratory distress syndrome (CARDS TX) toxin by M. pneumoniae, and the production of lipopolysaccharides and heat shock protein 60 (HSP60) by Ch. pneumoniae. A separate section is dedicated to the ability of atypical pathogens to form biofilms to enhance survival and pathogenicity. It is emphasized that damaged epithelium, in turn, induces the production of pro-inflammatory mediators, thereby exacerbating airway inflammation and contributing, in some cases, to the development of bronchial hyperresponsiveness. The authors believe that elucidating the mechanisms by which atypical pathogens damage the respiratory tract will facilitate the development of new approaches to the diagnosis, prevention, and treatment of respiratory diseases in children.  

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