Возможности иммунотерапии в лечении COVID-19

Обложка
  • Авторы: Малкова А.М.1, Старшинова А.А.2, Кудрявцев И.В.3,4, Довгалюк И.Ф.5, Зинченко Ю.С.5, Кудлай Д.А.6,7
  • Учреждения:
    1. ФГБОУ ВО «Санкт-Петербургский государственный университет»
    2. ФГБУ «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава России
    3. ФГБНУ «Институт экспериментальной медицины»
    4. ФГАОУ ВО «Дальневосточный федеральный университет»
    5. ФГБУ «Санкт-Петербургский научно-исследовательский институт фтизиопульмонологии» Минздрава России
    6. ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)
    7. ФГБУ «Государственный научный центр «Институт иммунологии» ФМБА России
  • Выпуск: Том 20, № 3 (2021)
  • Страницы: 158-168
  • Раздел: ОБЗОР ЛИТЕРАТУРЫ
  • Статья получена: 08.10.2021
  • Статья одобрена: 08.10.2021
  • Статья опубликована: 08.10.2021
  • URL: https://hemoncim.com/jour/article/view/556
  • DOI: https://doi.org/10.24287/1726-1708-2021-20-3-158-168
  • ID: 556

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Полный текст

Аннотация

Достаточно высокую смертность при COVID-19 можно объяснить развитием гипервоспалительного синдрома, характеризующегося цитокиновым штормом и обширным тромбообразованием. Основным направлением по предотвращению развития гипервоспалительного синдрома и по снижению летальности от COVID-19 является иммунная терапия, однако данные об эффективности и критериях назначения иммунных препаратов весьма разнородны. Целью данного обзора является анализ результатов клинических исследований по применению различных видов иммунной терапии при COVID-19 и возможных критериев ее назначения. Анализ литературных данных показал, что из существующих вариантов иммунной терапии наиболее эффективными оказались моноклональные антитела к IL-6, а также использование плазмы доноров на ранних этапах лечения. Ингибиторы янус-киназы, внутривенный иммуноглобулин способствовали улучшению клинического состояния пациентов, однако не влияли на уровень смертности. Авторами статьи был проведен анализ возможных маркеров предикторов развития цитокиновгого шторма. Наибольшую информативность и доступность в клинической практике на данный момент показали повышение количества нейтрофилов > 11 × 103/мл, снижение количества лимфоцитов > 1000 × 103/мл, повышение уровня IL-6 > 24 пг/мл, лактатдегидрогеназы > 300 МЕ/л, Д-димера > 1000 нг/мл и С-реактивного белка > 10 мг/дл.

Об авторах

А. М. Малкова

ФГБОУ ВО «Санкт-Петербургский государственный университет»

ORCID iD: 0000-0002-3880-1781

Санкт-Петербург

Россия

А. А. Старшинова

ФГБУ «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава России

Автор, ответственный за переписку.
Email: starshinova_777@mail.ru
ORCID iD: 0000-0002-9023-6986

Старшинова Анна Андреевна, д-р мед. наук, начальник Управления научными исследованиями

197341, Cанкт-Петербург, ул. Аккуратова, 2

Россия

И. В. Кудрявцев

ФГБНУ «Институт экспериментальной медицины»; ФГАОУ ВО «Дальневосточный федеральный университет»

Санкт-Петербург

Владивосток

Россия

И. Ф. Довгалюк

ФГБУ «Санкт-Петербургский научно-исследовательский институт фтизиопульмонологии» Минздрава России

ORCID iD: 0000-0001-8383-8519

Санкт-Петербург

Россия

Ю. С. Зинченко

ФГБУ «Санкт-Петербургский научно-исследовательский институт фтизиопульмонологии» Минздрава России

ORCID iD: 0000-0002-6273-4304

Санкт-Петербург

Россия

Д. А. Кудлай

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет); ФГБУ «Государственный научный центр «Институт иммунологии» ФМБА России

ORCID iD: 0000-0003-1878-4467

Москва

Россия

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© Малкова А.М., Старшинова А.А., Кудрявцев И.В., Довгалюк И.Ф., Зинченко Ю.С., Кудлай Д.А., 2021

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