medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-4-199-204medsovet-6109Research ArticleИНФЕКЦИОННЫЕ БОЛЕЗНИINFECTIOUS DISEASESЭндотелиальные прогениторные клетки в патогенезе новой коронавирусной инфекцииEndothelial progenitor cells in pathogenesis of new coronaviral infectionhttps://orcid.org/0000-0002-1166-9717КузубоваН. А.KuzubovaN. A.

Кузубова Наталия Анатольевна, доктор медицинских наук, заместитель директора по научной работе Научно-исследовательского института пульмонологии

197022, Санкт-Петербург, ул. Льва Толстого, д. 6–8

Natalia A. Kuzubova, Dr. Sci. (Med.), Deputy Director for Science of Research Institute of Pulmonology

6–8, Lev Tolstoy St., St Petersburg, 197022

kuzubova@mail.ruhttps://orcid.org/0000-0003-4678-3904ТитоваО. Н.TitovaO. N.

Титова Ольга Николаевна, доктор медицинских наук, профессор, директор Научно-исследовательского института пульмонологии

197022, Санкт-Петербург, ул. Льва Толстого, д. 6–8

Olga N. Titova, Dr. Sci. (Med.), Professor, Director of Research Institute of Pulmonology

6–8, Lev Tolstoy St., St Petersburg, 197022

titova-on@mail.ruhttps://orcid.org/0000-0001-6887-0166ЛебедеваЕ. С.LebedevaE. S.

Лебедева Елена Сергеевна, кандидат биологических наук, ведущий научный сотрудник Научно-исследовательского института пульмонологии

197022, Санкт-Петербург, ул. Льва Толстого, д. 6–8

Elena S. Lebedeva, Cand. Sci. (Bio.), Leading Research Associate of Research Institute of Pulmonology

6–8, Lev Tolstoy St., St Petersburg, 197022

osmelena@mail.ruhttps://orcid.org/0000-0001-6712-5121ВолчковаЕ. В.VolchkovaE. V.

Волчкова Елизавета Владимировна, аспирант кафедры анестезиологии, реаниматологии и неотложной педиатрии факультета послевузовского и дополнительного профессионального образования

194100, Санкт-Петербург, ул. Литовская, д. 2

Elizaveta V. Volchkova, Postgraduate Student, Department of Anesthesiology, Resuscitation and Emergency Pediatrics, Faculty of Postgraduate and Additional Professional Education

2, Litovskaya St., St Petersburg, 194100

elizavetavolch@mail.ruПервый Санкт-Петербургский государственный медицинский университет имени академика И.П. ПавловаРоссияPavlov First Saint Petersburg State Medical UniversityRussian FederationСанкт-Петербургский государственный педиатрический медицинский университетРоссияSt Petersburg State Pediatric Medical UniversityRussian Federation20212004202104199204Copyright © Кузубова Н.А., Титова О.Н., Лебедева Е.С., Волчкова Е.В., 20212021Кузубова Н.А., Титова О.Н., Лебедева Е.С., Волчкова Е.В.Kuzubova N.A., Titova O.N., Lebedeva E.S., Volchkova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6109

Дисфункция эндотелия легочных сосудов является одним из основных патогенетических факторов, обусловливающих многие клинические проявления тяжелого течения COVID-19. Циркулирующие эндотелиальные прогениторные клетки (ЭПК) представляют собой эндогенный регенеративный резерв, обеспечивающий поддержание целостности сосудистого эндотелия и его восстановление в случае повреждения патогенными факторами. Снижение количества циркулирующих ЭПК считается предиктором заболеваемости и смертности при состояниях, сопряженных с развитием эндотелиальной дисфункции, к числу которых относится COVID-19. Точный фенотип клеток-предшественников, способных дифференцироваться именно в эндотелиальные клетки, до сих пор не определен. В большинстве лабораторий для идентификации ЭПК используются антигены CD133+, CD34+, VEGFR-2+ (CD 309) или их комбинации. Процесс мобилизации и миграции ЭПК в организме управляется молекулярными сигналами от иммунных клеток, находящихся в зоне повреждения. Стромальный клеточный фактор 1 (SDF-1), вырабатываемый костным мозгом и многими другими тканями, является важным направляющим хемоаттрактантом для ЭПК, экспрессирующих его рецепторы на своей поверхности. Результаты исследований, выполненных в 2020 г., свидетельствуют о том, что вирус SARS-Cov-2 поражает гематопоэтические стволовые клетки, способные трансформироваться в ЭПК, и сами циркулирующие ЭПК, вызывая воспалительные и прокоагуляционные реакции, осложняющие течение COVID-19. Отсутствует единое мнение относительно механизма инфицирования ЭПК коронавирусом: напрямую через экспрессию рецепторов ангиотензинпревращающего фермента 2 (АПФ2) или посредством АПФ2-независимого механизма. На сегодняшний день не существует эффективной терапии COVID-19. Использование присущего ЭПК регенеративного потенциала, поиск способов усиления мобилизации ЭПК из депо и повышения их функциональной активности могут стать перспективным подходом к предупреждению тяжелых осложнений и смертности от COVID-19.

Pulmonary vascular endothelium dysfunction is one of the main pathogenic factors responsible for many clinical manifestations of the severe course of COVID-19. Circulating endothelial progenitor cells (EPCs) are the endogenous regenerative reserve that maintains the integrity of the vascular endothelium and its restoration in case of damage by pathogenic factors. A decrease in the circulating EPCs is regarded as a predictor of morbidity and mortality in conditions associated with development of endothelial dysfunction, including COVID-19. The exact phenotype of progenitor cells capable of differentiating into endothelial cells has not been determined. In most laboratories antigens CD133+, CD34+, VEGFR-2+ (CD 309) or combination of these are used to identify EPCs. The process of EPCs mobilization and migration is controlled by molecular signals from immune cells located in the damage area. Stromal cell factor 1 (SDF-1), produced by the bone marrow and many other tissues, is an important chemoattractant for EPCs which express its receptors. The results of studies carried out in 2020 indicate that SARS-Cov-2 infects both hematopoietic stem cells, transforming into EPCs, and directly circulating EPCs, causing inflammatory and procoagulant reactions that complicate the COVID-19 course. There is no consensus on the mechanism of EPCs infection with coronavirus – directly through the expression of angiotensin-converting enzyme (ACE2) receptor or through an ACE2-independent mechanism. Today there is no effective therapy for COVID-19. The use of the EPCs regenerative potential, and the search for ways to enhance the EPCs mobilization from the depot, and increase their functional activity may become a promising approach to the prevention of severe complications and mortality from COVID-19.

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