Вирусно-бактериальные коинфекции как глобальная проблема современной медицины

Аннотация


Коинфекции в современном мире приобретают все большее медико-социальное значение не только в связи с их широкой распространенностью, но и потому, что до настоящего времени не сформировано надежного методологического подхода ни к их клинической оценке, ни к лечению и профилактике. В основе такого методологического подхода должно лежать знание о механизмах взаимодействия патогенных микроорганизмов друг с другом - прямых и/или опосредованных иммунной системой. Наиболее частыми патогенами при коинфицировании служат бактерии и вирусы, ассоциация которых не только способствует более тяжелому течению инфекционного процесса, но и значительно повышает частоту его осложнений и летальных исходов. В данном обзоре на примере респираторных инфекций, опухолевых процессов, ассоциантов вируса иммунодефицита человека рассматриваются формы взаимодействия патогенов при бактериально-вирусных коинфекциях, показывающие их высокое разнообразие. В числе механизмов взаимодействия коинфицирующих агентов особое внимание уделяется влиянию вирусов на токсинообразование бактерий, а бактерий - на инфекционность вирусов. Коинфицирующие микроорганизмы способствуют сочетанному преодолению ими эпителиального барьера, могут взаимовыгодно модифицировать функции клеток иммунной системы и способствовать ускользанию этих патогенов от иммунного ответа. Установлено, что экспрессия генов целого ряда онкогенных вирусов и ВИЧ регулируется эпигеномными изменениями, вызванными бактериями, что приводит к канцерогенному эффекту. Показано, что разнообразие бактериально-вирусных взаимодействий при коинфицировании не только вызывает необходимость новых подходов к их своевременному распознаванию и контролю, но и порождает новые биотехнологии и стратегии борьбы с коинфицированием, развитию которых во всем мире уделяется огромное внимание.

Ирина Петровна Балмасова

iri.balm@mail.ru
Московский государственный медико-стоматологический университет им. А.И.Евдокимова; Российский университет дружбы народов

Е С Малова

iri.balm@mail.ru
Российский университет дружбы народов

Р И Сепиашвили

iri.balm@mail.ru
Российский университет дружбы народов

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© Балмасова И.П., Малова Е.С., Сепиашвили Р.И., 2018

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