RUDN Journal of MedicineRUDN Journal of MedicineВестник Российского университета дружбы народов. Серия: Медицина2313-02452313-0261Peoples’ Friendship University of Russia named after Patrice Lumumba (RUDN University)1843610.22363/2313-0245-2018-22-1-29-42IMMUNOLOGY. INFECTIOUS PATHOLOGYИММУНОЛОГИЯ. ИНФЕКЦИОННАЯ ПАТОЛОГИЯResearch ArticleViral and bacterial coinfection as a global problem of modern medicineВирусно-бактериальные коинфекции как глобальная проблема современной медициныBalmasovaIrina PБалмасоваИрина Петровнаiri.balm@mail.ruMalovaE SМаловаЕ Сiri.balm@mail.ruSepiashviliR IСепиашвилиР Иiri.balm@mail.ruMoscow State University of Medcine and Dentistry named by A.I. EvdokimovМосковский государственный медико-стоматологический университет им. А.И.ЕвдокимоваPeoples’ Friendship University of RussiaРоссийский университет дружбы народов15122018221VOL 22, NO1 (2018)ТОМ 22, №1 (2018)294201052018Copyright ©; 2018, Balmasova I.P., Malova E.S., Sepiashvili R.I.Copyright ©; 2018, Балмасова И.П., Малова Е.С., Сепиашвили Р.И.2018Balmasova I.P., Malova E.S., Sepiashvili R.I.Балмасова И.П., Малова Е.С., Сепиашвили Р.И.http://creativecommons.org/licenses/by/4.0https://journals.rudn.ru/medicine/article/view/18436Coinfection is becoming increasingly medical-social value in the modern world, not only because of their high incidence, but also because a reliable methodological approach to their clinical evaluation, treatment and prevention is absent. This methodological approach should be based on knowledge of the mechanisms of interaction of pathogenic microorganisms with each other - direct and/or mediated through immune system. The most pathogens in сoinfections are bacteria and viruses, their association not only contributes to a severity of infection, but also greatly increases the frequency of its complications and deaths. In this review, based on the example of respiratory coinfections, malignant processes, human immunodeficiency virus associated microorganisms, the interaction of bacterial-viral pathogens examines to show their high diversity. Among the mechanisms of interaction of coinfecting agents, special attention is paid to the impact of viruses on bacterial toxin production, and bacteria on the infectivity of viruses. Coinfecting microorganisms contribute to overcoming epithelial barrier by each other, can mutually beneficial to modify the functions of the cells of the immune system and help to escape from the immune response. It was found that the gene expression of oncogenic viruses and HIV is governed by epigenomic changes caused by the bacteria that leads to carcinogenesis. It was shown that the diversity of bacterial-viral interactions in coinfections not only requires new approaches to their timely identification and control, but also generates new biotechnology and strategies for combating of coinfection development around the world.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.coinfectionviral-bacterial interactionrespiratory infectionscarcinogenesisHIV-associated bacteriathe treatment and prevention of coinfectionsкоинфекциявирусно-бактериальные взаимодействияреспираторные инфекцииканцерогенезВИЧ-ассоциированные бактериилечение и профилактика коинфекций1.Griffiths Е.С., Pedersen A.B., Fenton A., Petchey O.L. The nature and consequences of coinfection in humans // J Infect. 2011. V. 63. № 3. Р. 200-206.2.Gupta S., Tang C., Tran M., Kadouri D.E. Effect of predatory bacteria on human cell lines // PLoS ONE. 2016. V. 11. № 8. e0161242.3.Stanton T.B. A call for antibiotic alternatives research // Trends Microbiol. 2013. V. 21. № 3. 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