Вопросы вирусологии. 2020; 65: 317-325
Роль герпесвирусов в развитии заболеваний урогенитального тракта и бесплодия у женщин
https://doi.org/10.36233/0507-4088-2020-65-6-2Аннотация
В обзоре представлены данные о распространении всех известных герпесвирусов человека (ГВ) в урогенитальном тракте женщин. Согласно ВОЗ почти у 500 млн людей во всём мире выявлена генитальная инфекция, вызванная ГВ. Эти возбудители обнаруживаются при различных воспалительных заболеваниях в нижних и верхних отделах женского генитального тракта: при вагините, цервиците; у имеющих внематочную беременность – в фаллопиевых трубах; у страдающих бесплодием – в цервикальном канале, эндометрии, яичниках. Вирус простого герпеса 1 типа (ВПГ-1) впервые обнаружен в ооцитах женщин с неудачными по- пытками экстракорпорального оплодотворения (ЭКО). ГВ-инфекции (ГВИ) негативно влияют на все стадии репродуктивного процесса от зачатия до рождения ребёнка. Доказано, что ВПГ и цитомегаловирус (ЦМВ), а также вирус герпеса человека 6 типа (ВГЧ-6) в период беременности значительно увеличивают риск спонтанных абортов, преждевременных родов и мертворождений. Внутриутробная ГВИ – одна из ведущих причин врождённых пороков развития. В работе рассмотрены особенности гуморального и клеточного иммунитета при генитальных инфекциях герпесвирусной этиологии. Интравагинальное заражение ВПГ‑2 вызывает изменение клеточного состава слизистой оболочки влагалища; наряду с клетками, мобилизуемыми из крови, защитную роль играют резидентные Т-клетки памяти (TRM), натуральные киллеры (NK-клетки), а также регуляторные Т-клетки (Treg), функция которых – поддержание баланса активности лимфоцитов. Продолжающееся распространение ГВИ в значительной степени объясняется переходом первичной инфекции в латентную форму с последующей возможностью реактивации, так как латентный возбудитель недоступен для иммунного распознавания и действия лечебных препаратов. В последние годы разработана новая биотехнологическая система редактирования генома CRISPR/Cas9, которая в принципе способна распознавать не только активные, но и латентные вирусы и действовать на них. Первые обнадёживающие результаты открывают возможность разработки в будущем эффективных технологий элиминации ГВ и эрадикации вызываемых ими инфекций.
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Problems of Virology. 2020; 65: 317-325
The role of herpesviruses in development of diseases of the urogenital tract and infertility in women
https://doi.org/10.36233/0507-4088-2020-65-6-2Abstract
This review presents the data on the spreading of all known human herpesviruses (НHVs) in female urogenital tract. According to the WHO almost 500 million people worldwide suffer from genital infection caused by НHVs. НHVs were detected in various inflammatory diseases of female upper and lower genital tract (vaginitis and cervicitis), in extrauterine pregnancy (in fallopian tubes), in infertility (cervical channel, endometrium and ovaries). Herpes simplex virus 1 (HSV‑1) was identified for the first time in oocytes after failed in vitro fertilization (IVF). НHVs produce negative effect on the entire reproductive process from conception to childbirth. It was established that HSV, cytomegalovirus (CMV) and human herpesvirus 6 (HHV-6) markedly increase the risk of spontaneous abortion, preterm birth and stillbirth. Intrauterine НHV infection is a major cause of congenital malformations. Data on humoral and cell immunity in genital herpesvirus infections (НHVI) are also reviewed. Intravaginal HSV‑2 infection changes cell composition of vaginal mucosa, i.e., together with cells mobilized from the blood, protective role is performed by resident memory T‑cells (TRM), natural killer cells (NK‑cells) and regulatory T‑cells (Treg) whose function consists in maintaining the balance of the activities of lymphocytes. Constant НHVI spreading is largely explained by transition of primary infection to potentially reactivating latent form, since latent virus is unavailable to immune recognition and medicines. The genome editing system CRISPR/Cas9 can recognize and modify not only active but also latent viruses. The promising pilot results with the use of this system offer the possibility of developing innovative technologies for НHV elimination and НHVI eradication.
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