Вопросы вирусологии. 2022; 67: 115-125
Проблема применения интерферонов при новой коронавирусной инфекции COVID-19 (Coronaviridae: Coronavirinae: Betacoronavirus: Sarbecovirus)
https://doi.org/10.36233/0507-4088-103Аннотация
К концу 2021 г. в мире зарегистрировано около 200 исследований по изучению влияния интерферонов (ИФН, IFN) на заболеваемость новой коронавирусной инфекцией COVID-19 (Coronaviridae: Coronavirinae: Betacoronavirus: Sarbecovirus) и её течение, при этом количество таких работ неуклонно возрастает. В настоящем обзоре рассмотрены основные вопросы применения препаратов IFN при этом заболевании. Поиск литературы проводился по базам данных PubMed, Scopus, Cochrane Library, Web of Science, РИНЦ, а также в базе препринтов Google Scholar с использованием доступных поисковых запросов «MeSH для коронавируса», «SARS-CoV-2», «препараты IFN», «COVID-19». Следует считать показанным раннее назначение интерферонотерапии (в первые 5 сут поступления пациента) в случаях лёгкого и среднетяжёлого течения COVID-19, чтобы воспользоваться узким окном терапевтического воздействия IFN. Для контроля и подавления репликации возбудителя требуется лечение препаратами этого класса и другими эффективными противовирусными средствами, ингибирующими репродукцию SARS-CoV-2 и индуцирующими ряд интерферон-стимулированных генов (interferon-stimulated genes, ISG), продукты экспрессии которых контролируют противовирусную активность и запускают механизмы элиминации патогена. IFN I типа (IFN-I) проявляют мощные провоспалительные свойства и активируют широкий спектр клеток различных типов, реагирующих на стимуляцию этими молекулами и внедрение вируса. В то же время IFN-III обеспечивают местный противовирусный иммунитет на слизистых оболочках, не приводя к развитию сильного системного провоспалительного ответа, присущего IFN-I. Использование препаратов IFN в терапии новой коронавирусной инфекции требует осторожного и дифференцированного подхода, так как в тяжёлых случаях они способны усугублять вирусный патогенез, обусловливая чрезмерную интенсивность воспалительных реакций. Уникальные биологические свойства веществ этого класса позволяют рассматривать их в качестве терапевтических средств с большим потенциалом применения у пациентов с COVID-19.
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Problems of Virology. 2022; 67: 115-125
The problem of the use of interferons in the novel coronavirus disease COVID-19 (Coronaviridae: Coronavirinae: Betacoronavirus: Sarbecovirus)
https://doi.org/10.36233/0507-4088-103Abstract
By the end of 2021, about 200 studies on the effect of interferons (IFNs) on the incidence and course of the new coronavirus infection COVID-19 (Coronaviridae: Coronavirinae: Betacoronavirus: Sarbecovirus) have been reported worldwide, with the number of such studies steadily increasing. This review discusses the main issues of the use of IFN drugs in this disease. The literature search was carried out in the PubMed, Scopus, Cochrane Library, Web of Science, RSCI databases, as well as in the Google Scholar preprint database using the available search queries «MeSH for coronavirus», «SARS-CoV-2», «IFN drugs», and «COVID-19». Interferon therapy is indicated for early administration (within the first 5 days of patient admission) in cases of mild to moderate COVID-19 to take advantage of the narrow therapeutic window of IFNs action. Control and suppression of viral replication requires therapy with IFNs and other effective antiviral agents that inhibit the reproduction of SARS-CoV-2 and induce several interferon-stimulated genes (ISG). Type I IFNs (IFN-I) exhibit potent pro-inflammatory properties and activate a wide variety of different cell types that respond to IFNs stimulation and pathogen entry. IFN-III confer local mucosal antiviral immunity without inducing the strong systemic pro-inflammatory responses associated with IFN-I. The use of IFNs drugs in the therapy of new coronavirus infection requires a cautious and differentiated approach, because in severe cases they can aggravate viral pathogenesis by causing excessive intensity of inflammatory reactions. The unique biological properties of substances of this class allow us to consider them as therapeutic agents with significant potential for use in patients with COVID-19.
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