jofinЖурнал инфектологииJournal Infectology2072-6732IPO “АIDSSPbR"10.22625/2072-6732-2019-11-2-26-34jofin-880Research ArticleОбзорReviewТромбоциты при инвазивном аспергиллезе: роль в патогенезе и иммунной защитеPlatelets in invasive aspergillosis: role in pathogenesis and immune defenseСеребрянаяН. Б.SerebryanayaN. B.

Серебряная Наталья Борисовна – профессор кафедры клинической микологии, аллергологии и иммунологии Северо-Западного государственного медицинского университета им. И.И. Мечникова; ведущий научный сотрудник отдела общей патологии и патологический физиологии Института экспериментальной медицины; профессор кафедры гистологии и цитологии Санкт-Петербургского государственного университета, доктор медицинских наук, профессор 

serebr@gmail.comЯкуцениП. П.YakutseniP. P.

Якуцени Павел Павлович – главный научный сотрудник Центра перспективных исследований 

Санкт-Петербург

ypp@csa.ruКлимкоН. Н.KlimkoN. N.

Климко Николай Николаевич – заведующий кафедрой клинической микологии, аллергологии и иммунологии, доктор медицинских наук, профессор

Санкт-Петербург

n_klimko@mail.ruСеверо-Западный государственный медицинский университет им. И.И. Мечникова; Институт экспериментальной медицины; Санкт-Петербургский государственный университетРоссияNorth-Western State Medical University named after I.I. Mechnikov; Institute of Experimental Medicine; Saint-Petersburg State UniversityRussian FederationСанкт-Петербургский политехнический университет Петра ВеликогоРоссияPeter the Great Saint-Petersburg Polytechnic UniversityRussian FederationСеверо-Западный государственный медицинский университет им. И.И. МечниковаРоссияNorth-Western State Medical University named after I.I. MechnikovRussian Federation2019160520191122634Copyright © Серебряная Н.Б., Якуцени П.П., Климко Н.Н., 20192019Серебряная Н.Б., Якуцени П.П., Климко Н.Н.Serebryanaya N.B., Yakutseni P.P., Klimko N.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.niidi.ru/jofin/article/view/880

Инвазивный аспергиллез – тяжелое заболевание, при котором летальность может достигать 80%. Aspergillus fumigatus – самый частый возбудитель заболевания, ангионвазивный патоген, фрагменты гифов которого могут циркулировать в кровотоке. Тромбоциты активируются поверхностными структурами, метаболитами и растворимыми грибковыми комплексами, после чего наблюдается их адгезия к конидиям и гифам гриба. Содержащиеся в конидиях меланин и гидрофобин, а также содержащийся в гифах галактозаминогалактан и секретируемый гифами глиотоксин подавляют фагоцитирующие клетки, но активируют тромбоциты. Активированные тромбоциты проявляют прямую противогрибковую активность путем высвобождения микробицидных белков и серотонина, а также формируют интерактивную сеть с клеточными компонентами иммунной системы и системой комплемента, увеличивая ответ нейтрофилов и моноцитов. В присутствии тромбоцитов существенно усиливается эффективность антимикотиков. Неблагоприятные эффекты активации тромбоцитов при инвазивном аспергиллезе связаны с развитием легочного кровотечения и инфарктов различных органов. Другой опасностью, связанной с инвазивным аспергиллезом, является развитие тромбоцитопении. Тромбоцитопения определена как независимый фактор риска летальности при инвазивном аспергиллезе у онкогематологических больных после аллогенной трансплантации гемопоэтических стволовых клеток. Изучение количества и функционального состояния тромбоцитов позволит создать новые методы прогнозирования и лечения инвазивного аспергиллеза.

Invasive aspergillosis (IA) is a serious disease, with mortality rate up to 80%. A. fumigatus is an angiovasive pathogen, fragments of its hyphae can detach and circulate in the bloodstream. Platelets are activated by surface structures, metabolites and soluble fungal complexes, resulting in adhesion to conidia and fungal hyphae. The melanin and hydrophobin contained in the conidia, as well as the galactosaminogalactan contained in the hyphae and the glyphotoxin secreted by the hyphae, suppress phagocytic cells, but activate the platelets. Activated platelets show direct antifungal activity by releasing microbicidal proteins and serotonin. In addition to direct antifungal effect, platelets form an interactive network with cellular components of the immune system and a complement system, increasing the response of neutrophils and monocytes. In the presence of platelets, the efficacy of antimycotics is greatly enhanced. The adverse effects of platelet activation in IA are associated with clinical conditions such as hemoptysis, pulmonary hemorrhage and infarctions of various organs. Another danger associated with IA is the development of thrombocytopenia. Thrombocytopenia is defined as an independent risk factor of mortality in IA in oncohematological patients after allogeneic transplantation of hematopoietic stem cells. Numerous evidences of the important role of platelets in protection from A. fumigatus suggest that the study of the number and functional state of platelets will provide a new data, which will help develop new methods for prediction and treatment of IA.

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