Тромбоциты при инвазивном аспергиллезе: роль в патогенезе и иммунной защите

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.

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