mimmunМедицинская иммунологияMedical Immunology (Russia)1563-06252313-741XSPb RAACI10.15789/1563-0625-PRR-3328mimmun-3328Research ArticleОБЗОРЫREVIEWSПаттерн-распознающие рецепторы и их роль в иммунопатогенезе пневмонииPattern recognition receptors and their role in immunopathogenesis of pneumoniahttps://orcid.org/0000-0002-4806-050XЗолотовМ. О.ZolotovM. O.

Золотов Максим Олегович – к.м.н., доцент кафедры медицинской микробиологии и иммунологии, заведующий лабораторией трансляционных технологий и междисциплинарных связей научно-образовательного профессионального центра генетических и лабораторных технологий 

443079, г. Самара, ул. Гагарина, 20

Maxim O. Zolotov - PhD (Medicine), Associate Professor, Department of Medical Microbiology and Immunology; Head, Laboratory of Translational Technologies and Interdisciplinary Relations at the Professional Center for Education and Research in Genetic and Laboratory Technologies

20 Gagarin St Samara 443079

m.o.zolotov@samsmu.ruhttps://orcid.org/0000-0003-0941-9871МигачеваН. Б.MigachevaN. B.

Д.м.н., доцент, заведующий кафедрой педиатрии ИПО

Самара

PhD, MD (Medicine), Associate Professor, Head, Department of Pediatrics

Samara

n.b.migacheva@samsmu.ruhttps://orcid.org/0000-0002-5905-1895ЛяминА. В.LyaminA. V.

Д.м.н., доцент, профессор кафедры медицинской микробиологии и иммунологии, директор научно-образовательного профессионального центра генетических и лабораторных технологий 

Самара

PhD, MD (Medicine), Associate Professor, Professor, Department of Medical Microbiology and Immunology; Director, Professional Center for Education and Research in Genetic and Laboratory Technologies

Samara

a.v.lyamin@samsmu.ruФГБОУ ВО «Самарский государственный медицинский университет» Министерства здравоохранения РФРоссияSamara State Medical UniversityRussian Federation202620062026282241252Copyright © Золотов М.О., Мигачева Н.Б., Лямин А.В., 20262026Золотов М.О., Мигачева Н.Б., Лямин А.В.Zolotov M.O., Migacheva N.B., Lyamin A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mimmun.ru/mimmun/article/view/3328

Неспецифическое связывание антигенов обеспечивают т. н. паттерн-распознающие (образ-распознающие) рецепторы (PRR). PRR могут располагаться на мембране клетки, в цитозоле и в растворимом виде в сыворотке крови. К мембранным относятся: TOLL-подобные рецепторы (TLR), лектиновые рецепторы С-типа, рецепторы-мусорщики. В цитозоле располагаются TLR, NOD-подобные рецепторы, RIG-I-подобные рецепторы, AIM-2-подобные рецепторы. К растворимым относятся пентраксины, коллектины, фиколины. После попадания микроорганизма в легкие в первую очередь в иммунный ответ вовлекаются неспецифические факторы защиты и механизмы врожденного иммунитета. При неэффективности неспецифического распознавания патогенов возникает формирование очага пневмонии. В этой связи представляет интерес роль PRR в развитии внебольничной пневмонии. Для поиска источников литературы был проведен анализ научных баз Scopus, Web of Science, Pubmed, CyberLeninka, РИНЦ. В исследованиях продемонстрировано значение TLR4 в борьбе с грамположительными и грамотрицательными микроорганизмами. Уровень лектинового рецептора sCD206 в крови установлен в качестве предиктора тяжелого течения пневмонии и летального исхода. Повышенная продукция рецептора-мусорщика CD5-подобного рецептора наблюдается при пневмонии, вызванной S. aureus. NOD-подобные рецепторы играют важную роль в борьбе с Acinetobacter baumannii. Пентраксины выполняют множество функций: являются опсонинами, активируют комплемент по классическому пути, активируют нейтрофилы, регулируют хемотаксис и апоптоз. Повышение уровня CRP в крови у взрослых соответствует тяжести заболевания. Определение уровня CRP позволяет отличить пневмонию от других острых респираторных заболеваний. В исследованиях большое внимание уделяется PTX3 как фактору, с помощью которого возможно определение тяжести и прогноза пневмонии. MBL распознает капсульные липополисахариды, липосахариды клеточной стенки грамотрицательных бактерий, липоарабиноманнаны, маннаны грибов, гликопротеины SARS-CoV-2, PAMP простейших и гельминтов. Фиколины взаимодействует с вирусными, бактериальными и грибковыми антигенами. L-фиколин распознает пневмолизин пневмококка, активирует комплемент по лектиновому пути, чем нейтрализует токсин. Таким образом, важнейшая роль факторов врожденного иммунитета в патогенезе пневмонии не вызывает сомнений, но требует проведения дальнейших исследований. Изучение механизмов иммунопатогенеза заболевания позволит разработать новые прогностические модели и повысить эффективность терапии, особенно при тяжелом течении пневмонии.

Non-specific binding of antigens is provided by the so-called pattern recognition receptors (PRR) that may be located on the cell membrane, in the cytosol, or, as soluble molecules in the blood serum. Membrane receptors include: Toll-like receptors, C-type lectin receptors, scavenger receptors. TLR, NOD-like receptors, RIG-I-like receptors, AIM-2-like receptors are located in the cytosol. Soluble receptors include pentraxins, collectins, and ficolins. After entering a microorganism to lung spaces, the non-specific defense factors and innate immunity mechanisms are primarily involved in the immune response. If non-specific recognition of pathogens is ineffective, a pneumonia focus is formed. In this regard, the role of PRR in the development of community-acquired pneumonia is quite significant. To search for literature appropriate publications, an analysis of the research databases Scopus, Web of Science, Pubmed, CyberLeninka, and RINC was conducted. The studies have demonstrated the importance of TLR4 in combating both Gram-positive and Gram-negative microorganisms. In addition, the blood levels of sCD206 lectin receptor have been considered a predictor of severe pneumonia and lethal outcomes. Increased production of a CD5-like scavenger receptor was observed in pneumonia caused by S.aureus. NOD-like receptors play an important role in defense against Acinetobacter baumannii. Pentraxins perform many functions: they exhibit opsonic properties, activate complement via the classical pathway, activate neutrophils, and regulate chemotaxis and apoptosis. In adult patients with pneumonia, elevated blood CRP levels correspond to disease severity; measurement of CRP levels helps differentiate pneumonia from other acute respiratory infections. PTX3 is a factor that can help determine the severity and prognosis of pneumonia. Mannane-binding lectin (MBL) recognizes bacterial lipopolysaccharides (LPS) in capsular layer, or cell wall of Gram-negative bacteria, lipoarabinomannans, fungal mannans, SARSCoV-2 glycoproteins, PAMP of protozoa and helminths. Ficolins interact with viral, bacterial and fungal antigens. L-ficolin recognizes pneumococcal pneumolysin, activates complement via the lectin pathway, thereby neutralizing the toxin. Thus, a critical role of innate immunity factors in pathogenesis of pneumonia is well proven but requires further research. Studying the mechanisms of disease immunopathogenesis will allow development of new prognostic models and improve the efficiency of therapy, especially in severe cases of pneumonia.

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