PATTERN RECOGNITION RECEPTORS AND THEIR ROLE IN IMMUNOPATHOGENESIS OF PNEUMONIA (LITERATURE REVIEW)

Non-specific binding of antigens is provided by the so-called pattern recognition receptors (PRR). PRR can be located on the cell membrane, in the cytosol and in soluble form 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 a microorganism enters the lungs, 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 of interest. To search for literature sources, an analysis of the scientific databases Scopus, Web of Science, Pubmed, CyberLeninka, and RINTS was conducted. Studies have demonstrated the importance of TLR4 in the fight against gram-positive and gram-negative microorganisms. In addition, the level of the lectin receptor sCD206 in the blood has been established as a predictor of severe pneumonia and death. Increased production of the scavenger receptor CD5-like receptor is observed in pneumonia caused by S.aureus. NOD-like receptors play an important role in the fight against Acinetobacter baumannii. Pentraxins perform many functions: they are opsonins, activate complement via the classical pathway, activate neutrophils, and regulate chemotaxis and apoptosis. In adults, elevated blood CRP levels correspond to disease severity. Determining CRP levels helps differentiate pneumonia from other acute respiratory infections. PTX3 is a factor that can help determine the severity and prognosis of pneumonia. MBL recognizes capsular lipopolysaccharides, lipopolysaccharides of the cell wall of gram-negative bacteria, lipoarabinomannans, fungal mannans, SARS-CoV-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, the critical role of innate immunity factors in the pathogenesis of pneumonia is beyond doubt, but requires further research. Studying the mechanisms of disease immunopathogenesis will allow the development of new prognostic models and improve the effectiveness of therapy, especially in severe cases of pneumonia.

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