Статья

Coronavirus disease 2019 (covid-19) and immune-mediated inflammatory rheumatic diseases: At the crossroads of thromboinflammation and autoimmunity

E. Nasonov, T. Beketova, T. Reshetnyak, A. Lila, L. Ananieva, T. Lisitsyna, S. Soloviev,
2021

Inflammation and coagulation are key basic mechanism of protection against all potentially pathogenic mechanical and biological factors targeting human organism from inner and outer environment. On the other hand, uncontrolled inflammation results in hypercoagulation, inhibition of anticoagulation and alteration of mechanisms responsible for resolution of inflammation, while production of "procoagulant" mediators (thrombin, tissue factor and others), activation of platelets and of vascular endothelial cells maintains inflammation. All factors taken together serve as the basis for a pathological process called thromboinflammation or immunothrombosis. Currently thromboinflammation is considered in the broad sense as a universal pathogenetic mechanism of numerous widespread acute and chronic conditions, including immune-mediated (autoimmune) inflammatory rheumatic diseases, oftentimes complicated by severe irreversible damage to vital organs. Thromboinflammation gained specific attention during COVID-19 (coronavirus disease 2019) pandemic, caused by SARS-Cov-2 (severe acute respiratory syndrome Coronavirus-2). COVID-19 is considered currently as systemic thromboinflammation syndrome, manifesting via generalized thrombosis of arterial and venous macro- and microvasculature, termed as COVID-19-coagulopathy. The paper discusses common pathogenetic coagulopathy mechanisms in COVID-19 and immune-mediated (autoimmune) inflammatory rheumatic diseases (IMRDs), associated with overproduction of antiphospholipid antibodies, activation of the complement system, and dis-regulated synthesis of proinflammatory cytokines, etc. Delineating the autoimmune subtype of thromboinflammation, identification of genetic (i.e., genes encoding the complement system and others) and molecular-biologic biomarkers associated with higher occurrence of COVID-19-coagulopathy are the most relevant undertakings for the current practice. Gaining insights into mechanisms of thromboinflammation and converting them into potential pharmacotherapies of IMDs would facilitate and accelerate the drafting of effective therapeutic strategies for COVID-19. © 2020 Ima-Press Publishing House. All rights reserved.

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  • 1. Version of Record от 2021-04-27

Метаданные

Об авторах
  • E. Nasonov
    VA Nasonova Research Institute of Rheumatology, 34A Kashirskoye shose, Moscow, 115522, Russian Federation
  • T. Beketova
    I.M. Sechenov First Moscow State Medical University, MOH (Sechenov University), 8, Trubetskaya St., Moscow, 119991, Russian Federation
  • T. Reshetnyak
    Russian Medical Academy of Continuing Prefessional Education, Ministry of Health of Russia, 2/1 Barrikadnaya St., Moscow, 125993, Russian Federation
  • A. Lila
  • L. Ananieva
  • T. Lisitsyna
  • S. Soloviev
Название журнала
  • Nauchno-Prakticheskaya Revmatologiya
Том
  • 58
Выпуск
  • 4
Страницы
  • 353-367
Ключевые слова
  • cytokine; phospholipid antibody; antibody production; Article; autoimmunity; blood clotting disorder; complement system; coronavirus disease 2019; cytokine production; human; inflammation; pathogenesis; rheumatic disease; thrombosis
Издатель
  • Ima-Press Publishing House
Тип документа
  • journal article
Тип лицензии Creative Commons
  • CC
Правовой статус документа
  • Свободная лицензия
Источник
  • scopus