РОЛЬ АНГИОТЕНЗИНПРЕВРАЩАЮЩЕГО ФЕРМЕНТА 2 В РАЗВИТИИ ЭНДОТЕЛИАЛЬНОЙ ДИСФУНКЦИИ ПРИ COVID-19

Резюме.

Цель: предметно-содержательный анализ публикаций, посвящённых изучению ангиотензинпревращающего фермента 2 и его роли в развитии эндотелиальной дисфункции при COVID-19.

Материалы и методы. Были проанализированы 24 отечественные и зарубежные статьи, описывающие строение и функцию ангиотензинпревращающего фермента 2, а также его роль в развитии эндотелиальной дисфункции при COVID-19, опубликованные за последние 5 лет.

Результаты и их обсуждение. Молекулы ангиотензинпревращающего фермента 2, расположенные на поверхности эндотелиоцитов, играют важную роль в развитии эндотелиальной дисфункции и связанной с ней сепсис-индуцированной коагулопатии и васкулопатии, являясь рецепторами, связывающими коронавирус SARS-CoV-2, и тем самым обеспечивают внедрение патогена в клетку. Внедрение вируса SARS-CoV-2 в эндотелиоциты и их повреждение под влиянием провоспалительных цитокинов и активированных клеток врожденного иммунитета, индуцирует продукцию «маркеров эндотелиальной дисфункции», что способствует изменению гемостаза в сторону гиперкоагуляции.

Заключение. Посредством ангиотензинпревращающего фермента 2 реализуется проникновение в клетки вируса SARS-CoV-2 и запуск патофизиологического каскада, приводящего к развитию дисфункции эндотелия, иммунотромбозу, «цитокиновому шторму» и полиорганной недостаточности.

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