Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia.
School of Medical Biology, South Ural State University, 454080 Chelyabinsk, Russia.
Int J Mol Sci. 2021 Jul 15;22(14):7582. doi: 10.3390/ijms22147582.
The COVID-19 pandemic examines not only the state of actual health care but also the state of fundamental medicine in various countries. Pro-inflammatory processes extend far beyond the classical concepts of inflammation. They manifest themselves in a variety of ways, beginning with extreme physiology, then allostasis at low-grade inflammation, and finally the shockogenic phenomenon of "inflammatory systemic microcirculation". The pathogenetic core of critical situations, including COVID-19, is this phenomenon. Microcirculatory abnormalities, on the other hand, lie at the heart of a specific type of general pathological process known as systemic inflammation (SI). Systemic inflammatory response, cytokine release, cytokine storm, and thrombo-inflammatory syndrome are all terms that refer to different aspects of SI. As a result, the metabolic syndrome model does not adequately reflect the pathophysiology of persistent low-grade systemic inflammation (ChSLGI). Diseases associated with ChSLGI, on the other hand, are risk factors for a severe COVID-19 course. The review examines the role of hypoxia, metabolic dysfunction, scavenger receptors, and pattern-recognition receptors, as well as the processes of the hemophagocytic syndrome, in the systemic alteration and development of SI in COVID-19.
COVID-19 大流行不仅检验了实际医疗保健的状况,也检验了各国基础医学的状况。促炎过程远远超出了经典炎症概念的范围。它们以多种方式表现出来,从极端生理学开始,然后是低度炎症的全身适应,最后是“炎症性全身微循环”的休克发生现象。包括 COVID-19 在内的危急情况的发病核心是这种现象。另一方面,微循环异常是一种称为全身炎症(SI)的特定类型全身性病理过程的核心。全身炎症反应、细胞因子释放、细胞因子风暴和血栓炎症综合征都是指 SI 的不同方面。因此,代谢综合征模型不能充分反映持续性低度全身炎症(ChSLGI)的病理生理学。另一方面,与 ChSLGI 相关的疾病是 COVID-19 严重病程的危险因素。该综述探讨了缺氧、代谢功能障碍、清道夫受体和模式识别受体以及噬血细胞综合征的过程在 COVID-19 中全身改变和 SI 发展中的作用。