Рациональная стратегия поддержания противовирусного иммунитета к новым вариантам SARS-COV-2

Автор: В.П. Баклаушев, Г.М. Юсубалиева, М.В. Бычинин, С.М. Юсубалиева, В.А. Кальсин, А.В. Троицкий

Журнал: Клиническая практика @clinpractice

Статья в выпуске: 3 т.13, 2022 года.

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Новые варианты вируса SARS-CoV-2 Омикрон BA.2, BA.4/5, BA.2.12.1 и BA.2.75 характеризуются более высокой заразностью и способностью ускользать от вируснейтрализующих антител, выработанных против других, более ранних вариантов коронавируса. S-тример BA.2 и его филогенетических потомков характеризуется преимущественным конформационным Uр-положением, облегчающим взаимодействие с ACE2 на клетках-мишенях. Иммунитет, приобретаемый в результате инфицирования SARS-CoV-2, является нестерильным как для ранних, так и для более поздних вариантов вируса; бустерная системная иммунизация значимо не влияет на эффективность защитного иммунитета против новых штаммов, и в настоящее время ее целесообразность ставит- ся под сомнение. Исследования мукозального иммунного ответа показали, что интраназальная иммунизация аденовирусными вакцинами способствует выработке большего защитного иммунитета, чем системная реиммунизация, как с точки зрения титра секреторных IgA, обеспечивающих элиминацию вируса со слизистых оболочек, так и в плане активации специфических клонов Т-клеток. Для обеспечения последнего может иметь значение не только иммунизация S-белком, но и дополнительная интраназальная иммунизация N-белком, активирующая большее количество клонов Т-клеток, распознающих соответствующие консервативные пептидные эпитопы N-белка. Перспективным является создание мультивалентных ингаляционных вакцин, содержащих иммуноадъюванты, активирующие В- и Т-клеточный ответ в бронхоальвеолярном дереве. В настоящее время большое количество интраназальных вакцин проходит испытание I/II фазы: доклинические и предварительные клинические результаты свидетельствуют о том, что при та- ком способе вакцинации иммунный ответ в месте входа вируса — на слизистых оболочках — осуществляется гораздо более эффективно, чем при системной иммунизации. Эта стратегия может обеспечить продолжительную иммунную защиту от уже существующих и еще неизвестных новых штаммов SARS-CoV-2.

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COVID-19, ковид, SARS-CoV-2, Омикрон BA.1, BA.2, BA.4, BA.5, BA.2.75, вируснейтрализующие антитела, мукозальный иммунный ответ, интраназальная иммунизация, назальные вакцины

Короткий адрес: https://sciup.org/143179226

IDR: 143179226

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