medbioМедико-биологические проблемы жизнедеятельностиMedical and Biological Problems of Life Activity2074-2088Республиканский научно-практический центр радиационной медицины и экологии человека10.58708/2074-2088.2025-1(33)-66-72medbio-405Research ArticleМЕДИКО-БИОЛОГИЧЕСКИЕ ПРОБЛЕМЫMEDICAL-BIOLOGICAL PROBLEMSХарактер воспалительной реакции в лёгочной паренхиме пациентов с разным клиническим течением COVID-19Character of inflammatory response in pulmonary parenchyma of patients with different clinical courses of COVID-19КорнееваМ. А.KorneevaM. A.

Марина Александровна Корнеева

Минск

Minsk

mari.derewianko@mail.ruСемёникИ. А.SiamionikI. A.

Ирина Александровна Семёник

Минск

Minsk

irina.derewianko@yandex.byЧеботарьА. О.ChabatarA. O.

Анастасия Олеговна Чеботарь

Минск

Minsk

anastasia.parashchenko99@gmail.comРябцеваС. Н.RjabtsevaS. N.

Светлана Николаевна Рябцева

Минск

Minsk

sveta.rjabceva@tut.byГузовС. А.GuzovS. A.

Сергей Андреевич Гузов

Минск

Minsk

guzsa.57@mail.ruГНУ «Институт физиологии НАН Беларуси»Institute of Physiology of the National Academy of Sciences of BelarusУЗ «Городское клиническое патологоанатомическое бюро»UZ "City Clinical Pathology Bureau"202527042025016672Copyright © Корнеева М.А., Семёник И.А., Чеботарь А.О., Рябцева С.Н., Гузов С.А., 20252025Корнеева М.А., Семёник И.А., Чеботарь А.О., Рябцева С.Н., Гузов С.А.Korneeva M.A., Siamionik I.A., Chabatar A.O., Rjabtseva S.N., Guzov S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medbio.ejournal.by/jour/article/view/405

   В статье представлены новые отличительные черты иммунной реакции в лёгочной паренхиме пациентов с верифицированной инфекцией COVID-19, выявленные при анализе характера иммуногистохимической экспрессии маркеров CD8, CD4 и IL-6. Оценена связь между гистологическими изменениями паренхимы лёгких пациентов и тяжестью клинических проявлений COVID-19. Изучена экспрессия IL-6 как одного из основных медиаторов цитокинового шторма. Установлено, что в паренхиме лёгких пациентов, инфицированных SARS-CoV-2, выявлена атипичная экспрессия маркеров CD4 и CD8 в цитоплазме альвеолярных макрофагов и десквамированных пневмоцитов II типа. При развитии цитокинового шторма у пациентов, инфицированных вирусом SARS-CoV-2, запускается механизм формирования раннего интерстициального фиброза лёгких, выраженность и тяжесть которого зависят от клинико-лабораторных показателей цитокинового шторма.

   COVID-19 presents with a wide range of symptoms and is classified as an infectious disease in which an excessive inflammatory response is the main cause of poor clinical outcome. Further research into the issues of pathogenesis, morphogenesis, especially features of the inflammatory response during infection caused by the SARS-CoV-2 virus is promising.

   The aim of this study was to evaluate the relationship between histological changes in the lung parenchyma of patients and the severity of clinical manifestations of COVID-19.

   The object of the study was lung tissue from patients with verified new coronavirus infection SARS-CoV-2 using PCR testing and hospital records of patients.

   Immunohistochemical analysis with CD8 and CD4 antibodies was performed to identify cytotoxic and helper T lymphocytes in lung tissue. The expression of IL-6 as one of the main mediators of the cytokine storm was studied. It was found that in the lung parenchyma of patients infected with the new strain of coronavirus SARS-CoV-2, atypical expression of CD4 and CD8 markers was detected in the cytoplasm of alveolar macrophages and desquamated type II pneumocytes. With the development of a cytokine storm in patients infected with the SARS-CoV-2 virus, a mechanism for the formation of early interstitial pulmonary fibrosis is triggered, the severity of which depends on the clinical and laboratory parameters of the cytokine storm.

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The authors declare that there are no conflicts of interest present.