IMMUNE STATUS AND CYTOKINE SPECTRUM AS PREDICTORS OF THE RISK OF SEVERE DISEASE AND PERFORMANCE INDICATORS OF INTENSIVE THERAPY IN PATIENTS WITH CORONAVIRUS INFECTION COVID-19

The pandemic caused by a new strain of the SARS-CoV-2 coronavirus has swept the whole world but effective methods for treating this severe pathology have not yet been created. It has now been established that a risk of a severe course of COVID-19 is not so much a patient's age itself, but so-called age-related diseases;the renin-angiotensin system (RAS) is directly or indirectly involved into their development. The SARS-CoV-19 virus interacts with one of the main regulatory elements of this system, ACE2, and disrupts the balance between the two RAS branches. This ultimately manifests itself in an increase in levels of angiotensin II, which, through binding to the angiotensin type 1 receptor (AT1R), causes a number of pathological conditions, including hypertension, atherosclerosis, and cardiovascular diseases, enhances cell proliferation, apoptosis, death of vascular endothelial cells, etc. This process has been described in many reviews by Russian and foreign authors. However, cells of innate and adaptive immunity are another less well-described but no less important target of angiotensin II. The consequences of this interaction are analyzed in detail in this review. With COVID-19, dendritic cells are activated, macrophage proliferation and neutrophil infiltration increase with further involvement of CD4-lymphocytes and other cellular elements of the adaptive immunity in this process. Hyperactivation of the immune system is accompanied with the release of a large amount of pro-inflammatory cytokines, which can lead to the occurrence of a cytokine storm. The picture is aggravated by the inhibitory effect produced by the virus itself on the synthesis of signaling interferons at initial stages in its internalization into the cell. A separate section in the review addresses the problem how to predict a risk of a developing serious condition and search for its predictors by analyzing the state of the RAS and ratios of key cellular elements in the immune system. This is extremely important for making decisions concerning the amount of necessary medical care and strategies for subsequent treatment. © Sadykov V.F., Poltavtseva R.A., Chaplygina A.V., Bobkova N.V., 2022

The balance between two branches of ras can protect from severe COVID-19 course

The COVID-19 pandemic has spread all over the world and required the mobilization of the efforts of scientists and doctors to develop new methods of treatment this serious disease. Along with research of the SARS- C6V-2 virology, understanding of the fundamental physiological processes, molecular cell mechanisms and intracellular signaling pathways underlying the clinical manifestations of COVID-19 is important for the rational design of effective therapy. The review describes in details the interaction of the components of the renin-angiotensin system (RAS) and receptor for advanced glycation end products (RAGE), which plays a special role in normal lung physiology and pathology in COVID-19, up to the development of acute respiratory distress syndrome and cytokine storm. A separate section presents modern approaches for correcting RAS dysfunction caused by binding the virus to angiotensin converting enzyme 2(ACE2), a central component of this system. Analysis of published theoretical, clinical, and experimental data suggests the need for complex treatment to prevent severe COVID-19 course using MasR agonists, blockers of AT1R and NF-κB signaling pathway, as well as compounds with neuroprotective and regenerative effects. © 2021 Russian Academy of Sciences, Institute of Archaeology. All rights reserved.

The Balance between Two Branches of RAS Can Protect from Severe COVID-19 Course.

The COVID-19 pandemic has swept the world and required the mobilization of scientists and clinicians around the world to combat this serious disease. Along with SARS-CoV-2 virology research, understanding of the fundamental physiological processes, molecular and cellular mechanisms and intracellular signaling pathways underlying the clinical manifestations of COVID-19 is important for effective therapy of this disease. The review describes in detail the interaction of the components of the renin-angiotensin system (RAS) and receptors of end-glycosylated products (RAGE), which plays a special role in normal lung physiology and in pathological conditions in COVID-19, including the development of acute respiratory distress syndrome and "cytokine storm". A separate section is devoted to the latest developments aimed at correcting the dysfunction of the RAS caused by the binding of the virus to angiotensin converting enzyme 2 (ACE2)- the central element of this system. Analysis of published theoretical, clinical, and experimental data indicates the need for a complex treatment to prevent a severe course of COVID-19 using MasR agonists, blockers of the AT1R and NF-κB signaling pathway, as well as compounds with neuroprotective and neuroregenerative effects.