rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2016-100-104rsp-2174Research ArticleОБЗОРREVIEWОппортунистические микроорганизмы при ревматических заболеванияхOPPORTUNISTIC MICROORGANISMS IN RHEUMATIC DISEASESГульневаМ. Ю.GulnevaM. Yu.

150000 Ярославль, ул. Революционная, 5

5, Revolyutsionnaya St., Yaroslavl 150000

ch-ma@mail.ruНосковС. М.NoskovS. M.

150000 Ярославль, ул. Революционная, 5

5, Revolyutsionnaya St., Yaroslavl 150000

МалафееваЭ. В.MalafeevaE. V.

150000 Ярославль, ул. Революционная, 5

5, Revolyutsionnaya St., Yaroslavl 150000

ГБОУ ВПО «Ярославский государственный медицинский университет» Минздрава РоссииРоссияYaroslavl State Medical University, Ministry of Health of RussiaRussian Federation201623032016541100104Copyright © Гульнева М.Ю., Носков С.М., Малафеева Э.В., 20162016Гульнева М.Ю., Носков С.М., Малафеева Э.В.Gulneva M.Y., Noskov S.M., Malafeeva E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2174

Представлены данные литературы о роли оппортунистических микроорганизмов при ревматических заболеваниях (РЗ). Предполагается возможное участие условно-патогенных микроорганизмов (УПМ) в качестве триггерных факторов, инициирующих развитие хронического воспаления. Наряду с этим УПМ при аутоиммунных заболеваниях могут играть защитную роль за счет взаимодействия с Toll-like рецепторами и активации T-клеток, обладающих супрессорной активностью. Возможность участия УПМ в патогенезе РЗ подтверждает не только выделение микроорганизмов, но и обнаружение антибактериальных антител различных классов. Велико значение УПМ в этиологии коморбидных инфекций, риск развития которых обусловлен как наличием аутоиммунного РЗ, так и необходимостью применения препаратов, обладающих иммуносупрессивным действием. Активное внедрение в клиническую практику генно-инженерных биологических препаратов сопровождается нарастанием частоты и тяжести течения различных инфекций, в том числе вызванных УПМ. Оппортунистические микроорганизмы, обладая выраженной биологической и экологической пластичностью, способны длительно персистировать в условиях изменения иммунной защиты организма больных РЗ. Приводятся данные о повышении адгезивных свойств и персистентного потенциала микроорганизмов, колонизирующих организм больных РЗ. При РЗ выделяются УПМ, которые отличаются выраженной полирезистентностью к антибиотикам, что затрудняет лечение и профилактику оппортунистических инфекций в ревматологии. Результаты работ, анализируемых в обзоре, свидетельствуют о практической значимости изучения оппортунистических микроорганизмов при РЗ.

The paper gives the data available in the literature on the role of opportunistic microorganisms (OMs) in rheumatic diseases (RDs). OMs are anticipated to be involved as triggers initiating the development of chronic inflammation. Along with this, OMs in autoimmune diseases may play a defensive role through the interaction with Toll-like receptors and the activation of T cells that have suppressor activity. The possible involvement of OMs in the pathogenesis of RDs provides support not only the isolation of microorganisms, but also the detection of antibacterial antibodies of different classes. Of great importance are OMs in the etiology of comorbid infections, the risk of which is due to both the presence of autoimmune RDs and the necessity of using the drugs having immunosuppressive activity. The active clinical introduction of biological agents is followed by a rise in the rate and severity of different infections, including those caused by OMs. Having a marked biological and environmental plasticity, OMs are able to persist long when there are changes in the immune defense of patients with RDs. There is evidence for the higher adhesive properties and persistent potential of the microorganisms that colonize the body of patients with RDs. In the latter, OMs that are distinguished by pronounced antibiotic polyresistance are isolated, making the treatment and prevention of opportunistic infections more difficult in rheumatology. The results of the papers analyzed in the review suggest that the study of OMs in RDs is of practical importance.

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