pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-202434-5-708-718pulmo-4268Research ArticleОБЗОРЫREVIEWПерспективы применения вакцинации против пневмококковой инфекции с позиций феноэндотипической дифференцировки бронхиальной астмыProspects of vaccination against pneumococcal infection based on the asthma phenotypehttps://orcid.org/0000-0001-9665-1382КостиновА. М.KostinovA. M.

Костинов Антон Михайлович – аспирант лаборатории аллергодиагностики.

105064, Москва, Малый Казенный переулок, 5А; тел.: (495) 917-86-51

Anton M. Kostinov - Postgraduate Student, Allergy Diagnostics Laboratory.

Malyy Kazennyy per. 5A, Moscow, 105064; tel.: (495) 917-86-51

amkostinov@gmail.comhttps://orcid.org/0000-0002-3623-4293КонищеваА. Ю.KonishchevaA. Yu.

Конищева Анна Юрьевна – к. м. н., ведущий научный сотрудник лаборатории аллергодиагностики.

105064, Москва, Малый Казенный переулок, 5А; тел.: (495) 917-86-51

Anna Yu. Konishcheva - Candidate of Medicine, Leading Researcher, Allergy Diagnostics Laboratory.

Malyy Kazennyy per. 5A, Moscow, 105064; tel.: (495) 917-86-51

ankon81@list.ruФедеральное государственное бюджетное научное учреждение «Научно-исследовательский институт вакцин и сывороток им. И.И. Мечникова»РоссияFederal State Budgetary Scientific Institution “I.I.Mechnikov Vaccine and Serum Research Institute”Russian Federation202411102024345708718Copyright © Костинов А.М., Конищева А.Ю., 20242024Костинов А.М., Конищева А.Ю.Kostinov A.M., Konishcheva A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/4268

Бронхиальная астма (БА) характеризуется широкой вариабельностью механизмов возникновения и прогрессирования заболевания. Данная гетерогенность обусловлена паттернами преобладающих клеток и медиаторов воспаления, которые опосредуют специфические процессы и определяют различия в иммунологических параметрах, наблюдаемых у пациентов с определенными эндотипами в зависимости от доминирующего типа медиаторов (высокого и низкого Т2-воспаления). Как отечественными, так и зарубежными учеными в ходе многолетних наблюдений накоплена существенная база исследовательских работ, по данным которых обосновывается эффективность вакцинации против пневмококковой инфекции (ПИ) в популяции пациентов с диагнозом БА, в результате которой отмечается снижение частоты обострений заболевания и госпитализаций в краткосрочном и среднесрочном периоде. Однако в данных исследованиях оценивалась популяция БА в целом, при этом вопросы о том, существуют ли различия во влиянии пневмококковых вакцин (ПВ) на БА в зависимости от эндотипа заболевания и каковы механизмы подобного дифференцированного эффекта, остаются неизученными.

Целью данного обзора является представление результатов современных исследований, отражающих данные об изменениях профиля воспалительных медиаторов БА под действием иммунобиологических препаратов на основе антигенов Streptococcus pneumoniae, в первую очередь вакцин.

Заключение. Гетерогенность БА может приводить к отличающимся клиническим исходам при ПИ и, соответственно, клиническим эффектам от иммунизации у пациентов в зависимости от характера воспаления. То есть, однородность клинического эффекта вакцинации против ПИ у всех участников исследований может быть опосредована суммарным действием совокупности молекулярных механизмов, регулирующих специфическую активность Th1-, Th2-, Th17-, NKT- и Treg-клеток. По результатам ряда исследований доказано свойство ПВ модулировать Th1-, Th2-, Th17-, Tregиммунный ответ у пациентов с БА, что способствует повышению интереса к разработке новых иммунорегуляторных терапевтических агентов на основе антигенов S. pneumoniae.

According to recent studies, bronchial asthma is characterized by a wide variability of the mechanisms of occurrence and progression. This heterogeneity is caused by patterns of predominant cells and inflammatory mediators, which determine differences in immunological parameters observed in patients with certain endotypes depending on the dominant type of mediators (high and low T2 inflammation). In long-term observations, a substantial research base has been accumulated justifying the effectiveness of vaccination against pneumococcal infection in patients with asthma. The vaccination decreases the frequency of exacerbations of the disease and hospitalizations in the short and medium term. However, these studies evaluated the asthma patients as a wholesome population, and it remains unexplored whether the effect of pneumococcal vaccines on asthma differs depending on the endotype of the disease and what are the mechanisms of such a differentiated effect.

The aim of this work is to present the results of recent quality studies on changes in the profile of inflammatory asthma mediators under the action of immunobiological substances based on Streptococcus pneumoniae antigens, primarily from the vaccines.

Conclusion. The asthma heterogeneity can lead to different clinical outcomes in pneumococcal infection and, respectively, the clinical effects of immunization in patients differentiate according to the nature of inflammation. In other words, the uniformity of the clinical effect of vaccination against pneumococcal infection in all patients in ongoing studies may represent the combined effect of molecular mechanisms regulating the specific activity of Th1-, Th2-, Th17-, NKT-, and Treg-cells. The results of studies proving the ability of pneumococcal vaccines to modulate the Th1-, Th2-, Th17-, Treg immune response in patients with asthma contributed to increased interest in developing new immunoregulatory therapeutic agents based on S. pneumoniae antigens.

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