actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.29413/ABS.2022-7.5-1.8actabiomedica-3804Research ArticleИНФЕКЦИОННЫЕ БОЛЕЗНИINFECTIOUS DISEASESМеханизмы аутоиммунной патологии постковидного синдромаMechanisms of autoimmune pathology in post-COVID syndromehttps://orcid.org/0000-0003-2169-0242ОрловаЕ. А.OrlovaE. A.

Орлова Елизавета Андреевна – аспирант, младший научный сотрудник лаборатории эпидемиологически и социально-значимых инфекций

664003, г. Иркутск, ул. Тимирязева, 16

Elizaveta A. Orlova – Postgraduate, Junior Research Officer at the Laboratory of Epidemically and Socially Significant Infections

Timiryazeva str. 16, Irkutsk 664003

elizaveta.a.orlova@gmail.comhttps://orcid.org/0000-0002-2631-4724КондратовИ. Г.KondratovI. G.

Кондратов Илья Геннадьевич – кандидат биологических наук, научный сотрудник лаборатории эпидемиологически и социально-значимых инфекций

664003, г. Иркутск, ул. Тимирязева, 16

Ilya G. Kondratov – Cand. Sc. (Biol.), Research Officer at the Laboratory of Epidemically and Socially Significant Infections

Timiryazeva str. 16, Irkutsk 664003

kondratovig@mail.ruhttps://orcid.org/0000-0002-3168-1983ОгарковО. Б.OgarkovO. B.

Огарков Олег Борисович – доктор медицинских наук, заведующий отделом эпидемиологии и микробиологии

664003, г. Иркутск, ул. Тимирязева, 16

Oleg B. Ogarkov – Dr. Sc. (Med.), Head of the Department of Epidemiology and Microbiology

Timiryazeva str. 16, Irkutsk 664003

obogarkov@mail.ruhttps://orcid.org/0000-0003-3354-2992КолесниковаЛ. И.KolesnikovaL. I.

Колесникова Любовь Ильинична – доктор медицинских наук, профессор, академик РАН, научный руководитель

664003, г. Иркутск, ул. Тимирязева, 16

Lyubov I. Kolesnikova – Dr. Sc. (Med.), Professor, Academician of RAS, Academic Director

Timiryazeva str. 16, Irkutsk 664003

iphr@sbamsr.irk.ruФГБНУ «Научный центр проблем здоровья семьи и репродукции человека»Scientific Centre for Family Health and Human Reproduction Problems20220612202275-16276Copyright © Орлова Е.А., Кондратов И.Г., Огарков О.Б., Колесникова Л.И., 20222022Орлова Е.А., Кондратов И.Г., Огарков О.Б., Колесникова Л.И.Orlova E.A., Kondratov I.G., Ogarkov O.B., Kolesnikova L.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/3804

   Одним из отсроченных последствий инфекции SARS-CoV-2 является постковидный синдром – развивающиеся у реконвалесцентов COVID-19 полиморфные нарушения различных систем организма, которые сохраняются более четырёх недель после перенесённой острой инфекции. В силу инфекционной природы заболевания отдельного внимания требуют осложнения со стороны иммунной системы, особенно сопутствующая и впервые возникающая аутоиммунная патология. В этом обзоре проводится анализ современного состояния вопроса постковидных осложнений, обсуждаются молекулярные особенности вируса SARS-CoV-2 и механизмы, лежащие в основе нарушений иммунного ответа в период острой инфекции COVID-19 и возникновения аутоиммунных и аутовоспалительных состояний при реконвалесценции. Особое внимание уделено молекулярной мимикрии антигенных детерминант вируса SARS-CoV-2, структурно сходных с эпитопами аутоантигенов человека. Приведены современные данные о постковидных аутоиммунных осложнениях со стороны гуморального иммунитета и эндокринной системы, а также репродуктивных нарушений, с которыми сталкиваются пациенты мужского пола. Впервые высказывается гипотеза о роли структурной гомологии аутоантигена SOX13 человека (HMG box factor SOX13), ассоциированного с сахарным диабетом, и белка Е оболочки SARS-CoV-2 в развитии постковидных аутоиммунных патологий. В силу структурного сходства двух белков и перекрывания их иммуногенных регионов мы предполагаем, что повышенный риск развития сахарного диабета и нарушений со стороны репродуктивной системы у мужчин после перенесённого COVID-19 могут быть связаны с перекрёстной иммунологической реактивностью.

   One of the delayed consequences of SARS-CoV-2 infection is post-acute COVID-19 – polymorphic disorders of various organ systems that affect COVID-19 convalescents and persist for more than four weeks after an acute infection. Due to the infectious nature of the COVID-19, we would like to pay special attention to complications from the immune system, especially concomitant and new-onset autoimmune pathology. This review analyzes the current state of the issue of post-acute COVID-19 complications, discusses the molecular features of the SARS-CoV-2 virus and the mechanisms underlying the impaired immune response during acute COVID-19 infection and the occurrence of autoimmune and autoinflammatory conditions during convalescence. Particular attention is paid to the molecular mimicry of antigenic determinants of the SARS-CoV-2 virus, which are structurally similar to the epitopes of human autoantigens. The current data on post-acute COVID-19 autoimmune complications from humoral immunity and the endocrine system, as well as reproductive disorders faced by male patients are presented. For the first time, we hypothesize a role of the structural homology of the human SOX13 autoantigen (HMG box factor SOX13) associated with diabetes mellitus and SARS-CoV-2 envelope (E) protein in the development of the post-acute COVID-19 autoimmune pathologies. Due to the structural similarity of the two proteins and the overlap of their immunogenic regions, we suggest that the increased risk of developing diabetes mellitus and reproductive disorders in men after suffering from COVID-19 may be associated with immunological cross-reactivity.

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