[Exosomes' role in intercellular interactions in different variants of lung injury in fatal cases of COVID-19]. / Rol' ekzosom v mezhkletochnykh vzaimodeistviyakh pri razlichnykh variantakh porazheniya legkikh v letal'nykh sluchayakh COVID-19.

BACKGROUND: Extracellular vesicles are surrounded by a phospholipid bilayer, carrying various active biomolecules and participating in many physiological and pathological processes, including infectious ones. OBJECTIVE: To research the role of exosomes in intercellular interactions in the pathogenesis of various types of lung damage in fatal cases of COVID-19. MATERIAL AND METHODS: We conducted a clinical and morphological analysis of 118 fatal cases caused by coronavirus infection in Moscow. We selected 32 cases with morphological signs of various types of lung lesions for immunohistochemical reaction (IHC) with antibodies against tetraspanin proteins (CD63, CD81), which are involved in the assembly of exosomes, as well as with antibodies against viral proteins: nucleocapsid and spike protein. We determined the main producing cells of extracellular vesicles and cells containing viral proteins, carried out their comparison and quantitative analysis. RESULTS: IHC reaction with antibodies against CD63 showed cytoplasmic granular uniform and subapical staining of cells, as well as granular extracellular staining. We determined similar staining using antibodies against viral proteins. Extracellular vesicles were found in the same cells as viral proteins. The main producing cells of vesicles and cells containing viral proteins were found to be macrophages, type II pneumocytes, and endothelial cells. CONCLUSION: Taking into account the results of the literature, the localization of viral proteins and extracellular vesicles in the same cells indicates the key role of vesicles in the pathogenesis of various forms of lung damage by the SARS-CoV-2 virus, in the dissemination of the pathogen in the organism, which leads to interaction with the adaptive immune system and the formation of immunity.

[Pathogenesis and morphological changes in the lung in COVID-19]. / Patogenez i morfologicheskie izmeneniya v legkikh pri COVID-19.

The novel coronavirus infection is a rapidly spreading infectious disease that primarily affects the respiratory system and vascular endothelium and has a serious negative impact on healthcare economy and system around the world. To effectively combat the virus, there is a need for a full understanding of the pathogenesis of this infectious disease, and every day there are more and more works that shed light on certain mechanisms of SARS-CoV-2 penetration, replication, and spread. One of these works is studies showing the role of extracellular vesicles (ECVs). The latter are the membrane-enclosed vesicles with a different composition, which are involved in many physiological processes and various diseases, including infectious ones. This review gives the available data on the pathomorphogenesis of COVID-19 and on the possible role of ECVs.