Regeneration potential activation of lung tissue in severe community-acquired pneumonia

O.N. Titova, N.A. Kuzubova, E.S. Lebedeva, E.V. Volchkova

National Research Institute of Pulmonology of the Pavlov First Saint Petersburg State Medical University, Saint Petersburg

Community-acquired pneumonia is one of the most common acute infectious diseases in the world, occurring on an outpatient basis or diagnosed in the first two days of hospitalization. It is characterized by variability in clinical manifestations and a high rate of fatal outcomes, especially among the elderly, infants and patients with comorbidities. The mortality rate caused by community-acquired pneumonia in Russia is from 1% to 30%.

The review presents an analysis of scientific publications over the last five years devoted to the search for fundamentally new treatment methods of community-acquired pneumonia based on the regenerative therapy principles. The results of experimental studies performed on models of bacterial and viral pneumonia, aimed at stimulating the regenerative potential of the alveolar epithelium, which is most suscepti ble to infectious damage, are discussed. The regenerative potential of the alveolar epithelium is crucial for survival after severe pneumonia and lung functions recovery. Various ways of activating the main progenitor cells of the epithelium — type II alveolocytes — and reprogramming the signaling systems involved in launching the epithelial-mesenchymal regenerative cascade are proposed. It is necessary to further study the association of simultaneously occurring inflammatory and regenerative processes and establish factors allowing to regulate the intensity of these processes in order to form a favorable microenvironment for regeneration.

Keywords: community-acquired pneumonia, infection, influenza virus, regeneration, alveolar epithelium, alveolocyte, inflammation.

For citation: Titova O.N., Kuzubova N.A., Lebedeva E.S., Volchkova E.V. Regeneration potential activation of lung tissue in severe community-acquired pneumonia. RMJ. 2020;4:24–28.