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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">microcirculation</journal-id><journal-title-group><journal-title xml:lang="ru">Регионарное кровообращение и микроциркуляция</journal-title><trans-title-group xml:lang="en"><trans-title>Regional blood circulation and microcirculation</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1682-6655</issn><issn pub-type="epub">2712-9756</issn><publisher><publisher-name>Academician I.P. Pavlov First St. Petersburg State Medical University</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.24884/1682-6655-2022-21-4-5-15</article-id><article-id custom-type="elpub" pub-id-type="custom">microcirculation-1123</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Эндотелиопатия и системное воспаление: обратимость причинно-следственных связей в патологической функциональной системе (обзор литературы)</article-title><trans-title-group xml:lang="en"><trans-title>Endotheliopathy and systemic inflammation: reversibility of cause-and-effect relationship in the pathological functional system (review of literature)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8668-492X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сазонова</surname><given-names>Е. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Sazonova</surname><given-names>E. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сазонова Елена Николаевна – д-р мед. наук, профессор, исполняющий обязанности проректора по научной работе, зав. кафедрой нормальной и патологической физиологии, Дальневосточный государственный медицинский университет; главный научный сотрудник, Хабаровский филиал Дальневосточного научного центра физиологии и патологии дыхания</p><p>680000, г. Хабаровск, ул. Муравьева-Амурского, д. 35680022, г. Хабаровск, ул. Воронежская, д. 49/1</p></bio><bio xml:lang="en"><p>Sazonova Elena N. – MD, Dr. of Sci. (Med.), Professor, prorector for International and Scientific Work, Far-East State Medical University; chief researcher of the Khabarovsk branch of the Far Eastern Scientific Center of Physiology and Pathology of Respiration</p><p>35, Muravyva-Amurskogo str., Khabarovsk, 68000049/1, Voronegskaya str., Khabarovsk, 680022</p></bio><email xlink:type="simple">sazen@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6790-3146</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Жмеренецкий</surname><given-names>К. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhmerenetsky</surname><given-names>K. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Жмеренецкий Константин Вячеславович – д-р мед. наук, доцент, исполняющий обязанности ректора</p><p>680000, г. Хабаровск, ул. Муравьева-Амурского, д. 35</p></bio><bio xml:lang="en"><p>Zhmerenetsky Konstantin V. – MD, Dr. of Sci. (Med.), docent, rector</p><p>35, Muravyva-Amurskogo str., Khabarovsk, 680000</p></bio><email xlink:type="simple">rec@mail.fesmu.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0924-1970</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Животова</surname><given-names>Е. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhivotova</surname><given-names>E. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Животова Елена Юрьевна – д-р мед. наук, доцент, зав. кафедрой нормальной и топографической анатомии с курсом оперативной хирургии</p><p>680000, г. Хабаровск, ул. Муравьева-Амурского, д. 35</p></bio><bio xml:lang="en"><p>Zhivotova Elena Yu. – MD, Dr. of Sci. (Med.), docent, Head of the Department Normal and Topography anatomy with a course of operative surgery</p><p>35, Muravyva-Amurskogo str., Khabarovsk, 680000</p></bio><email xlink:type="simple">elena-jivotova@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1862-0414</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Яковенко</surname><given-names>И. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Yakovenko</surname><given-names>I. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Яковенко Ирина Геннадьевна – канд. мед. наук, доцент, доцент кафедры нормальной и патологической физиологии</p><p>680000, г. Хабаровск, ул. Муравьева-Амурского, д. 35</p></bio><bio xml:lang="en"><p>Yakovenko Irina G. – MD, Cand. of Sci. (Med.), docent, associate professor of the Department of Pathological physiology</p><p>35, Muravyva-Amurskogo str., Khabarovsk, 680000</p></bio><email xlink:type="simple">irin-yakovenk@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное образовательное учреждение высшего образования «Дальневосточный государственный медицинский университет» Министерства образования и науки Российской Федерации; Хабаровский филиал Федерального государственного бюджетного научного учреждения «Дальневосточный научный центр физиологии и патологии дыхания»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Far-East State Medical University; Khabarovsk branch of the Federal State Budgetary Scientific Institution «Far Eastern Scientific Center of Physiology and Pathology of Respiration»</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Федеральное государственное образовательное учреждение высшего образования «Дальневосточный государственный медицинский университет» Министерства образования и науки Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Far-East State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>26</day><month>12</month><year>2022</year></pub-date><volume>21</volume><issue>4</issue><fpage>5</fpage><lpage>15</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Сазонова Е.Н., Жмеренецкий К.В., Животова Е.Ю., Яковенко И.Г., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Сазонова Е.Н., Жмеренецкий К.В., Животова Е.Ю., Яковенко И.Г.</copyright-holder><copyright-holder xml:lang="en">Sazonova E.N., Zhmerenetsky K.V., Zhivotova E.Y., Yakovenko I.G.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.microcirc.ru/jour/article/view/1123">https://www.microcirc.ru/jour/article/view/1123</self-uri><abstract><p>   Рассмотрено участие эндотелия и эндотелиального гликокаликса в системной воспалительной реакции. Роль эндотелия в механизмах воспаления двояка и зависит от характера воспалительного процесса в организме. Реакция эндотелиоцитов на локальное воспаление имеет физиологический регулируемый характер и направлена на успешную элиминацию патогена, восстановление тканевого гомеостаза. При системном воспалении эндотелий является наиболее «страдающей» структурой организма. Вместе с тем эндотелиоциты могут выступать в роли источника медиаторов системного воспаления, поддерживая патологический воспалительный процесс. Обсуждается проблема генерализации воспаления, при котором возникающая эндотелиопатия замыкает порочный круг, являясь и следствием системного воспаления, и причиной его пролонгирования и усиления. Наиболее демонстративно связь повреждения эндотелия и системного воспаления проявилась в патогенезе новой коронавирусной инфекции. Предшествующая эндотелиальная дисфункция обуславливает тяжелое течение COVID-19 с развитием «цитокинового шторма» и коагулопатии, способных привести к гибели организма. Инфекция SARS-CoV-2 индуцирует длительную эндотелиальную дисфункцию, регистрируемую после элиминации вируса из организма. Предполагается, что эффективным подходом к профилактике тяжелых форм COVID-19 может быть раннее выявление повреждения эндотелия регистрацией в крови пациентов маркеров распада эндотелиального гликокаликса. Лекарственные средства, обладающие эндотелийпротективным эффектом, способны уменьшить риск тяжелого течения новой коронавирусной инфекции и нивелировать проявления long-COVID.</p></abstract><trans-abstract xml:lang="en"><p>   The review considers the involvement of the endothelium and endothelial glycocalyx in the systemic inflammatory response. The role of the endothelium in the inflammation is ambivalent and depends on the nature of the inflammatory process. The physiological response of endothelial cells to local inflammation is necessary to successful eliminate the pathogen and restore the tissue homeostasis. In systemic inflammation, the endothelium is the most «suffering» structure of the body. However, endothelial cells can be a source of systemic inflammatory mediators, supporting the pathological inflammatory process. The problem of generalization of inflammation is discussed where endotheliopathy develops and closes the vicious circle, being both a consequence of systemic inflammation and the cause of its prolongation and intensification. In the pathogenesis of a new coronavirus infection the relationship between endotheliopathy and systemic inflammation was most clearly manifested. Preceding endothelial dysfunction causes a severe course of COVID-19 with a «cytokine storm» and coagulopathy that can lead to the death. SARS-CoV-2 infection induces long-term endothelial dysfunction, which is recorded even after the virus elimination. The early detection of blood level of endothelial glycocalyx damage markers (i. e. syndecan-1, glycosaminoglycans like heparan sulfate and hyaluronic acid) may seem to be an effective approach to the prevention of severe forms of COVID-19. Endothelial-protective drugs can reduce the risk of severe new coronavirus infection and eliminate the manifestations of long-COVID.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>эндотелиопатия</kwd><kwd>воспаление</kwd><kwd>COVID-19</kwd></kwd-group><kwd-group xml:lang="en"><kwd>endotheliopathy</kwd><kwd>inflammation</kwd><kwd>COVID-19</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Эндотелий: функция и дисфункция / З. А. 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