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Bobrova E.E., Shchupakova A.N., Semenov V.M.
The peculiarities of IHD clinical manifestation in the grippe and ARI. The role of cellular adhesion molecules. Literature review
Education establishment "Vitebsk State Order of Peoples’ Friendship Medical University", Republic of Belarus

The main factor in the development of IHD and its complications is the atherosclerotic lesion of coronary vessels. The primary lesion of the vascular endothelium resulting in an inflammatory reaction in the vessel wall is the basis of atherosclerosis pathogenesis. The inflammatory reaction occurs with the ejection of cytokines, increasing the production and activating cellular adhesion molecules, VCAM-1 being the most important among them. This molecule contributes to the migration of T-lymphocytes and monocytes to the subendothelial space. Having migrated leukocytes produce pro-inflammatory cytokines, this stimulating the expression of adhesion molecules and contributing to further infiltration of the vessel wall by inflammatory cells amplifying local inflammatory processes, causing the progression of atherosclerosis. The role of chronic infection in the processes of atherosclerosis development and progression is evident. Influenza and ARI virus is regarded as an etiological factor, it is able to persist for a long time in atherosclerotic plaques and to cause their destabilization both directly and through the autoimmune mechanisms triggering. Viruses change heological blood properties, decrease anti-inflammatory properties of HDL, stimulate the ejection of catecholamines, cause tachycardia, dehydration, leading to hypotension and hemoconcentration, decrease NO synthesis. A number of biochemical blood indices (fibrinogen, total cholesterol and C-reactive protein, triglycerides, molecules of adhesion to the endothelium) have seasonal fluctuations, the rise of which is synchronized with the incidence of influenza and ARI.
Key words: IHD, influenza, atherosclerosis progression, VCAM-1.


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