Russian Journal of Infection and ImmunityRussian Journal of Infection and ImmunityИнфекция и иммунитет2220-76192313-7398SPb RAACI181510.15789/2220-7619-LFL-1815REVIEWSОБЗОРЫReview ArticleLassa fever. Part 2. Laboratory diagnostics, treatment, development of medicationsЛихорадка Ласса. Часть 2. Лабораторная диагностика, лечение, разработки лекарственных препаратовhttps://orcid.org/0000-0002-1856-6147KazachinskaiaElena I.КазачинскаяЕлена Ивановна
Russian Federation

PhD, MD (Biology), Leading Researcher, Department of Experimental Modeling of Pathogenesis of Infectious Diseases, Leading Researcher, Department of Bioengineering

д.б.н., ведущий научный сотрудник отдела экспериментального моделирования патогенеза инфекционных заболеваний, ведущий научный сотрудник отдела биоинженерии

lena.kazachinskaia@mail.ruAripovV. S.АриповВ. С.
Russian Federation

PhD Candidate, Junior Researcher, Department of Bioengineering

аспирант, младший научный сотрудник отдела биоинженерии

aripov_vs@vector.nsc.ruIvanovaA. V.ИвановаА. В.
Russian Federation

PhD (Biology), Senior Researcher, Department of Bioengineering

к.б.н., старший научный сотрудник отдела биоинженерии

Ivanova_av@vector.nsc.ruShestopalovA. M.ШестопаловА. М.
Russian Federation

PhD, MD (Biology), Professor, Head of the Department of Experimental Modeling of Pathogenesis of Infectious Diseases

д.б.н., профессор, зав. отделом экспериментального моделирования патогенеза инфекционных заболеваний

shestopalov2@mail.ruResearch Institute of Virology, Federal Research Center of Fundamental and Translational Medicine, Siberian Branch of Russian Academy of SciencesНаучно-исследовательский институт вирусологии Федерального исследовательского центра фундаментальной и трансляционной медицины Cибирского отделения Российской Академии наукState Research Centre of Virology and Biotechnology “Vector”, Federal Service for the Oversight of Consumer Protection and Welfare (Rospotrebnadzor)Государственный научный центр вирусологии и биотехнологии «Вектор» Роспотребнадзора12042022151120221246096230411202119022022Copyright ©; 2022, Kazachinskaia E.I., Aripov V.S., Ivanova A.V., Shestopalov A.M.Copyright ©; 2022, Казачинская Е.И., Арипов В.С., Иванова А.В., Шестопалов А.М.2022Kazachinskaia E.I., Aripov V.S., Ivanova A.V., Shestopalov A.M.Казачинская Е.И., Арипов В.С., Иванова А.В., Шестопалов А.М.https://creativecommons.org/licenses/by/4.0https://iimmun.ru/iimm/article/view/1815

Globalization and high-speed means of transportation contribute to the spread of infections dangerous to humans. Airborne pathogens have pandemic potential as currently shown in case of the novel coronavirus SARS-CoV-2. Natural focal Lassa fever (LF) common in West African countries, in 35 cases was registered in non-endemic geographical areas because any person infected with Lassa virus (LASV) is a long-term source of infection (up to two months). Cases of person-to-person infection in endemic territories are described. In Germany, the facts of secondary virus transmission from patients to doctors have been recorded during the examination and blood collection from an apparently healthy person as well as during the autopsy of a deceased subjects due to severe LF course. Nonspecific malaise symptoms in LF are also characteristic of numerous other diseases common on the African continent, e.g., malaria and typhoid fever or viral infections such as yellow fever, Chikungunya, dengue and Zika, monkey pox and Ebola virus disease. In this regard, there may be similar dermatological manifestations. Timely detection of cases and differential diagnosis are crucial to ensure safe patient care and use of affordable antiviral therapy for LL provided by the drug Ribavirin. Research methods for studying LASV use polymerase chain reaction (PCR) for detecting viral RNA, electron microscopy, isolation of infectious virus cultured sensitive cells, indirect immunofluorescence reaction, enzyme immunoassay (ELISA) and immunochromatographic assays for the detection of antibodies and/or antigen as well as immunoblotting. Currently, test kits based on molecular and genetic methods are mainly used for LF laboratory diagnostics. Since the 1980s, ribavirin has been used to treat patients with LF. The serum accumulation of the drug in large quantities causes hemolysis, development of anemia and impaired renal function. In this regard, treatment options are being considered with decline in its concentration due to combined use with other antiviral drugs. A search for new therapeutic agents capable of inhibiting viral replication at disease early stage has been in progress due to lack of any approved vaccines.

Глобализация и скоростные средства передвижения способствуют распространению инфекций, опасных для человека. Патогены, передаваемые воздушно-капельным путем, обладают пандемическим потенциалом, как в настоящее время показано на примере нового коронавируса SARS-CoV-2. Природно-очаговая лихорадка Ласса (ЛЛ), распространенная в странах западной Африки, в 35 случаях была зарегистрирована на неэндемичных географических районах, так как человек, инфицированный вирусом Ласса (Lassa virus, LASV), является источником инфекции длительное время (до двух месяцев). На эндемичных территориях описаны случаи заражения при передаче вируса «от человека к человеку». В Германии зафиксированы факты вторичной передачи вируса от пациентов врачам при осмотре и взятии крови у внешне здорового человека, а также при вскрытии погибшего в результате тяжелого течения ЛЛ. Неспецифические симптомы недомогания при ЛЛ характерны и для других многочисленных заболеваний, распространенных на африканском континенте, например, при малярии и брюшном тифе или при вирусных инфекциях — это желтая лихорадка, лихорадки Чикунгунья, денге и Зика, оспа обезьян и болезнь, вызванная вирусом Эбола. При протекании этих болезней могут быть и схожие дерматологические проявления. Своевременное выявление заболевших и дифференциальная диагностика имеют решающее значение для обеспечения безопасного ухода за пациентами и применения доступной противовирусной терапии (при ЛЛ это препарат рибавирин). Методы научных исследований LASV включают: анализы на основе полимеразной цепной реакции (ПЦР) по определению вирусной РНК, электронную микроскопию, выделение инфекционного вируса на культуре чувствительных клеток, реакцию непрямой иммунофлуоресценции (РНИФ), иммуноферментный (ИФА) и иммунохроматографический (ИХА) анализы по выявлению антител и/или антигена, а также иммуноблоттинг. Для диагностики ЛЛ в настоящее время, в основном, используют тест-системы на основе молекулярно-генетических методов. С 80-х гг. XX в. и до сих пор для лечения пациентов с ЛЛ используют рибавирин, но накопление этого препарата в плазме в больших количествах вызывает гемолиз, развитие анемии и нарушение функции почек. В связи с этим рассматриваются варианты лечения при уменьшении его концентрации за счет сочетанного использования с другими противовирусными препаратами. Идет поиск новых терапевтических средств, способных ингибировать вирусную репликацию на ранней стадии болезни, так как зарегистрированные вакцины отсутствуют.

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