Аннотация:
The information presented in this analytical review of the literature and our own clinical observations supplements the pathogenic role of chronic alcohol intoxication in the mechanisms of comorbidity with the effects of desialization and structural and functional disintegration of the glycocalyx of cell membranes. It is assumed that alcohol-induced membranopathies and canalopathies and the subsequent disturbance of the balance and functions of circulating sialic acid in the cycle of its transformations in the body can cause a serious modulation of the body’s defense reactions at the level of innate and adaptive immunity. In the world literature, this is described in such clinical syndromes as immune and receptor dysregulation, endotoxinemia, and even «cellular stroke», manifested in systemic lesions of many organs and neurodegenerative diseases. This allows us to speak about sialopathology and a new, glycom-dependent pathway (in addition to the known acetaldehyde and stress-oxidative metabolic pathways) in the mechanisms of selective tissue tropism in patients with alcoholism. The specificity of sialoglycopathology can explain the individual profile or spectrum of target organs affected (and the polymorbidity index) in chronic alcohol intoxication, as well as determine the pathodynamics of somatoneurological pathology, the course and outcome of the underlying disease. Revealed the intersection or conjugation of the trajectories of the molecular and cellular effects of alcohol consumed on the glycoconjugates of membranes and, in general, on the sialic status of the body with the effects of additional potentially pathogenic factors acting on the body (viral, bacterial infections, as well as occupational hazards, nutritional disorders, etc.). It is obvious that the structural and functional modulations in membrane glycomes caused by alcohol consumption, reflected on the level of expression of receptors built into the membranes, lead to the induction or activation of participants in inflammation and autoimmune processes, in some cases integrating with the mechanisms of pathogenesis of viral infectious lesions, and thus can accelerate and / or complicate their course and prognosis of the latter. The results of the review expand the understanding of the role of sialobiology in the fundamental foundations of comorbidity in alcoholism, open up a new route of innovative approaches to personification of treatment, prevention of severe complications and mortality from alcohol-related diseases, and also serve as a justification for limiting or prohibiting the advertising and use of ethyl alcohol for the prevention or treatment of coronavirus disease. The review is presented in three parts. The first part describes the transferrin test in narcology, the properties, cycle of transformations and functions of cells structured in components or circulating in biological media of sialic acids, as well as the consequences of the desializing effect of alcohol on lipids in atherogenesis and the role of the desializing effects of alcohol in hematology and coagulology. The second part describes the diagnostic significance of changes in glycome sialation, and the features of clinical manifestations of sialoglycopathology in obstetrics, gynecology, neonatology; in neurology and psychiatry; in immunology and virology. The molecular mechanisms of sialoglycopathology in alcohol-associated diseases of the lungs, kidneys, olfactory organs, and other organs and systems reveal similarities with lesions in infectious viral diseases. The third part of the review discusses possible promising directions of using sialoglycobiology in narcology to study the pathogenesis and search for new biomarkers and the improvement of early and differential diagnosis of comorbid complications in patients with chemical dependence and to develop innovative approaches to prevention and personalized therapy. The importance of glycosialoproteomics with the determination of glycome profiles and sial status parameters in biological media along the sialic acid – sialoglycoproteins – lectins – sialidase axis in biomarker clusters for monitoring alcohol pathologies and substantiating targeted therapy is discussed.
Ключевые слова:
sialic acid, alcohol, glycom, sialidases, viral infection, organopathology, membranopathies, biomarkers, polymorbidity, targeted therapy.