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BACKGROUND This review is devoted to the analysis of the features of the immune response in COVID-19. The review indicates the clinical manifestations of COVID-19, modern data on the immunopathogenesis of the disease and its complications are considered.Aim of STUDY To clarify some pathogenetic mechanisms of the immune response in COVID-19, which can help in creating an algorithm for examining patients for early prognosis and prevention of severe course and complications of the disease.MATERIAL AND METHODS To achieve this goal, the results of domestic and foreign scientific studies on the pathogenesis, diagnosis and treatment of COVID-19 were analyzed. The literature search was carried out in electronic search engines Scopus and PubMed. For the analysis, scientific articles published in the period from 2019 to 2021 were selected; 88% of analyzed works are not older than 5 years.CONCLUSION The late production of type I IFN, an increase in the level of pro-inflammatory monocytes, a decrease in the expression of HLA-DR on monocytes, violation of the presentation of the virus and the formation of specific lymphocytes, the death of T-lymphocytes and profound immunosuppression are of greatest importance for the development of a severe form of COVID-19.

Vaccines for many years act as one of the most effective and successfully used medicines. Vaccines obtained by traditional methods contain in their composition live, weakened or killed microorganisms (bacteria, viruses, etc.). Now more often, modern, split, subunit, recombinant, polyvalent and some other types of vaccines are being used. The addition of adjuvants to vaccines generally increases the immune response to their administration. It was established that the formation of postvaccinal immunity begins immediately after the introduction of the vaccine, by activating the factors of innate immunity in the interaction of pathogen-associated molecular patterns (PAMPs), in vaccines, with the pathogen-recognition receptors (PRRs) of the immunocompetent cells of the recipient. It is also shown that PRRs activators, including TOLL-like receptor agonists (TLRs) and poly (I:C) polynucleotide oligomers of inosine and cytidylic acids, have the ability to substantially increase the immunogenicity of vaccines, and attempts are being made to use them creation of new types of adjuvants. Defective interfering viral particles (D-particles, DIPs) are also classed as effective stimulants of innate immunity and can also be considered promising vaccine adjuvants.

Abstract. A study of leukocyte regulation system in patients with exacerbated bronchial asthma (BA) was performed by means of measuring spontaneous and induced production of certain cytokines (IL-4, IL-1b, IL-10 and IFNg) in whole blood, and drawing some specific coefficients reflecting production of the cytokines, as compared to control values. Group 1 consisted of mixed-type BA patients, with mild clinical manifestations at exacerbation stage. A control group included twelve healthy persons. The cytokine network was evaluated according to spontaneous production of cytokines (IL-4, IL-1b, IL-10 and IFNg), or their induction with standard mitogens (PHA and E. coli LPS). The results obtained have shown that in BA as a clinical model of chronic inflammation, synthesis and activation of the cytokines depend on the phase of disease. At stage of exacerbation, an imbalance occurs between pro- and anti-inflammatory cytokines, with predominance of anti-inflammatory IL-10, which is targeted to suppression of bronchial inflammation.