r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2021-26-1-4-14r-n-j-147Research ArticleОБЗОРLITERATURE REVIEWВозможные биомаркеры эффективности терапии при рассеянном склерозеPossible biomarkers of therapy effectivehttps://orcid.org/0000-0002-1580-6096ОспельниковаТ. П.OspelnikovaT. P.

105064, Москва;

123098, Москва

105064, Moscow;

123098, Moscow

ospelnikovat@mail.ruhttps://orcid.org/0000-0003-0787-6251ШитоваА. Д.ShitovaA. D.

105064, Москва;

119991, Москва

105064, Moscow;

119991, Moscow

countess.iris@yandex.ruФГБНУ Научно-исследовательский институт вакцин и сывороток им. И.И. Мечникова; ФГБУ Национальный исследовательский центр эпидемиологии и микробиологии им. Н.Ф. Гамалеи («НИЦЭМ им. Н.Ф. Гамалеи») Минздрава РоссииРоссияFederal State Budget Scientific Institution Research Institute of Vaccines and Sera of I.I. Mechnikov; Federal Research Center of Epidemiology and Microbiology of N.F. Gamaleya of the Russian Ministry of HealthRussian FederationФГБНУ Научно-исследовательский институт вакцин и сывороток им. И.И. Мечникова; ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет)РоссияFederal State Budget Scientific Institution Research Institute of Vaccines and Sera of I.I. Mechnikov; I.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202126032021261414Copyright © Оспельникова Т.П., Шитова А.Д., 20212021Оспельникова Т.П., Шитова А.Д.Ospelnikova T.P., Shitova A.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/147

Применение препаратов, изменяющих течение рассеянного склероза (ПИТРС), сопряжено с изменением реактивности иммунной системы. Препараты интерферонов IFN-β-1a и IFN-β-1b входят в первую линию лечения рассеянного склероза (РС). Однако как белковые субстанции препараты IFN-β потенциально иммуногенны с возможным образованием через 3–6 месяцев после начала лечения в сыворотке крови пациентов с РС нейтрализующих антител (НАТ), блокирующих активность молекул интерферона. Выявление НАТ к применяемому препарату интерферона позволяет своевременно изменить стратегию ведения пациента. В качестве прогностического биомаркера эффективности применения IFN-β также может рассматриваться уровень провоспалительных и проапоптотических каспаз в сыворотке крови и цереброспинальной жидкости. Кроме того, определенное прогностическое значение имеет определение микроРНК, нейрофиламентов в сыворотке крови и секреторных гликопротеинов (хитиназ) в цереброспинальной жидкости. Повышение специфичности действия лекарственных препаратов, поиск новых звеньев патогенеза как мишеней терапевтического воздействия, нахождение эффективных биомаркеров является основным направлением лечения РС в настоящее время. В обзоре рассмотрено современное понимание механизмов РС, роль инфекционных агентов в инициации нейровоспаления, обсуждаются прогностические биомаркеры основных методов патогенетической терапии.

Administration of the disease modifying therapy in patients with multiple sclerosis is associated with alterations in immune system reactivity. Interferon’s IFN-β-1a and IFN-β-1b are included in the first-line treatment for multiple sclerosis cure. However, as protein substances, they are potentially immunogenic, hence neutralizing antibodies (Nab) can appear after 3–6 months in the serum of a multiple sclerosis patient, reducing IFN-molecules activity. Detection of the NAb to the administrated IFN-medication enables to change the patient management strategy. The level of inflammatory and apoptotic caspases in serum and cerebrospinal fluid may also be considered as a prognostic biomarker for the IFN-therapy efficiency. In addition, the level of microRNA, neurofilaments in serum and secreted glycoproteins (chitinases) in cerebrospinal fluid have certain prognostic value. Increasing of medical substances action specificity, searching for new pathogenesis links as targets for the therapeutic action and identification of the effective prognostic biomarkers are the main strategies of multiple sclerosis treatment nowadays.

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The authors declare that there are no conflicts of interest present.