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Иммунопатогенез и подходы к разработке иммунотерапии нейродегенеративных и цереброваскулярных заболеваний с когнитивными нарушениями. Современное состояние проблемы и перспективы

https://doi.org/10.30629/2658-7947-2021-26-5-4-15

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Аннотация

Когнитивные нарушения (КН) представляют серьезную проблему современного общества. Наиболее частыми причинами развития КН являются нейродегенеративные заболевания (прежде всего, болезнь Альцгеймера (БА) и цереброваскулярные расстройства). В настоящее время стратегия терапии этих заболеваний имеет ограниченную эффективность в отношении восстановления когнитивных функций и течения болезни, хотя и способна замедлять темпы когнитивного снижения.

Понимание иммунопатогенеза нейродегенеративных и цереброваскулярных заболеваний определяет новые мишени и подходы к лечению. Подавление нейровоспаления целесообразно уже на ранних стадиях когнитивного снижения, когда информативность рутинного клинического, лабораторного и инструментального обследования пациентов недостаточна для уточнения причин КН.

Статья суммирует современные представления об иммунопатогенезе БА и хронической церебральной ишемии (ХЦИ). Механизм развития нейровоспаления представлен как каскад последовательных событий, замыкающихся в конечном итоге в самоподдерживающийся воспалительный ответ. В качестве потенциальных точек приложения иммуномодулирующей терапии рассмотрены молекулярные фрагменты, ассоциированные с повреждением, и воспринимающие их специфические рецепторы (паттерн-распознающие рецепторы), внутриклеточная передача сигнала в микроглиальных клетках, цитокины и адгезионные молекулы. Приведены сведения о современном уровне разработанности иммунотерапии БА и ХЦИ и дальнейшие перспективы ее применения.

Об авторах

А. А. Смирнова
ФГБУН Институт мозга человека им. Н.П. Бехтеревой Российской академии наук
Россия

197376, Санкт-Петербург



Л. Н. Прахова
ФГБУН Институт мозга человека им. Н.П. Бехтеревой Российской академии наук
Россия

Прахова Лидия Николаевна

197376, Санкт-Петербург



A. Г. Ильвес
ФГБУН Институт мозга человека им. Н.П. Бехтеревой Российской академии наук
Россия

197376, Санкт-Петербург



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Для цитирования:


Смирнова А.А., Прахова Л.Н., Ильвес A.Г. Иммунопатогенез и подходы к разработке иммунотерапии нейродегенеративных и цереброваскулярных заболеваний с когнитивными нарушениями. Современное состояние проблемы и перспективы. Российский неврологический журнал. 2021;26(5):4-15. https://doi.org/10.30629/2658-7947-2021-26-5-4-15

For citation:


Smirnova A.A., Prakhova L.N., Ilves A.G. Immunopathogenesis and immunotherapeutic approaches of neurodegenerative and cerebrovascular diseases with cognitive impairment. The current state of the problem and prospects. Russian neurological journal. 2021;26(5):4-15. (In Russ.) https://doi.org/10.30629/2658-7947-2021-26-5-4-15

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