DOI: https://doi.org/10.22263/2312-4156.2020.6.31
Пальгуева А.Ю., Литвяков А.М.1, Лагутчев В.В.
Ревматоидный артрит и атеросклероз: общее в иммунопатогенезе. Обзор литературы
Витебский государственный ордена Дружбы народов медицинский университет, г. Витебск, Республика Беларусь
Вестник ВГМУ. – 2020. – Том 19, №6. – С. 31-40.
Резюме.
Результаты многочисленных исследований демонстрируют взаимосвязь ревматоидного артрита (РА) и атеросклероза. Хорошо известен факт раннего возникновения и быстрого прогрессирования сердечно-сосудистых заболеваний у пациентов с РА, но дох сих пор нет точного объяснения этого феномена. Однозначно известно, что такое ускоренное течение атеросклеротического процесса невозможно объяснить с позиции традиционных кардиоваскулярных факторов риска. РА может служить моделью для изучения ускоренного атерогенеза.
В патогенезе атеросклероза и РА имеет место ряд схожих иммунологических процессов. При данных заболеваниях преобладает CD4+ Т-лимфоцитарная реакция. Описан общий для РА и атеросклероза генетический дефект в регуляции антигенпрезентирующего механизма MHC класс II. В качестве возможных антигенов, вызывающих Т-клеточную активацию, рассматриваются белки теплового шока, в частности типичный представитель этой группы белков – HSP 60.
Неоангиогенез – важный феномен при РА, приводящий к разрушению суставного хряща. При атеросклерозе неоангиогенез имеет значение в инвазивном росте атеросклеротической бляшки. Процессы деструкции тканей, опосредованные матриксными металлопротеазами, приводят к дестабилизации атеросклеротической бляшки при атеросклерозе и деструкции тканей сустава при РА.
Эффективная терапия РА может сопровождаться улучшением состояния сосудистого русла.
Ключевые слова: атеросклероз, ревматоидный артрит, воспаление, цитокины, неоангиогенез, белки теплового шока.
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Сведения об авторах:
Пальгуева А.Ю. – к.м.н., доцент кафедры внутренних болезней, Витебский государственный ордена Дружбы народов медицинский университет;
Литвяков А.М. – д.м.н., профессор, заведующий кафедрой внутренних болезней, Витебский государственный ордена Дружбы народов медицинский университет.
Лагутчев В.В. – к.м.н., доцент кафедры внутренних болезней, Витебский государственный ордена Дружбы народов медицинский университет.
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