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Научно-практическая ревматология

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Перспективы анти-В-клеточной терапии при иммуновоспалительных ревматических заболеваниях

https://doi.org/10.14412/1995-4484-2019-3-40

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Аннотация

Нарушение В-клеточной иммунологической толерантности играет центральную роль в патогенезе иммуновоспалительных (аутоиммунных) ревматических заболеваний (ИВРЗ). В-клетки осуществляют связь между врожденным и приобретенным иммунитетом: экспрессируют Toll-подобные рецепторы, реагирующие на сигналы «опасности» («danger signals»); выступают в роли антиген-презентирующих клеток; индуцируют антиген-специфический иммунный ответ; определяют развитие «иммунологической памяти»; синтезируют широкий спектр цитокинов, регулирующих (стимулирующих или подавляющих) иммунный ответ и воспаление. При ИВРЗ наблюдаются нарушения метаболизма и клеточной сигнализации В-клеток, приводящие к дефектам В-регуляторных, Т-регуляторных, фолликулярных Т-хелперных и дендритных клеток. В-клетки синтезируют органонеспецифические и органоспецифические аутоантитела, являющиеся биомаркерами аутоиммунных заболеваний и играющие важную роль в их иммунопатогенезе. Анти-(пан)-В-клеточная терапия, вызывающая деплецию (истощение) В-клеток в крови и органах-мишенях, эффективна при широком круге ИВРЗ. Ее эффективность определяется различными механизмами: подавлением синтеза патогенных аутоантител; модуляцией функции В-клеток (презентация антигенов, синтез цитокинов, костимуляция), Т-лимфоцитов и дендритных клеток. Дальнейшее изучение стратегии «таргетной» анти-В-клеточной терапии, механизмов действия и новых «мишеней» имеет важное значение для прогресса современной  ревматологии, в отношении совершенствовании стратегии терапии ИВРЗ.

Об авторах

Е. Л. Насонов
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой», ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)
Россия
115522, Москва, Каширское шоссе, 34А;
119991, Москва, ул. Трубецкая, 8, стр. 2



Т. В. Бекетова
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
115522, Москва, Каширское шоссе, 34А


Л. П. Ананьева
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
115522, Москва, Каширское шоссе, 34А


В. И. Васильев
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
115522, Москва, Каширское шоссе, 34А


С. К. Соловьев
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
115522, Москва, Каширское шоссе, 34А


А. С. Авдеева
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
115522, Москва, Каширское шоссе, 34А


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Для цитирования:


Насонов Е.Л., Бекетова Т.В., Ананьева Л.П., Васильев В.И., Соловьев С.К., Авдеева А.С. Перспективы анти-В-клеточной терапии при иммуновоспалительных ревматических заболеваниях. Научно-практическая ревматология. 2019;57:1-40. https://doi.org/10.14412/1995-4484-2019-3-40

For citation:


Nasonov e.L., Beketova T.V., Ananyeva L.P., Vasilyev V.I., Solovyev S.K., Avdeeva A.S. PROSPECTS FOR ANTI-B-CELL THERAPY IN IMMUNO-INFLAMMATORY RHEUMATIC DISEASES. Rheumatology Science and Practice. 2019;57:1-40. (In Russ.) https://doi.org/10.14412/1995-4484-2019-3-40

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ISSN 1995-4484 (Print)
ISSN 1995-4492 (Online)