Эндотипическая гетерогенность хронического риносинусита
Хронический риносинусит (ХРС) – одно из самых распространенных хронических заболеваний респираторного тракта во всем мире. ХРС с полипами (ПХРС) характеризуется высокой частотой рецидивов, рефрактерностью к проводимой терапии и является нерешенной проблемой клинической ринологии. ПХРС представляет собой гетерогенное заболевание с множеством клинико-иммунологических вариантов. Основа патогенеза ПХРС – хроническое воспаление слизистых оболочек, ассоциированное с патологическим ремоделированием. Данное воспаление может протекать как с высоким, так и с низким уровнем ответа иммунитета 2 типа. Фокусировка на одном типе воспаления (преимущественно Т2) не отражает всей картины патогенеза. Появление новых биологических препаратов, нацеленных на «алармины» и специфические цитокины, требует глубокого понимания задействованных иммунных путей для адекватного подбора терапии и прогнозирования ответа. В литературе наблюдается быстрый рост данных о роли отдельных клеточных популяций и медиаторов, однако отсутствует целостное представление об их взаимодействиях и значимости для разных эндотипов ХРС. Систематизация этих знаний поможет выявить пробелы в исследованиях, обозначить перспективные направления для разработки диагностических биомаркеров, потенциально пригодных для таргетной биологической терапии, а также повысит эффективность персонализированного подхода к лечению пациентов с ХРС. Целью настоящего обзора является комплексный анализ и систематизация современных данных об иммунологических механизмах патогенеза ПХРС. В статье представлен обзор научной литературы. Выполнен научный поиск по теме иммунногенеза ХРС. Использованы соответствующие ключевые термины и фильтры в поисковых системах PubMed и Google Scholar.Красильникова С.В., Горбунова К.В., Елисеева Т.И., Булгакова В.А.
Ключевые слова
хронический риносинусит
эндотип
эпителиальное ремоделирование
Список литературы
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Об авторах / Для корреспонденции
С.В. Красильникова, к.м.н., доцент кафедры болезней уха, горла и носа, Приволжский исследовательский медицинский университет, Нижний Новгород, Россия; mashkovasv@mail.ru, ORCID: https://orcid.org/0000-0001-6153-6691К.В. Горбунова, аспирант кафедры госпитальной педиатрии, Приволжский исследовательский медицинский университет, Нижний Новгород, Россия; ksenya.gorbunova@mail.ru, ORCID: https://orcid.org/0000-0003-4985-1546
Т.И. Елисеева, д.м.н., доцент, профессор кафедры госпитальной педиатрии, Приволжский исследовательский медицинский университет, Нижний Новгород, Россия; eliseevati@yandex.ru, ORCID: https://orcid.org/0000-0002-1769-3670
Виля Ахтямовна Булгакова, д.м.н., зав. отделом научно-информационного развития НИИ педиатрии и охраны здоровья детей НКЦ № 2, Российский научный центр хирургии имени академика Б.В. Петровского; профессор кафедры факультетской педиатрии педиатрического факультета, Российский национальный исследовательский медицинский университет им. Н.И. Пирогова, Москва, Россия; irvilbulgak@mail.ru,
ORCID: https://orcid.org/0000-0003-4861-0919 (автор, ответственный за переписку)
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