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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">Molekulyarnaya Meditsina (Molecular medicine)</journal-id><journal-title-group><journal-title xml:lang="en">Molekulyarnaya Meditsina (Molecular medicine)</journal-title><trans-title-group xml:lang="ru"><trans-title>Молекулярная медицина</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1728-2918</issn><issn publication-format="electronic">2499-9490</issn><publisher><publisher-name xml:lang="en">Russkiy Vrach Publishing House</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">717242</article-id><article-id pub-id-type="doi">10.29296/24999490-2026-04-12</article-id><article-id pub-id-type="edn">wnarcj</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Reviews</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Обзоры</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Alpha-Synuclein: from structural biology and conformational dynamics to molecular mechanisms of neurotoxicity</article-title><trans-title-group xml:lang="ru"><trans-title>Альфа-синуклеин: от структурной биологии и конформационной динамики до молекулярных механизмов нейротоксичности</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7853-6222</contrib-id><name-alternatives><name xml:lang="en"><surname>Kolotieva</surname><given-names>Nataliya A.</given-names></name><name xml:lang="ru"><surname>Колотьева</surname><given-names>Наталия Александровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Leading Researcher; Doctor of Medical Sciences</p></bio><bio xml:lang="ru"><p>ведущий научный сотрудник; Доктор медицинских наук</p></bio><email>kolotyeva.n.a@neurology.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4441-9025</contrib-id><name-alternatives><name xml:lang="en"><surname>Salmina</surname><given-names>Vladimir V.</given-names></name><name xml:lang="ru"><surname>Салмин</surname><given-names>Владимир Валерьевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Professor; Doctor of Physical and Mathematical Sciences, Professor</p></bio><bio xml:lang="ru"><p>профессор; Доктор физико-математических наук</p></bio><email>vsalmin@gmail.com</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-9385-3452</contrib-id><name-alternatives><name xml:lang="en"><surname>Guk</surname><given-names>Polina V.</given-names></name><name xml:lang="ru"><surname>Гук</surname><given-names>Полина Владимировна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Postgraduate Student, Research Laboratory Assistant</p></bio><bio xml:lang="ru"><p>аспирант, лаборант-исследователь</p></bio><email>bf30h36@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-4665-1961</contrib-id><name-alternatives><name xml:lang="en"><surname>Voronina</surname><given-names>Valeria S.</given-names></name><name xml:lang="ru"><surname>Воронина</surname><given-names>Валерия Сергеевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Postgraduate Student, Research Laboratory Assistant</p></bio><bio xml:lang="ru"><p>аспирант, лаборант-исследователь</p></bio><email>voronina.vlrs@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7024-7461</contrib-id><name-alternatives><name xml:lang="en"><surname>Rossokhin</surname><given-names>Alexey V.</given-names></name><name xml:lang="ru"><surname>Россохин</surname><given-names>Алексей Владимирович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Leading Researcher; Candidate of Physical and Mathematical Sciences</p></bio><bio xml:lang="ru"><p>ведущий научный сотрудник; Кандидат физико-математических наук</p></bio><email>rossokhin@neurology.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-4700-2366</contrib-id><name-alternatives><name xml:lang="en"><surname>Salmina</surname><given-names>Irena V.</given-names></name><name xml:lang="ru"><surname>Салмина</surname><given-names>Ирена Владимировна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>2<sup>nd</sup> year graduate student</p></bio><bio xml:lang="ru"><p>студентка 2 курса магистратуры</p></bio><email>irenairenairena0202@mail.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Tregub</surname><given-names>Pavel P.</given-names></name><name xml:lang="ru"><surname>Трегуб</surname><given-names>Павел Павлович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Senior Researcher; Doctor of Medical Sciences</p></bio><bio xml:lang="ru"><p>старший научный сотрудник; Доктор медицинских наук</p></bio><email>pfiza_asmu@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1878-4467</contrib-id><name-alternatives><name xml:lang="en"><surname>Kudlay</surname><given-names>Dmitry A.</given-names></name><name xml:lang="ru"><surname>Кудлай</surname><given-names>Дмитрий Анатольевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Research Director, Professor of the Department of Pharmacology, Institute of Pharmacy, I.M. Sechenov First Moscow State Medical University (Sechenov University); Deputy Dean for Scientific and Technological Development of the Faculty of Bioengineering and Bioinformatics, Senior Researcher, Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University. Doctor of Medical Sciences, Сorresponding member of the Russian Academy of Sciences</p></bio><bio xml:lang="ru"><p>профессор кафедры фармакологии Института фармации ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет); заместитель декана по научно-технологическому развитию факультета биоинженерии и биоинформатики, старший научный сотрудник факультета биоинженерии и биоинформатики, ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова». Доктор медицинских наук, член-корреспондент РАН</p></bio><email>D624254@gmail.com</email><xref ref-type="aff" rid="aff4"/><xref ref-type="aff" rid="aff5"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2704-6282</contrib-id><name-alternatives><name xml:lang="en"><surname>Illarioshkin</surname><given-names>Sergey N.</given-names></name><name xml:lang="ru"><surname>Иллариошкин</surname><given-names>Сергей Николаевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Director of the Brain Institute, Deputy Director; Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences</p></bio><bio xml:lang="ru"><p>директор Института мозга, заместитель директора по научной работе; Доктор медицинских наук, профессор, академик РАН</p></bio><email>snillario@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Federal State Budgetary Scientific Institution “Russian Center for Neurology and Neurosciences”</institution></aff><aff><institution xml:lang="ru">ФГБНУ «Российский центр неврологии и нейронаук»</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Federal State Autonomous Educational Institution of Higher Education “Bauman Moscow State Technical University”</institution></aff><aff><institution xml:lang="ru">ФГАОУ ВО «Московский государственный технический университет им. Н.Э. Баумана»</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">Federal State Autonomous Educational Institution of Higher Education “Siberian Federal University”</institution></aff><aff><institution xml:lang="ru">ФГАОУ ВО «Сибирский федеральный университет»</institution></aff></aff-alternatives><aff-alternatives id="aff4"><aff><institution xml:lang="en">I.M. Sechenov First Moscow State Medical University (Sechenov University)</institution></aff><aff><institution xml:lang="ru">ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)</institution></aff></aff-alternatives><aff-alternatives id="aff5"><aff><institution xml:lang="en">Lomonosov Moscow State University</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»</institution></aff></aff-alternatives><content-language>ru</content-language><pub-date date-type="pub" publication-format="electronic" iso-8601-date="2026-08-13"><day>13</day><month>08</month><year>2026</year></pub-date><pub-date date-type="collection"><year>2026</year></pub-date><volume>24</volume><issue>4</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>89</fpage><lpage>95</lpage><history><date date-type="received" iso-8601-date="2026-08-12"><day>12</day><month>08</month><year>2026</year></date><date date-type="accepted" iso-8601-date="2026-08-12"><day>12</day><month>08</month><year>2026</year></date></history><pub-history><event event-type="received"><event-desc>Received:<date date-type="received" iso-8601-date="2026-08-12"><day>12</day><month>08</month><year>2026</year></date></event-desc></event><event event-type="accepted"><event-desc>Accepted:<date date-type="accepted" iso-8601-date="2026-08-12"><day>12</day><month>08</month><year>2026</year></date></event-desc></event><event event-type="pub"><event-desc>Published:<pub-date date-type="pub" publication-format="electronic" iso-8601-date="2026-08-13"><day>13</day><month>08</month><year>2026</year></pub-date></event-desc></event></pub-history><permissions><copyright-statement xml:lang="en">Copyright ©; 2026, Russkiy Vrach Publishing House</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2026, ИД "Русский врач"</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="en">Russkiy Vrach Publishing House</copyright-holder><copyright-holder xml:lang="ru">ИД "Русский врач"</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2031-08-13"/></permissions><self-uri xlink:href="https://journals.eco-vector.com/1728-2918/article/view/717242">https://journals.eco-vector.com/1728-2918/article/view/717242</self-uri><abstract xml:lang="en"><p><bold>Objective.</bold><bold> </bold>To systematize current knowledge on the structural organization, conformational dynamics, and mechanisms of membrane toxicity of alpha-synuclein, as well as to analyze the role of age-associated impairment of proteostasis systems in the pathogenesis of synucleinopathies.</p> <p><bold>Material and methods.</bold><bold> </bold>A literature review was conducted covering publications indexed in PubMed, Scopus, Web of Science, and eLibrary databases for the period 2010 – 2026.</p> <p><bold>Key Findings.</bold><bold> </bold>Soluble prefibrillar oligomers, capable of integrating into the lipid bilayer and forming annular pores, possess the greatest damaging potential in synucleinopathies. An original hypothesis is proposed for the formation of a transmembrane pore based on the parallel stacking of NAC domains without register shifting and lateral association of subunits forming a hydrophobic interface, geometrically classified as a composite prismatoid or scutoid.</p> <p><bold>Conclusion.</bold><bold> </bold>Understanding the molecular mechanisms of oligomer membrane toxicity and age-related proteostasis failure opens new horizons for the development of pathogenetic therapies and substantiates the implementation of highly sensitive methods for early preclinical diagnosis.</p></abstract><trans-abstract xml:lang="ru"><p><bold>Цель обзора.</bold><bold> </bold>Систематизировать современные представления о структурной организации, конформационной динамике и механизмах мембранной токсичности альфа-синуклеина, а также проанализировать роль возраст-ассоциированного нарушения систем протеостаза в патогенезе синуклеинопатий.</p> <p><bold>Материал и методы.</bold><bold> </bold>Проведен анализ литературы, опубликованной в базах данных PubMed, Scopus, Web of Science, eLibrary за 2010–2026 гг.</p> <p><bold>Основные положения.</bold><bold> </bold>Максимальный повреждающий потенциал при синуклеинопатиях имеют растворимые префибриллярные олигомеры, способные интегрироваться в липидный бислой и формировать кольцевые поры. Предложена оригинальная гипотеза формирования трансмембранной поры на основе параллельной укладки NAC-доменов без регистрового сдвига и латеральной ассоциации субъединиц, образующих гидрофобный интерфейс, геометрически классифицируемый как составной призматоид или скутоид.</p> <p><bold>Заключение.</bold><bold> </bold>Понимание молекулярных механизмов мембранной токсичности олигомеров и возрастных сбоев протеостаза открывает новые горизонты для разработки патогенетической терапии и обосновывает внедрение высокочувствительных методов ранней доклинической диагностики.</p></trans-abstract><kwd-group xml:lang="en"><kwd>alpha-synuclein</kwd><kwd>synucleinopathies</kwd><kwd>conformational dynamics</kwd><kwd>membrane toxicity</kwd><kwd>proteostasis</kwd><kwd>neurodegeneration</kwd><kwd>brain aging</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>альфа-синуклеин</kwd><kwd>синуклеинопатии</kwd><kwd>конформационная динамика</kwd><kwd>мембранная токсичность</kwd><kwd>протеостаз</kwd><kwd>нейродегенерация</kwd><kwd>старение мозга</kwd></kwd-group><funding-group><funding-statement xml:lang="en">The work was carried out within the framework of the program for the development of a world-class scientific center “Healthy Longevity Medicine and Cognitive Technologies” (agreement No. 075-15-2026-326).</funding-statement><funding-statement xml:lang="ru">Работа выполнена в рамках реализации программы развития научного центра мирового уровня «Медицина здорового долголетия и когнитивные технологии» (соглашение № 075-15-2026-326).</funding-statement></funding-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>World Health Organization. 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