Эндотипическая гетерогенность хронического риносинусита

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Аннотация

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.

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Об авторах

С. В. Красильникова

Приволжский исследовательский медицинский университет

Email: mashkovasv@mail.ru
ORCID iD: 0000-0001-6153-6691

к.м.н., доцент кафедры болезней уха, горла и носа

Россия, Нижний Новгород

К. В. Горбунова

Приволжский исследовательский медицинский университет

Email: ksenya.gorbunova@mail.ru
ORCID iD: 0000-0003-4985-1546

аспирант кафедры госпитальной педиатрии

Россия, Нижний Новгород

Т. И. Елисеева

Приволжский исследовательский медицинский университет

Email: eliseevati@yandex.ru
ORCID iD: 0000-0002-1769-3670

д.м.н., доцент, профессор кафедры госпитальной педиатрии

Россия, Нижний Новгород

Виля Ахтямовна Булгакова

Российский научный центр хирургии имени академика Б.В. Петровского; Российский национальный исследовательский медицинский университет имени Н.И. Пирогова

Автор, ответственный за переписку.
Email: irvilbulgak@mail.ru
ORCID iD: 0000-0003-4861-0919

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

Россия, Москва; Москва

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