Деструктивный панкреатит: механизмы гибели клетки и их возможное клиническое значение


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Аннотация

В обзоре рассмотрены основные механизмы гибели клетки при остром панкреатите. Подробно анализированы варианты апоптоза и фазы его развития. Отражено значение рецепторных комплексов, инициирующих смерть клетки, роль каспаз и других ключевых структур молекулярного уровня. Дана оценка соотношению некроза и апоптоза в течении деструктивного панкреатита, зависимости указанных процессов от ряда интрацеллюлярных и внеклеточных сигналов, уровня макроэргов, экспрессии регуляторных белков. Подчеркнуто протективное значение каспазного каскада реакций в отношении некроза клетки. Приведены данные, указывающие на негативное прогностическое значение некроза как типа гибели клетки и обратное в отношении апоптоза. Представлены особенности аутофагии и ее вариантов, описаны морфологические признаки. На основании анализа публикаций авторы делают вывод о том, что процессы, ответственные за гибель клеток, многокомпонентны, имеют различные уровни регуляции и в ряде случаев связаны между собой общими факторами молекулярного уровня. Разработка методов терапии, направленных на блокирование какого-либо одного механизма может не привести к желаемому эффекту. Имеют определенные перспективы исследования, направленные на изменение экспрессии генов, участвующих в каскаде реакций воспаления, апоптоза, некроза.

Об авторах

В.Г. Фирсова

Нижегородская государственная медицинская академия, Нижний Новгород, Российская Федерация

Автор, ответственный за переписку.
Email: author@vestnik-surgery.com
врач – хирург городской больницы №35, г. Нижний Новгород

В.В. Паршиков

Нижегородская государственная медицинская академия, Нижний Новгород, Российская Федерация

Email: author@vestnik-surgery.com
д.м.н., профессор кафедры госпитальной хирургии им. Б.А.Королева Нижегородской государственной медицинской академии

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