Клиническое значение растворимого CD40 лиганда у больных ишемической болезнью сердца
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Аннотация
Воспаление и тромбоз играют важную роль в патогенезе различных сердечно-сосудистых заболеваний (ССЗ). Связь развития атеросклероза и острого коронарного синдрома (ОКС) является двусторонней. Одним из механизмов, связывающих воспаление и тромбообразование, является активация сигнальной системы CD40/CD40L. CD40 и CD40 лиганд (CD40L) - трансмембранные гликопротеиды, относящиеся к семейству рецепторов факторов некроза опухоли и семейству факторов некроза опухоли соответственно. CD40 и CD40L экспрессируются различными клетками, в т.ч. клетками атеросклеротической бляшки: В-лимфоцитами, макрофагами/моноцитами, эндотелиальными и гладкомышечными клетками. Недавно к источникам растворимой формы CD40L (sCD40L) были причислены тромбоциты. В исследованиях последних лет изучалось диагностическое и прогностическое значения sCD40L у больных ишемической болезнью сердца (ИБС). Было показано достоверное увеличение уровней sCD40L y больных инфарктом миокарда и нестабильной стенокардией по сравнению с больными стабильной стенокардией напряжения и здоровыми лицами. Прогностическое значение sCD40L изучено у относительно здоровых женщин, а также у больных с ОКС; высокие уровни sCD40L независимо предсказывали увеличение сердечно-сосудистого риска. Повышение уровней sCD40L в плазме связано с развитием рестеноза после баллонной ангиопластики коронарных артерий. Есть данные о повышенных концентрациях sCD40Ly больных сахарным диабетом, с гиперхолестеринемией, острой ишемией мозга, у курильщиков, а также у пациентов с первичной и вторичной легочной гипертензией. sCD40L можно рассматривать, как маркер воспаления и тромбообразования одновременно, а повышение его уровня является фактором риска ССЗ и связано с неблагоприятным прогнозом у больных ИБС.
Об авторах
О. П. Шевченко
Российский государственный медицинский университет на базе Клинической больницы Управления делами Президента РФ. Москва
Россия
Россия
О. Ф. Природова
Российский государственный медицинский университет на базе Клинической больницы Управления делами Президента РФ. Москва
Россия
Россия
А. О. Шевченко
Российский государственный медицинский университет на базе Клинической больницы Управления делами Президента РФ. Москва
Россия
Россия
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Рецензия
Для цитирования:
Шевченко О.П., Природова О.Ф., Шевченко А.О. Клиническое значение растворимого CD40 лиганда у больных ишемической болезнью сердца. Кардиоваскулярная терапия и профилактика. 2006;5(7):101-111.
For citation:
Shevchenko O.P., Prirodova O.F., Shevchenko A.O. Clinical value of soluble CD40 ligand in coronary heart disease patients. Cardiovascular Therapy and Prevention. 2006;5(7):101-111. (In Russ.)
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ISSN 2619-0125 (Online)
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