Регуляторные Т-клетки при ишемическом инсульте: маленький ключ от большой «музыкальной шкатулки»

Регуляторные Т-клетки при ишемическом инсульте: маленький ключ от большой «музыкальной шкатулки»

Автор: Жукова О.А., Чудакова Д.А., Белопасов В.В., Ширшова Е.В., Баклаушев В.П., Юсубалиева Г.М.

Журнал: Клиническая практика @clinpractice

Рубрика: Научные обзоры

Статья в выпуске: 3 т.14, 2023 года.

Бесплатный доступ

Ишемический инсульт - глобальная медицинская проблема и одна из основных причин смертности и инвалидности во всём мире. Основным направлением терапии ишемического инсульта в острейшем периоде, способным предотвратить или минимизировать развитие неврологического дефицита, является восстановление кровотока в ишемизированной ткани мозга с помощью ферментативного тромболизиса или эндоваскулярной тромбоэкстракции. В случаях, когда терапевтическое окно упущено, важное значение в судьбе ишемизированных нейронов в зоне пенумбры может иметь модуляция иммунного ответа с целью подавления системной воспалительной реакции. Ключевую роль в этом процессе играют T-регуляторные клетки - иммуносупрессивная популяция CD4+ T-клеток, имеющая фенотип CD4+, CD25+ CD127low, FoxP3+. Несмотря на отдельные сообщения о том, что Treg (или их определённые субпопуляции) могут усугублять микроциркуляторные нарушения в ишемизированной ткани, большинство исследователей убеждены в позитивной роли Treg при ишемическом инсульте. Резидентные CD69+ Treg, обнаруженные в нормальном мозге млекопитающих, обладают нейропротективной активностью, вырабатывают IL-10 и другие противоспалительные цитокины, контролируют астроглиоз и подавляют цитотоксические субпопуляции Т-клеток и микроглии. Системное введение Treg при инсульте сопровождается уменьшением объёма инфаркта мозга и упреждением вторичной гибели нейронов. Возможность активировать и наращивать Treg ex vivo открывает широкие перспективы по иммунокоррекции не только при системных и аутоиммунных заболеваниях: потенциально эта технология может быть применима в качестве нейропротективной терапии при ишемическом инсульте. Связь Treg, воспаления и цереброваскулярной патологии особенно показательна на примере развития ишемического инсульта на фоне COVID-19. Показано, что системное воспаление, обусловленное инфицированием SARS-CoV-2, приводит к значительному угнетению Treg, что сопровождается повышенным риском развития ишемического инсульта и других неврологических осложнений. Обобщённые сведения о возможном терапевтическом потенциале Treg при цереброваскулярной патологии могут представлять практический интерес не только для исследователей, но и для клиницистов.

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Treg, регуляторные т-клетки, ишемический инсульт, covid-19, биомаркеры

Короткий адрес: https://sciup.org/143180551

IDR: 143180551   |   DOI: 10.17816/clinpract568210

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