Научно-практический журнал
«Клиническая физиология кровообращения»

Главный редактор

Лео Антонович Бокерия, доктор медицинских наук, профессор, академик РАН и РАМН, президент ФГБУ «НМИЦ ССХ им. А.Н. Бакулева» МЗ РФ


Вопросы генетики и риска развития тяжелых инфекционных осложнений и сепсиса в кардиохирургии. Часть 4

Авторы: Кокшенёва И.В., Закарая И.Т., Малороева А.И., Ирасханов А.Ш.

Организация:
ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» Минздрава России, Москва, Российская Федерация

Для корреспонденции: Сведения доступны для зарегистрированных пользователей.

Раздел: Обзоры

DOI: https://doi.org/10.24022/1814-6910-2021-18-4-261-272

УДК: 616.94:616.12-089.168-06

Библиографическая ссылка: Клиническая физиология кровообращения. 2021; 4 (18): 261-272

Цитировать как: Кокшенёва И.В., Закарая И.Т., Малороева А.И., Ирасханов А.Ш. . Вопросы генетики и риска развития тяжелых инфекционных осложнений и сепсиса в кардиохирургии. Часть 4. Клиническая физиология кровообращения. 2021; 4 (18): 261-272. DOI: 10.24022/1814-6910-2021-18-4-261-272

Ключевые слова: генетическая вариабельность, генетические варианты, ассоциированные с риском инфекционных осложнений и сепсиса, генетическая вариабельность регуляторных путей воспалительной реакции

Поступила / Принята к печати:  07.10.2021 / 29.10.2021

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Аннотация

Несмотря на успехи в профилактике и лечении инфекционных осложнений после кардиохирургических операций, сепсис остается серьезной проблемой. Иммунная дисфункция – основной патофизиологический процесс, развивающийся у септических больных. Несбалансированная иммунная реакция организма обусловливает значительный процент негативных исходов у пациентов, находящихся в критическом состоянии. Предрасположенность к тяжелому течению инфекционного процесса имеет генетическую составляющую. Соответственно, генетическая вариабельность, которая нарушает иммунный ответ на внедрение инфекционных агентов, может объяснять способность иммунной системы по-разному реагировать на инфекцию, разнообразие клинической картины течения инфекционного процесса, ответы на лечение и генетическую предрасположенность к инфицированию у каждого конкретного пациента. Носительство таких генетических вариантов может позволить выявлять пациентов с высоким риском развития сепсиса и дисфункции органов при инфекционных процессах. В настоящем обзоре рассматриваются опубликованные данные о выявленных генетических вариантах, связанных с воспалительными каскадами и регуляторными путями, ассоциированными с тяжелым течением инфекционного процесса и сепсисом. Результаты опубликованных исследований по идентификации ключевых генов-кандидатов, участвующих в воспалительных сигнальных путях, могут быть полезны для стратификации риска сепсиса, мониторинга его развития, прогноза, в то время как их специфические функции и механизмы при развитии инфекционного процесса и сепсиса нуждаются в дальнейшем изучении. По-видимому, со временем генотипирование будет включено в стандартную оценку пациентов, находящихся в критическом состоянии, и поможет разрабатывать наиболее эффективные методы лечебного воздействия.

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****
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Об авторах

  • Кокшенёва Инна Валериевна, д-р мед. наук, ст. науч. сотр.; ORCID
  • Закарая Ираклий Темурович, мл. науч. сотр.
  • Малороева Амина Исаевна, аспирант
  • Ирасханов Атаби Шайхаевич, ординатор; ORCID

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