nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2024-28-4-30-38QXDFZInefr-2349Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESмРНК-терапия: проблемы и перспективы применения в нефрологииmRNA-therapy: problems and prospects of application in nephrologyhttps://orcid.org/0000-0003-4973-039XАйтбаевК. А.AitbaevK. A.

Проф. Айтбаев Кубаныч Авенович, д-р мед. наук, заведующий лабораторией патологической физиологии

720040, г. Бишкек, ул. Тоголока Молдо, д. 3

Prof. Kubanych Avenovich Aitbayev, MD, PhD, DMedSci, Head of the Laboratory of Pathological Physiology

720040, Kyrgyzstan, Bishkek, 3 Togoloka Moldo str. 

kaitbaev@yahoo.comhttps://orcid.org/0000-0001-8513-9279МуркамиловИ. Т.MurkamilovI. T.

Доц. Муркамилов Илхом Торобекович, д-р мед. наук

720020, г. Бишкек, ул. Ахунбаева, д. 92; 720000, г.Бишкек, ул. Киевская, д. 44

Associate Professor Ilkhom Torobekovich Murkamilov, DMedSci

720020, Kyrgyzstan, Bishkek, 92 Akhunbayev str.; 720000, Kyrgyzstan, Bishkek, 44 Kiev str. 

murkamilov.i@mail.ruhttps://orcid.org/0000-0002-2682-4417ФоминВ. B.FominV. V.

Чл.-кор. РАН, проф. Фомин Виктор Викторович, д-р мед. наук, Институт клинической медицины им. Н.В. Склифосовского, заведующий кафедрой факультетской терапии №1, проректор по инновационной и клинической деятельности

119991, Москва, ул. Большая Пироговская, д. 2

Prof. Viktor Viktorovich Fomin, MD, PhD, DMedSci, Corre sponding Member of the Russian Academy of Sciences

119991,   Russia,   Moscow,   2   Bolshaya   Pirogovskaya   str.

fomin_vic@mail.ruhttps://orcid.org/0000-0002-8502-2203ЮсуповаТ. Ф.YusupovaT. F.

Юсупова Турсуной Фуркатовна, студентка

714000, г.Ош, ул. Ленина, д. 331

 

Tursunoy Furkatovna Yusupova, Faculty of Medicine, Student

714000, Kyrgyzstan, Osh, 331 Lenin Street. 

yusupova_tursunoy_f@mail.ruhttps://orcid.org/0000-0001-7621-1128ЮсуповаЗ. Ф.YusupovaZ. F.

Юсупова Зулхумор Фуркатовна, студентка

714000, г.Ош, ул. Ленина, д. 331

Zulkhumor Furkatovna Yusupova, Faculty of Medicine, Student

714000, Kyrgyzstan, Osh, 331 Lenin Street. 

zulkhumor.yusupova.f_05@mail.ruhttps://orcid.org/0000-0003-0632-6653ЮсуповФ. А.YusupovF. A.

Проф. Юсупов Фуркат Абдулахатович, д-р мед. наук, заведующий кафедрой неврологии, нейрохирургии и психиатрии медицинского факультета

714000, г.Ош, ул. Ленина, д. 331

Prof. Furkat Abdulakhatovich Yusupov, DMedSci, Head of the Department of Neurology, Neurosurgery and Psychiatry of the Faculty of Medicine 

714000, Kyrgyzstan, Osh, 331 Lenin Street. 

furcat_y@mail.ruhttps://orcid.org/0009-0004-0437-0188ХакимовШ. Ш.HakimovSh. Sh.

Хакимов Шавкат Шукурбекович, врач-реаниматолог, нефролог

20040, г. Бишкек,  ул.  Насирдина  Исанова, д. 85.

Shavkat Shukurbekovich Hakimov, intensive care physician, nephrologist

720040, Kyrgyzstan, Bishkek, Nasirdina Isanova Street, 85

hakimovshaki13@gmail.comhttps://orcid.org/0009-0000-4975-1196ЫманкуловД. С.YmankulovD. S.

Ыманкулов Данияр Султанбекович, врач-пластический хирург

720040, г. Бишкек,  ул.  Насирдина  Исанова, д. 85

Daniyar Sultanbekovich Ymankulov, plastic surgeon

720020, Kyrgyzstan, Bishkek, 118 Nasirdin Isanov str. 

ymankulov9595@mail.ruhttps://orcid.org/0000-0003-3007-8127КудайбергеноваИ. О.KudaibergenovaI. O.

Проф. Кудайбергенова Индира Орозобаевна, д-р мед. наук, ректор

720020, г.Бишкек, ул. Ахунбаева, д. 92 

Prof. Indira Orozobaevna Kudaibergenova, DMedSci, Rector

720020, Kyrgyzstan, Bishkek, 92 Akhunbayeva str.

k_i_o2403@mail.ruНаучно-исследовательский институт молекулярной биологии и медицины при Национальном центре кардиологии и терапии им. акад. Мирсаида МиррахимоваКыргызстанScientific Research Institute of Molecular Biology and Medicine at the National Center of Cardiology and Therapy named after academician Mirsaid MirrakhimovKyrgyzstanКыргызская государственная медицинская академия им. И.К. Ахунбаева; Кыргызско-Российский славянский университетКыргызстанKyrgyz State Medical Academy named after I.K. Akhunbayev; Kyrgyz-Russian Slavic UniversityKyrgyzstanПервый Московский государственный медицинский университет им. И.М. СеченоваРоссияN.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical UniversityRussian FederationОшский государственный университетКыргызстанOsh State UniversityKyrgyzstanМедицинский центр «Life hospital»КыргызстанLife hospital Medical CenterKyrgyzstanМедицинский центр «Green Clinic»КыргызстанGreen Clinic Medical CenterKyrgyzstanКыргызско-Российский славянский университетКыргызстанKyrgyz State Medical Academy named after I.K. AkhunbayevKyrgyzstan2024160120252843038Copyright © Айтбаев К.А., Муркамилов И.Т., Фомин В.B., Юсупова Т.Ф., Юсупова З.Ф., Юсупов Ф.А., Хакимов Ш.Ш., Ыманкулов Д.С., Кудайбергенова И.О., 20252025Айтбаев К.А., Муркамилов И.Т., Фомин В.B., Юсупова Т.Ф., Юсупова З.Ф., Юсупов Ф.А., Хакимов Ш.Ш., Ыманкулов Д.С., Кудайбергенова И.О.Aitbaev K.A., Murkamilov I.T., Fomin V.V., Yusupova T.F., Yusupova Z.F., Yusupov F.A., Hakimov S.S., Ymankulov D.S., Kudaibergenova I.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/2349

Успешное применение вакцин на основе мессенджерных РНК (мРНК) с целью профилактики инфекции COVID-19 привлекло внимание научной общественности к потенциальному клиническому использованию этих молекул в качестве инновационных и альтернативных терапевтических подходов в различных областях медицины. В качестве терапевтических средств мРНК могут быть выгодны благодаря своим уникальным биологическим свойствам – способности нацеливаться практически на любой генетический компонент клетки, кодировать любые белки и пептиды без необходимости их переноса в ядра клеток-мишеней. Кроме того, эти молекулы могут быть быстро разработаны/произведены и клинически испытаны. После оптимизации химического состава РНК и системы ее доставки стоимость разработки новых вариантов этих лекарств для вновь выбранных клинических заболеваний значительно снижается. Однако, несмотря на потенциальную ценность в качестве нового и высокоэффективного терапевтического инструмента против ряда заболеваний почек, сложная архитектура почек и неспособность наночастиц, содержащих олигонуклеотиды, преодолеть интегральный барьер гломерулярной фильтрации в значительной степени снизили их потенциальное применение в нефрологии. Тем не менее, ожидается, что в ближайшие несколько лет технические усовершенствования мРНК, повышающие эффективность трансляции, модулирующие врожденную и адаптивную иммуногенность и увеличивающие их избирательную доставку к месту действия, позволят преодолеть эти ограничения и возможности терапии, направленной на почки, значительно расширятся. Это тем более важно, если учесть, что хронической болезнью почек в той или иной степени страдают более 10 % взрослого населения в мире, а по прогнозам, к 2040 году она станет пятой основной причиной смерти. Цель данного мини-обзора – обобщить основные преимущества терапии на основе мРНК и проиллюстрировать потенциальные будущие направления и проблемы этой многообещающей технологии для широкого терапевтического использования в нефрологии.

The successful application of messenger RNA (mRNA)-based vaccines for the prevention of COVID-19 infection has drawn the attention of the scientific community to the potential clinical applications of these molecules as innovative and alternative therapeutic approaches in various fields of medicine. As therapeutic agents, mRNAs may be advantageous due to their unique biological properties – the ability to target virtually any genetic component of the cell and encode any proteins and peptides without the need to transfer them to the nuclei of target cells. In addition, these molecules can be rapidly designed/produced and clinically tested. Once the RNA chemistry and delivery system are optimized, the cost of developing new variants of these drugs for newly selected clinical diseases is greatly reduced. However, despite their potential value as novel therapeutic weapons against several kidney diseases, the complex kidney architecture and the inability of oligonucleotide-containing nanoparticles to cross the integral glomerular filtration barrier have greatly reduced their potential application in nephrology. Nevertheless, technical improvements in mRNAs that increase translation efficiency, modulate innate and adaptive immunogenicity, and improve their selective delivery to the site of action are expected to overcome these limitations and the potential for kidneytargeted therapies will greatly expand over the next few years. This is all the more important given that chronic kidney disease (CKD) affects just over 10 % of the world's adult population to some degree, and CKD is projected to become the fifth leading cause of death by 2040, with about half of patients dying from cardiovascular disease. The purpose of this mini-review is to provide a summary of the main benefits of RNAi-based therapies and illustrate the potential future directions and challenges of this promising technology for widespread therapeutic use in nephrology.

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The authors declare that there are no conflicts of interest present.