Некоторые причины развития протеинурии при нефротическом синдроме
https://doi.org/10.36485/1561-6274-2020-24-1-9-21
Аннотация
В обзоре рассматриваются некоторые причины возникновения протеинурии при нефротическом синдроме, обусловленные внепочечными механизмами. Отмечены идентифицированные в последние годы аутоантитела, участвующие в нарушении селективной проницаемости фильтрационного барьера при мембранозной нефропатии. Анализируется прямая связь между уровнем гипергликемии и протеинурией при диабетической нефропатии. Подчеркивается роль в развитии этого заболевания активных форм кислорода, конечных продуктов гликирования, ангиотензина II, трансформирующего фактора роста β-1, эпителиально-мезенхимальной трансформации подоцитов, Rho ГТФаз, внутриклеточного сигнального пути mTOR, Wnt/β-катенин сигнального каскада. Особое внимание уделено проблеме поиска и идентификации циркулирующих факторов проницаемости в патогенезе идиопатического нефротического синдрома при болезни минимальных изменений и фокально-сегментарном гломерулосклерозе: фактор сосудистой проницаемости (VPF), вазодилататор-стимулированный фосфопротеин (VASP), гемопексин (Hpx), растворимый активатор рецептора плазминогена уриказного типа (suPAR), кардиотропиноподобный цитокин-1 (CLCF-1) и анти-CD40 антитела. Отмечено, что роль таких факторов сегодня не подвергается сомнению, однако с позиций доказательной медицины эта роль нуждается в серьезном подтверждении в соответствии со специально сформулированными критериями.
Об авторах
Я. Ф. Зверев
Алтайский государственный медицинский университет
Россия
Россия
Зверев Яков Федорович, профессор, доктор медицинских наук, кафедра фармакологии
656038, г. Барнаул, пр. Ленина, д. 40.
А. Я. Рыкунова
Барнаульский юридический институт
Россия
Россия
Рыкунова Анна Яковлевна, кандидат медицинских наук, кафедра криминалистики
656038, г. Барнаул, ул. Чкалова, д. 49
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Рецензия
Для цитирования:
Зверев Я.Ф., Рыкунова А.Я. Некоторые причины развития протеинурии при нефротическом синдроме. Нефрология. 2020;24(1):9-21. https://doi.org/10.36485/1561-6274-2020-24-1-9-21
For citation:
Zverev Ya.F., Rykunova A.Ya. Several reasons for the development of proteinuria in nephrotic syndrome. Nephrology (Saint-Petersburg). 2020;24(1):9-21. (In Russ.) https://doi.org/10.36485/1561-6274-2020-24-1-9-21
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