Роль свободных легких цепей иммуноглобулинов в развитии и прогрессировании заболеваний почек

Свободные легкие цепи (СЛЦ) иммуноглобулинов с момента их открытия в конце XIX начале XX веков представляют интерес для исследователей в различных отраслях медицины. Помимо гематологии, где активно изучается роль моноклональных СЛЦ (мСЛЦ), продуцируемых клоном В-клеточной линии, не стали исключением и другие специальности. Так, в современных неврологии и ревматологии активно исследуются поликлональные СЛЦ (пСЛЦ), вырабатываемые В-лимфоцитами при их избыточной иммунной/аутоиммунной стимуляции. В патогенезе заболеваний почек могут участвовать как мСЛЦ, так и пСЛЦ. Значение мСЛЦ для нефрологии связано, во-первых, с различными вариантами поражения почек при моноклональныхгаммапатиях - цилиндровой нефропатией, AL-амилоидозом и проч., а во-вторых, с инициацией эпителиально-мезенхимального перехода и прогрессированием склеротических изменений ренального тубулоинтерстиция. В отношении пСЛЦ их повышенный уровень при патологии почек различного генеза ассоциирован с неблагоприятным прогнозом не только в отношении прогрессирования хронической болезни почек, но и жизни. Это позволяет обоснованно предполагать участие пСЛЦ в инициации профибротических процессов в почке. На настоящий момент считается, что механизм эпителиально-мезенхимального перехода, лежащий в основе формирования фиброза почечной паренхимы, может быть опосредован не только мСЛЦ, но и пСЛЦ, что продемонстрировано в ограниченном числе исследований при некоторых гломерулопатиях. В обзоре изложены современные представления о СЛЦ, а также роли мСЛЦ и пСЛЦ при патологии почек.

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