sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.18699/SSMJ20230206sibmed-1040Research ArticleОБЗОРЫREVIEWSРоль клеточных факторов в этиопатогенезе остеоартритаThe role of immune factors in the etiopathogenesis of osteoarthritishttps://orcid.org/0000-0002-5492-0270ФедуличевП. Н.FedulichevP. N.

 Федуличев Павел Николаевич, к.м.н. 

295051, г. Симферополь, б-р Ленина, 5/7

 Pavel N. Fedulichev, candidate of medical sciences

295051, Simferopol, Lenina blvd., 5/7

p.fedulichev@gmail.comКрымкский федеральный университет им. В.И. ВернадскогоРоссияV.I. Vernadsky Crimean Federal UniversityRussian Federation2023280420234326173Copyright © Федуличев П.Н., 20232023Федуличев П.Н.Fedulichev P.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/1040

Остеоартрит обусловлен сложным взаимодействием генетических, метаболических, иммунологических, воспалительных, биохимических и биомеханических факторов. В последние годы достаточно большое количество исследований посвящено изучению роли в развитии остеоартрита клеточных факторов иммунной системы. Цель настоящей работы – анализ научных публикаций, посвященных изучению клеточных факторов в патогенезе остеоартрита и оценке их значимости в развитии патологии суставов. Материал и методы. Поиск публикаций по ключевым словам проводили в базах данных PubMed, Google Scholar, eLibrary и профильных журналах, относящихся к терапии, ревматологии, травматологии и иммунологии, за период с 2000 по 2022 г. Результаты и их обсуждение. Обобщая современные представления о роли клеточных факторов иммунной системы в патогенезе остеоартрита, необходимо отметить наличие синовиального воспаления, ключевую роль в развитии которого отводят макрофагам. При этом пациенты с остеоартритом характеризуются преобладанием классически активированных макрофагов с выраженным провоспалительным эффектом. Кроме того, в патогенезе поражения суставов принимают участие Т-лимфоциты. Среди них особая роль отводится Т-хелперным клеткам, цитотоксическим Т-лимфоцитам и Т-клеткам памяти. Нарушение баланса цитокинов и хемокинов, вырабатываемых субпопуляциями Т-лимфоцитов, является причиной запуска ряда механизмов возникновения и прогрессирования остеоартрита. Существенную роль в развитии и прогрессировании остеоартрита играют нейтрофилы, которые способствуют развитию воспаления. Продуцируемая нейтрофилами эластаза усиливает деградацию хряща, апоптоз хондроцитов, несбалансированное ремоделирование субхондральной кости и образование остеофитов. Заключение. Знание роли клеточных иммунных факторов в патогенезе остеоартрита и путей реализации их эффектов обусловливает перспективность использования иммунотропных средств. При этом необходимо учитывать, что возникновение и прогрессирование остеоартрита обусловлено одновременным сочетанием влияния широкого комплекса различных компонентов, включая факторы риска, травматическое повреждение сустава и др.

Osteoarthritis is caused by a complex interplay of genetic, metabolic, immunological, inflammatory, biochemical, and biomechanical factors. In recent years, a fairly large number of studies have been devoted to the role of cellular factors of the immune system in the development of osteoarthritis. The aim of the study was to analyze scientifc publications devoted to the study of cellular factors in the pathogenesis of osteoarthritis and to assess their signifcance in the development of joint pathology. Material and methods. The search for publications by keywords was carried out in the PubMed, Google Scholar, eLibrary databases and specialized journals related to therapy, rheumatology, traumatology and immunology from 2000 to 2022. Results and discussion. Summarizing modern ideas about the role of cellular factors of the immune system in the pathogenesis of osteoarthritis, it is necessary to note the presence of synovial inflammation, a key role in the development of which is assigned to macrophages. At the same time, patients with osteoarthritis are characterized by the predominance of classically activated macrophages with a pronounced pro-inflammatory effect. In addition, T lymphocytes also play an important role in the pathogenesis of joint damage. Among them, a special role is given to T helper cells, cytotoxic T lymphocytes and memory T cells. An imbalance of cytokines and chemokines produced by subpopulations of T lymphocytes is the reason for triggering a number of mechanisms for the onset and progression of osteoarthritis. A signifcant role in the development and progression of osteoarthritis is also assigned to neutrophils, which contribute to the development of inflammation. Neutrophil-produced elastase enhances cartilage degradation, chondrocyte apoptosis, unbalanced subchondral bone remodeling, and osteophyte formation. Conclusions. Knowledge of the role of cellular immune factors in the pathogenesis of osteoarthritis and ways to implement their effects determines the prospects for the use of immunotropic agents. Also, it should be taken into account that the occurrence and progression of osteoarthritis is due to the simultaneous combination of the influence of a wide range of various components, including risk factors, traumatic joint injury, etc.

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