sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.18699/SSMJ20240202sibmed-1455Research ArticleОБЗОРЫREVIEWSЦитокины – перспективные диагностические и прогностические биомаркеры микрососудистых осложнений сахарного диабетаСytokines as promising diagnostic and prognostic biomarkers of microvascular complications of diabeteshttps://orcid.org/0000-0002-5407-8722КлимонтовВ. В.KlimontovV. V.

Климонтов Вадим Валерьевич, д.м.н., проф.

630060, г. Новосибирск, ул. Тимакова, 2 

Vadim V. Klimontov, doctor of medical sciences, professor

630060, Novosibirsk, Timakova st., 2

klimontov@mail.ruhttps://orcid.org/0009-0009-3970-7218МавляноваК. Р.MavlianovК. R.

Мавлянова Камилла Рустамалиевна

630060, г. Новосибирск, ул. Тимакова, 2 

Kamilla R. Mavlianova

630060, Novosibirsk, Timakova st., 2

kamilla.mavlyanova@mail.ruНИИ клинической и экспериментальной лимфологии – филиал ФИЦ Институт цитологии и генетики СО РАНРоссияResearch Institute of Clinical and Experimental Lymphology – Branch of the Federal Research Center Institute of Cytology and Genetics of SB RASRussian Federation2024260420244421927Copyright © Климонтов В.В., Мавлянова К.Р., 20242024Климонтов В.В., Мавлянова К.Р.Klimontov V.V., Mavlianov К.R.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/1455

Классические знания о патогенезе сахарного диабета (СД) и его осложнений в последние годы дополнились представлениями о роли хронического воспаления. Установлено, что воспалительные реакции играют роль в дисфункции бета-клеток, формировании инсулинорезистентности и ремоделировании сосудистой стенки. Центральную роль в развитии воспаления играют цитокины – растворимые низкомолекулярные белки и пептиды, выполняющие информационные и регуляторные функции. Широкий спектр биологической активности и вовлеченность во многие аспекты патогенеза позволяют рассматривать цитокины как перспективные молекулы для диагностики и прогноза осложнений СД. В данном обзоре мы систематизировали данные исследований, в которых оценивалась роль цитокинов как диагностических и прогностических маркеров развития микрососудистых осложнений СД. Имеющиеся данные указывают, что ангиогенные и провоспалительные цитокины (VEGF, TNF-α, IL-6, IL-8, IL-15, IL-17, MCP-1, IP-10, INF-γ, PEDF и др.) являются перспективными биомаркерами пролиферативной диабетической ретинопатии, особенно при исследовании их локальной продукции (в стекловидном теле, водянистой влаге и слезной жидкости). Роль этих молекул как индикаторов непролиферативной диабетической ретинопатии и диабетического макулярного отека заслуживает дальнейших исследований. Сывороточные провоспалительные и фиброгенные цитокины (прежде всего, MCP-1, IL-6, TNF-α, YKL-40, TGF-β и bFGF) и рецепторы цитокинов (sTNFR1, sTNFR2) рассматриваются как перспективные диагностические и прогностические маркеры диабетического поражения почек. Мочевая экскреция IL-6 и MCP-1 является предиктором прогрессирования диабетической нефропатии. Мультиплексный анализ, масс-спектрометрия позволяют исследовать панели цитокинов в небольших по объему образцах биологического материала. Комбинированные биомаркеры, включающие несколько цитокинов, могут повышать надежность прогноза диабетических осложнений.

Classical knowledge about the pathogenesis of diabetes and its complications in recent years has been supplemented by ideas about the role of chronic inflammation. It has been established that inflammatory reactions play a role in the beta cell dysfunction, the formation of insulin resistance and remodeling of the vascular wall. Cytokines, soluble low molecular weight proteins and peptides that perform informational and regulatory functions, play central role in the development of inflammation. A wide range of biological activity and involvement in many aspects of pathogenesis make it possible to consider cytokines as promising molecules for diagnosing and predicting the complications. In this review, we summarize data from studies that assessed the role of cytokines as diagnostic and prognostic markers for the development of microvascular diabetic complications. Current data indicate that angiogenic and pro-inflammatory cytokines (VEGF, TNF-α, IL-6, IL-8, IL-15, IL-17, MCP-1, IP-10, INF-γ, PEDF, etc.) are promising biomarkers for proliferative diabetic retinopathy, especially when their local production is assessed (in vitreous, aqueous humor and tears). The role of these molecules as biomarkers of non-proliferative diabetic retinopathy and diabetic macular edema needs further research. Serum proinflammatory and fibrogenic cytokines (primarily MCP-1, IL-6, TNF-α, YKL-40, TGF-β and bFGF) and cytokine receptors (sTNFR1, sTNFR2) are considered as promising diagnostic and prognostic markers of diabetic kidney disease. Urinary excretion of IL-6 and MCP-1 turned out to be a predictor of the progression of diabetic nephropathy. Multi-bead assay and mass spectrometry make it possible to study cytokine panels in small samples of biological material. Combined biomarkers, including several cytokines, may increase the reliability of the prognosis of diabetic complications.

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