Фармакологическое прекондиционирование

Ключевые слова: фармакологическое прекондиционирование, нейропротекция, кардиопротекция, трансляционная медицина

Аннотация

Прекондиционирование — это применение различных превентивных воздействий с целью повышения устойчивости отдельных органов или организма в целом к повреждающим факторам. Существует два основных подхода прекондиционирования — немедикаментозный, основанный на применении физических факторов умеренной интенсивности (гипоксия/ишемия, холодовой и тепловой стресс и др.), и медикаментозный, получивший название фармакологическое прекондиционирование. Как следует из названия, фармакологическое прекондиционирование осуществляется путем превентивного использования различных фармакологических агентов и в настоящее время рассматривается как перспективный подход для обеспечения кардио- и нейропротекции. В частности, предварительная фармакологическая подготовка может быть удобна для операционных клинических сценариев. Многие фармакологические агенты, предлагаемые для прекондиционирования, уже имеют многолетний опыт применения в клинике. Данные фармакологические агенты могут использоваться и для иных целей. Например, это ингаляционные анестетики, антибиотики, опиоиды. Другими группами веществ, рассматриваемых для фармакологического прекондиционирования, являются агенты бактериального и эндогенного происхождения: стероидные гормоны, липополисахарид, дефероксамин, эритромицин, тромбин, эритропоэтин. С трансляционной точки зрения тот факт, что профили безопасности многих из этих веществ хорошо изучены и проверены, должен облегчать их быстрое клиническое внедрение и применение. Тем не менее, несмотря на то что многие виды фармакологического прекондиционирования доказали свою эффективность и значительный потенциал в модельных исследованиях на животных, большинство из них еще не изучены в клинических условиях. Таким образом, технологии фармакологического прекондиционирования имеют высокий трансляционный потенциал, проблема недостаточности клинических исследований в этой области является крайне актуальной, а ее решение и внедрение данных технологий в клинику может стать прорывом в превентивной медицине. Цель настоящего обзора — привлечь внимание широкого круга исследователей и клиницистов к данной проблеме в надежде, что это будет способствовать активному продвижению к ее решению.

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Опубликован
2020-03-02
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