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Федеральное государственное бюджетное учреждение науки
Институт теоретической и экспериментальной биофизики
Российской академии наук


ООО "ИЦ КОМКОН"

ФГБУН "Институт токсикологии" ФМБА России

Адрес редакции и реквизиты

192012, Санкт-Петербург, ул.Бабушкина, д.82 к.2, литера А, кв.378

Свидетельство о регистрации электронного периодического издания ЭЛ № ФС 77-37726 от 13.10.2009
Выдано - Роскомнадзор

ISSN 1999-6314


Клиническая медицина » Педиатрия •

Том: 24
Статья: « 15 »
Страницы:. 176-199
Опубликована в журнале: 25 марта 2023 г.
English version

Системный ювенильный идиопатический артрит и его биомаркеры (Обзор литературы)

Хальчицкий С.Е., Грачева Ю.А., Печальнова С.А., Буслов К.Г., Виссарионов С.В., Батоцыренова Е.Г., Комов Ю.В., Крецер Т.Ю., Кашуро В.А.

ФГБУ «Национальный медицинский исследовательский центр детской травматологии и ортопедии им. Г.И. Турнера» Минздрава России
ФГБОУ ВО «Санкт-Петербургский государственный педиатрический медицинский университет» Минздрава России
ФГБОУ ВО «Российский государственный педагогический университет им. А.И.Герцена»
ФГБГОУ ВО «Санкт-Петербургский государственный университет»


Резюме
Системный ювенильный идиопатический артрит (сЮИА) и его осложнение, синдром активации макрофагов (сЮИА-МAS), являются редкими, но иногда очень серьезными или даже критическими заболеваниями детского возраста, которые иногда могут характеризоваться неспецифическими клиническими признаками и симптомами в начале заболевания, такими как непрекращающаяся лихорадка, головная боль, сыпь или артралгия - что сопровождается повышенным уровнем реагентов острой фазы. Для правильного утвердительного диагноза необходимо исключить бактериальные или вирусные инфекции, новообразования и другие иммуноопосредованные воспалительные заболевания. Задержка в постановке диагноза приводит к позднему началу таргетной терапии. Набор биомаркеров полезен для того, чтобы отличить сЮИА или сЮИА-МАS от аналогичных клинических состояний, особенно при отсутствии артрита. Анализ биомаркеров должен быть доступен для пациентов, иметь приемлемые цены производства и приобретения для медицинских лабораторий, а также быть достаточно простым в определении, иметь высокую чувствительность и специфичность и коррелировать с патофизиологическими путями развития болезни. В настоящее время назрела необходимость определить наиболее значимые биомаркеры и их синергетическое взаимодействие для простого и точного распознавания сЮИА и сЮИА-МАS, чтобы немедленно ориентировать клиницистов в направлении правильной постановки диагноза, в прогнозировании исходов заболевания, реакции на лечение, и риска рецидивов. Биомаркеры сЮИА представляют собой в настоящее время захватывающую область исследований, особенно из-за гетерогенной природы синдромов цитокинового шторма (CSS) в эпоху COVID. Они должны быть выбраны с особой тщательностью - факт, поддерживаемый все более совершенным генетическим и патофизиологическим пониманием сЮИА, а также CSS - так, чтобы вскоре могли быть разработаны новые системы классификации для правильной дифференцировки сходных групп пациентов, но имеющих заболевания разного генеза. В обзоре представлены сведения о последних достижениях в разработке и применении биомаркеров при системном ювенильном идиопатическом артрите. Выполнялся поиск статей в PubMed, сочетающий заранее определенные ключевые слова, относящиеся к биомаркерам системного ЮИА, его осложнениям и сопутствующим заболеваниям.


Ключевые слова
ювенильный артрит, синдром активации макрофагов, биомаркеры, цитокины, хемокины, предикторы, ремиссия, рецидив, реакция на лечение


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