РОЛЬ ПРОПРОТЕИН-КОНВЕРТАЗЫ СУБТИЛИЗИН/КЕКСИН ТИПА 9 (PCSK9) В ПАТОФИЗИОЛОГИИ АТЕРОСКЛЕРОЗА


Чаулин А.М., Александров А.Г., Александрова О.С., Дупляков Д.В.

Аннотация


Повышенная концентрация липопротеинов низкой плотности (ЛПНП) в сыворотке крови, бесспорно, является важнейшим фактором риска возникновения сердечно-сосудистых заболеваний. В настоящее время статины являются наиболее широко используемыми препаратами для лечения пациентов с гиперхолестеринемией, однако у некоторых пациентов резидуальный сердечно-сосудистый риск остается высоким даже после проведения статиновой терапии максимально переносимыми дозами. Относительно недавно обнаруженная белковая молекула − пропротеин-конвертаза субтилизин/кексин типа 9 (PCSK9) стала новой терапевтической мишенью для снижения сывороточных уровней ЛПНП. PCSK9 усиливает деградацию рецепторов липопротеинов низкой плотности (рЛПНП), из-за чего снижается элиминация частиц ЛПНП из кровотока, что приводит к гиперлипидемии и возникновению атеросклероза. Помимо липидных эффектов, PCSK9 обладает также нелипидными функциями, среди которых усиление воспалительных реакций имеет наибольшее значение для патофизиологии атеросклероза. В обзоре также обсуждается возможность использования PCSK9 в качестве диагностического маркера сердечно-сосудистых заболеваний.


Ключевые слова


пропротеин-конвертаза субтилизин/кексин типа 9 (PCSK9); атеросклероз; липопротеины низкой плотности (ЛПНП); рецепторы липопротеинов низкой плотности (рЛПНП); воспаление

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Литература


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