9 research outputs found
ΠΠΊΡΠΏΡΠ΅ΡΡΠΈΡ ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΠΎΠΉ ΡΠΎΡΠΊΠΈ ΠΈΠΌΠΌΡΠ½ΠΈΡΠ΅ΡΠ° B7-H3 Π² ΠΎΠΏΡΡ ΠΎΠ»ΠΈ ΠΈ Π΅Π΅ ΡΠ°ΡΡΠ²ΠΎΡΠΈΠΌΠΎΠΉ ΡΠΎΡΠΌΡ Π² ΡΡΠ²ΠΎΡΠΎΡΠΊΠ΅ ΠΊΡΠΎΠ²ΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡΠΌΠΈ ΠΊΠΎΡΡΠ΅ΠΉ
B7-H3, also called CD276, is a type I transmembrane glycoprotein that is encoded on human chromosome 15. It was discovered back in 2001. The original study described it as a positive co-stimulant, as it can stimulate T-cell response and IFN-y production. However, recent researches have shown that B7-H3 is involved in T-cell inhibition. A B7-H3 receptor has not been yet identified, and this may explain the complex immunomodulatory activity of B7-H3, as it can have more than one binding partner with different functions. Expression of the B7-H3 protein has been found on activated immune cells such as T-cells, NK cells and antigen presenting cells. Interestingly, it is overexpressed in a wide range of tumor cells and is associated with disease progression and outcome. The soluble form of this protein is also of particular interest. Increased sB7-H3 levels in the plasma of bone tumor patients might be their important diagnostic criterion.B7-H3, ΡΠ°ΠΊΠΆΠ΅ Π½Π°Π·ΡΠ²Π°Π΅ΠΌΡΠΉ CD276, ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ΅Ρ ΡΠΎΠ±ΠΎΠΉ ΡΡΠ°Π½ΡΠΌΠ΅ΠΌΠ±ΡΠ°Π½Π½ΡΠΉ Π³Π»ΠΈΠΊΠΎΠΏΡΠΎΡΠ΅ΠΈΠ½ ΡΠΈΠΏΠ° I, ΠΊΠΎΡΠΎΡΡΠΉ ΠΊΠΎΠ΄ΠΈΡΡΠ΅ΡΡΡ Π½Π° Ρ
ΡΠΎΠΌΠΎΡΠΎΠΌΠ΅ 15 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ°. ΠΠ½ Π±ΡΠ» ΠΎΡΠΊΡΡΡ Π΅ΡΠ΅ Π² 2001 Π³. ΠΠ΅ΡΠ²ΠΎΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΎΠΏΠΈΡΠ°Π»ΠΎ Π΅Π³ΠΎ ΠΊΠ°ΠΊ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΠΉ ΠΊΠΎΡΡΠΈΠΌΡΠ»ΡΡΠΎΡ Π²ΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅ ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΠΈ ΡΡΠΈΠΌΡΠ»ΠΈΡΠΎΠ²Π°ΡΡ Π’-ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΉ ΠΎΡΠ²Π΅Ρ ΠΈ ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΡ IFN-Y. ΠΠ΄Π½Π°ΠΊΠΎ Π½Π΅Π΄Π°Π²Π½ΠΈΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ, ΡΡΠΎ B7-H3 ΡΡΠ°ΡΡΠ²ΡΠ΅Ρ Π² ΠΈΠ½Π³ΠΈΠ±ΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ Π’-ΠΊΠ»Π΅ΡΠΎΠΊ. Π Π΅ΡΠ΅ΠΏΡΠΎΡ Π΄Π»Ρ B7-H3 Π΅ΡΠ΅ Π½Π΅ ΠΈΠ΄Π΅Π½ΡΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½. ΠΡΠΎ ΠΎΠ±ΡΡΡΠ½ΡΠ΅Ρ ΡΠ»ΠΎΠΆΠ½ΡΡ ΠΈΠΌΠΌΡΠ½ΠΎΠΌΠΎΠ΄ΡΠ»ΠΈΡΡΡΡΡΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ B7-H3, ΠΊΠΎΡΠΎΡΡΠΉ ΠΌΠΎΠΆΠ΅Ρ ΠΈΠΌΠ΅ΡΡ Π±ΠΎΠ»Π΅Π΅ ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΏΠ°ΡΡΠ½Π΅ΡΠ° ΠΏΠΎ ΡΠ²ΡΠ·ΡΠ²Π°Π½ΠΈΡ Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠΌΠΈ ΡΡΠ½ΠΊΡΠΈΡΠΌΠΈ. ΠΠΊΡΠΏΡΠ΅ΡΡΠΈΡ Π±Π΅Π»ΠΊΠ° B7-H3 Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΈ Π½Π° Π°ΠΊΡΠΈΠ²ΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΈΠΌΠΌΡΠ½Π½ΡΡ
ΠΊΠ»Π΅ΡΠΊΠ°Ρ
, ΡΠ°ΠΊΠΈΡ
ΠΊΠ°ΠΊ Π’-ΠΊΠ»Π΅ΡΠΊΠΈ, NK-ΠΊΠ»Π΅ΡΠΊΠΈ ΠΈ Π°Π½ΡΠΈΠ³Π΅Π½ΠΏΡΠ΅Π·Π΅Π½ΡΠΈΡΡΡΡΠΈΠ΅ ΠΊΠ»Π΅ΡΠΊΠΈ. ΠΠ½ΡΠ΅ΡΠ΅ΡΠ½ΠΎ, ΡΡΠΎ ΠΎΠ½ Π³ΠΈΠΏΠ΅ΡΡΠΊΡΠΏΡΠ΅ΡΡΠΈ-ΡΠΎΠ²Π°Π½ Π² ΡΠΈΡΠΎΠΊΠΎΠΌ ΡΠΏΠ΅ΠΊΡΡΠ΅ ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΡ
ΠΊΠ»Π΅ΡΠΎΠΊ ΠΈ ΡΠ²ΡΠ·Π°Π½ Ρ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΠ΅ΠΉ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΈ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΎΠΌ. ΠΡΠΎΠ±ΡΠΉ ΠΈΠ½ΡΠ΅ΡΠ΅Ρ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ΅Ρ ΡΠ°ΠΊΠΆΠ΅ ΡΠ°ΡΡΠ²ΠΎΡΠΈΠΌΠ°Ρ ΡΠΎΡΠΌΠ° Π΄Π°Π½Π½ΠΎΠ³ΠΎ Π±Π΅Π»ΠΊΠ°. ΠΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡ sB7-H3 Π² ΠΏΠ»Π°Π·ΠΌΠ΅ ΠΊΡΠΎΠ²ΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΎΠΏΡΡ
ΠΎΠ»ΡΠΌΠΈ ΠΊΠΎΡΡΠ΅ΠΉ ΠΌΠΎΠΆΠ΅Ρ ΠΎΠΊΠ°Π·Π°ΡΡΡΡ Π²Π°ΠΆΠ½ΡΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅ΠΌ
Π₯ΡΠΎΠΌΠΎΠ³ΡΠ°Π½ΠΈΠ½ Π ΠΈ ΡΠ΅ΡΠΎΡΠΎΠ½ΠΈΠ½ Π² ΠΎΡΠ΅Π½ΠΊΠ΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ Π½Π΅ΠΉΡΠΎΡΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½ΡΡ ΠΎΠΏΡΡ ΠΎΠ»Π΅ΠΉ
Background: The utility of biochemical markers in the monitoring of treatment efficacy in patients with neuroendocrine tumors (NETs) goes beyond any doubt. However, there are still no clear criteria for the assessment of clinically significant abnormalities of the main NET biomarkers chromogranin A (CgA) and serotonin. Aim: To evaluate the value of serial measurement of serum CgA and serotonin in the monitoring of the treatment effect in NET patients. Materials and methods: Serum CgA and serotonin levels were measured in 107 patients with NETs at baseline and at 3β4 weeks after the end of treatment (chemotherapy, biotherapy), as well as in 60 healthy controls. We used enzyme immunoassay based on Chromogranin A NEOLISA (Euro Diagnostica) and Serotonin ELISA (IBL International GmbH) test systems. Results: There was an association between CgA levels and the efficacy of chemotherapy in NET patients. With progression of the disease, median CgA increased significantly from 412 to 2679 ng/mL (p = 0.012), whereas in the patients with partial response it decreased from 811 to 254 ng/mL (p = 0.023). The ROC analysis showed the 33% cut-off for significant CgA changes for progression, with sensitivity of 80.0% and specificity of 95.6%. A decrease (of more than 33% compared to baseline levels) or absence of significant CgA changes was associated with stabilization of the disease or with partial response to treatment. Significantly decreased CgA levels were found in 75.0% cases of partial response and 43.48% of stabilized patients, whereas the absence of any significant changes in 25 and 66.7%, respectively. There was no association between serotonin levels and the disease behavior under treatment.Conclusion: CgA could be used as a sensitive marker of NET progression on chemotherapy.ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. Π¦Π΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΠΎΡΡΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² Π² ΠΊΠΎΠ½ΡΡΠΎΠ»Π΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
Π½Π΅ΠΉΡΠΎΡΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½ΡΠΌΠΈ ΠΎΠΏΡΡ
ΠΎΠ»ΡΠΌΠΈ (ΠΠΠ) Π½Π΅ Π²ΡΠ·ΡΠ²Π°Π΅Ρ ΡΠΎΠΌΠ½Π΅Π½ΠΈΠΉ. ΠΠ΄Π½Π°ΠΊΠΎ Π΄ΠΎ ΡΠΈΡ
ΠΏΠΎΡ ΠΎΡΡΡΡΡΡΠ²ΡΡΡ ΡΠ΅ΡΠΊΠΈΠ΅ ΠΊΡΠΈΡΠ΅ΡΠΈΠΈ ΠΎΡΠ΅Π½ΠΊΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΡΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ ΡΡΠΎΠ²Π½Π΅ΠΉ ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² ΠΠΠ β Ρ
ΡΠΎΠΌΠΎΠ³ΡΠ°Π½ΠΈΠ½Π° Π (Π₯Π³Π) ΠΈ ΡΠ΅ΡΠΎΡΠΎΠ½ΠΈΠ½Π°. Π¦Π΅Π»Ρ β ΠΎΡΠ΅Π½ΠΈΡΡ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΡ ΡΠ΅ΡΠΈΠΉΠ½ΠΎΠ³ΠΎ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Π₯Π³Π ΠΈ ΡΠ΅ΡΠΎΡΠΎΠ½ΠΈΠ½Π° Π² ΡΡΠ²ΠΎΡΠΎΡΠΊΠ΅ ΠΊΡΠΎΠ²ΠΈ Π΄Π»Ρ ΠΌΠΎΠ½ΠΈΡΠΎΡΠΈΠ½Π³Π° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ Π₯Π³Π ΠΈ ΡΠ΅ΡΠΎΡΠΎΠ½ΠΈΠ½Π° Π² ΡΡΠ²ΠΎΡΠΎΡΠΊΠ΅ ΠΊΡΠΎΠ²ΠΈ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΎ Ρ 107 Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ ΠΏΡΠΈ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΌ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΠΈ Π² Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ΅ ΡΠ΅ΡΠ΅Π· 3β4 Π½Π΅Π΄Π΅Π»ΠΈ ΠΏΠΎΡΠ»Π΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΊΡΡΡΠ° Π»Π΅ΡΠ΅Π½ΠΈΡ (Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΡ, Π±ΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΡ), Π° ΡΠ°ΠΊΠΆΠ΅ Ρ 60 ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π΄ΠΎΡΠΎΠ²ΡΡ
Π»ΡΠ΄Π΅ΠΉ. ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈ ΠΈΠΌΠΌΡΠ½ΠΎΡΠ΅ΡΠΌΠ΅Π½ΡΠ½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ ΡΠ΅ΡΡ-ΡΠΈΡΡΠ΅ΠΌ Chromogranin A NEOLISA (Euro Diagnostica) ΠΈ Serotonin ELISA (IBL International GmbH). Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΡΠ²Π»Π΅Π½Π° ΡΠ²ΡΠ·Ρ ΡΡΠΎΠ²Π½Π΅ΠΉ Π₯Π³Π Ρ ΡΡΡΠ΅ΠΊΡΠΎΠΌ Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ. ΠΡΠΈ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΠ°Π½Π° Π₯Π³Π ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎ ΠΏΠΎΠ²ΡΡΠ°Π»Π°ΡΡ (Ρ 412 Π΄ΠΎ 2679 Π½Π³/ΠΌΠ», p=0,012), ΡΠΎΠ³Π΄Π° ΠΊΠ°ΠΊ ΠΏΡΠΈ ΡΠ°ΡΡΠΈΡΠ½ΠΎΠΌ ΠΎΡΠ²Π΅ΡΠ΅ Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΈ Π΅Π΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ (Ρ 811 Π΄ΠΎ 254 Π½Π³/ΠΌΠ», p=0,023). ΠΠΎ Π΄Π°Π½Π½ΡΠΌ ROC-Π°Π½Π°Π»ΠΈΠ·Π°, ΠΏΠΎΡΠΎΠ³ Π·Π½Π°ΡΠΈΠΌΠΎΠ³ΠΎ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ Π₯Π³Π Π΄Π»Ρ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠΎΡΡΠ°Π²ΠΈΠ» 33% ΠΏΡΠΈ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ 80,0% ΠΈ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΠΈ 95,6%. Π‘Π½ΠΈΠΆΠ΅Π½ΠΈΠ΅ (Π±ΠΎΠ»Π΅Π΅ 33% ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΡΡΠΎΠ²Π½Ρ Π΄ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ) ΠΈΠ»ΠΈ ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ Π·Π½Π°ΡΠΈΠΌΡΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ Π₯Π³Π Π±ΡΠ»ΠΎ ΡΠ²ΡΠ·Π°Π½ΠΎ ΡΠΎ ΡΡΠ°Π±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠ΅ΠΉ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΈΠ»ΠΈ ΡΠ°ΡΡΠΈΡΠ½ΡΠΌ ΠΎΡΠ²Π΅ΡΠΎΠΌ Π½Π° ΡΠ΅ΡΠ°ΠΏΠΈΡ. ΠΠ½Π°ΡΠΈΠΌΠΎΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΡΠΎΠ²Π½Π΅ΠΉ Π₯Π³Π ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ Π² 75,0% ΡΠ»ΡΡΠ°Π΅Π² ΠΏΡΠΈ ΡΠ°ΡΡΠΈΡΠ½ΠΎΠΌ ΠΎΡΠ²Π΅ΡΠ΅ ΠΈ Π² 43,48% β ΠΏΡΠΈ ΡΡΠ°Π±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ, ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ Π·Π½Π°ΡΠΈΠΌΡΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ β Π² 25 ΠΈ 66,7% ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ. ΠΠ»Ρ ΡΠ΅ΡΠΎΡΠΎΠ½ΠΈΠ½Π° Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠΈ Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π½Π° ΡΠΎΠ½Π΅ Π»Π΅ΡΠ΅Π½ΠΈΡ Π½Π΅ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π₯Π³Π ΠΌΠΎΠΆΠ΅Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡΡΡ Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΌΠ°ΡΠΊΠ΅ΡΠ° ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΠΠ Π½Π° ΡΠΎΠ½Π΅ Ρ
ΠΈΠΌΠΈΠΎΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ
ΠΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΎΠΌΠΈΠΊΠΈ ΡΡΠ΅ΡΠΎΠΈΠ΄ΠΎΠ² ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ Π³Π°Π·ΠΎΠ²ΠΎΠΉ Ρ ΡΠΎΠΌΠ°ΡΠΎ-ΠΌΠ°ΡΡ-ΡΠΏΠ΅ΠΊΡΡΠΎΠΌΠ΅ΡΡΠΈΠΈ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ Π°Π΄ΡΠ΅Π½ΠΎΠΊΠΎΡΡΠΈΠΊΠ°Π»ΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ ΠΈ Ρ ΠΈΠ½ΡΠΈΠ΄Π΅Π½ΡΠ°Π»ΠΎΠΌΠΎΠΉ Π½Π°Π΄ΠΏΠΎΡΠ΅ΡΠ½ΠΈΠΊΠΎΠ² ΠΏΡΠΈ Π²ΡΠΎΠΆΠ΄Π΅Π½Π½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ ΠΊΠΎΡΡ Π½Π°Π΄ΠΏΠΎΡΠ΅ΡΠ½ΠΈΠΊΠΎΠ²
Background: Prolonged episodes of uncontrolled congenital adrenal hyperplasia (CAH) have been shown to result in the occurrence of secondary adrenal neoplasms. Prevalence of adrenal incidentalomas in the patients with 21-hydroxylase deficiency ranges from 11% to 82%. As assessed by gas chromatography-mass spectrometry (GC-MS), patients with adrenocortical cancer (ACC) have increased level of steroid hormone precursors due to decreased activity of adrenal steroidogenesis enzymes, mainly that of 21-hydroxylase and 11-hydroxylase. It seems relevant to compare the specific characteristics of steroid metabolism by GC-MS in ACC patients and in patients with adrenal incidentalomas and CAH associated with 21-hydroxylase deficiency (21-OHD).
Aim: To identify (by GC-MS) common abnormalities in steroid metabolism and differential diagnostic biomarkers in ACC patients and CAH patients with 21-OHD and adrenal masses.
Materials and methods: The study included 41 patients with adrenal cortex neoplasms aged 18 to 65 years without clinical and laboratory signs of endogenous hypercortisolism. Twenty three (23) patients had non-metastatic ACC and 18 patients had CAH due to 21-OHD. The control group included 26 healthy blood donors aged 20 to 59 years. Urine steroid profiles were measured by GC-MS with a gas chromatograph-mass spectrometer (Shimadzu GCMS-QP2020).
Results: In the ACC patients, there was an increase in urinary excretion of tetrahydro-11-deoxycortisol, dehydroepiandrosterone, androstenediol-17, etiocholanolone, pregnenediol, and 3,16,20-pregnenetriol (3,16,20-dP3), as well as a decrease in the 3,16,20-dP3/3,16,20-dP3 ratio, compared to the values in the patients with CAH due to 21-OHD. Compared to the healthy control, 21-hydroxylase, 11-hydroxylase, 5-reductase and 11-hydroxysteroid-dehydrogenase (11-HSDH) type 2 activities were lower. Compared to the ACC patients, those with CAH due to 21-OHD had higher urinary excretion of 11-oxo-pregnanetriol (11-oxo-P3) and 21-deoxy-tetrahydrocortisol and lower 5-THF+5-THF+THE)/11-oxo-P3 ratio of 9.0, determination of 11-oxo-dP3, signs higher 5-reductase activity and lower 11-HSDH type 1 activity. The ACC patients and the patients with CAH due to 21-OHD had common abnormalities of steroid metabolism, such as lower activities of 21-hydroxylase, 3-hydroxysteroid-dehydrogenase and 11-hydroxylase, and no differences in urinary excretion of a number of ACC biomarkers (androgens, pregnanediol, and 5-ene-pregnenes).
Conclusion: The assessment of urinary excretion of androgens, progestagens, and glucocorticoids by GC-MS made it possible to identify common abnormalities in steroid metabolism in the patients with ACC and CAH due to 21-OHD, which confirms the role of disordered steroidogenesis in the formation of adrenocortical tumors.ΠΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠ΅. Π£ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ ΡΠΏΠΈΠ·ΠΎΠ΄Ρ Π΄Π΅ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠ°ΡΠΈΠΈ Π²ΡΠΎΠΆΠ΄Π΅Π½Π½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ ΠΊΠΎΡΡ Π½Π°Π΄ΠΏΠΎΡΠ΅ΡΠ½ΠΈΠΊΠΎΠ² (ΠΠΠΠ) ΠΏΡΠΈΠ²ΠΎΠ΄ΡΡ ΠΊ ΠΏΠΎΡΠ²Π»Π΅Π½ΠΈΡ Π²ΡΠΎΡΠΈΡΠ½ΡΡ
Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ Π² Π½Π°Π΄ΠΏΠΎΡΠ΅ΡΠ½ΠΈΠΊΠ°Ρ
. Π£ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π΄Π΅ΡΠ΅ΠΊΡΠΎΠΌ 21-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΠ»Π°Π·Ρ ΡΠ°ΡΡΠΎΡΠ° Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ ΠΈΠ½ΡΠΈΠ΄Π΅Π½ΡΠ°Π»ΠΎΠΌ Π½Π°Π΄ΠΏΠΎΡΠ΅ΡΠ½ΠΈΠΊΠΎΠ² ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ ΠΎΡ 11 Π΄ΠΎ 82%. Π£ Π±ΠΎΠ»ΡΠ½ΡΡ
Π°Π΄ΡΠ΅Π½ΠΎΠΊΠΎΡΡΠΈΠΊΠ°Π»ΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ (ΠΠΠ ) ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ Π³Π°Π·ΠΎΠ²ΠΎΠΉ Ρ
ΡΠΎΠΌΠ°ΡΠΎ-ΠΌΠ°ΡΡ-ΡΠΏΠ΅ΠΊΡΡΠΎΠΌΠ΅ΡΡΠΈΠΈ (ΠΠ₯-ΠΠ‘) ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½Π° ΠΏΠΎΠ²ΡΡΠ΅Π½Π½Π°Ρ ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΡ ΠΏΡΠ΅Π΄ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΈΠΊΠΎΠ² ΡΡΠ΅ΡΠΎΠΈΠ΄Π½ΡΡ
Π³ΠΎΡΠΌΠΎΠ½ΠΎΠ² Π²ΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ΅ΡΠΌΠ΅Π½ΡΠΎΠ² Π°Π΄ΡΠ΅Π½Π°Π»ΠΎΠ²ΠΎΠ³ΠΎ ΡΡΠ΅ΡΠΎΠΈΠ΄ΠΎΠ³Π΅Π½Π΅Π·Π°, Π³Π»Π°Π²Π½ΡΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠΌ, 21-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΠ»Π°Π·Ρ ΠΈ 11-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΠ»Π°Π·Ρ. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ΅ΡΡΡ Π°ΠΊΡΡΠ°Π»ΡΠ½ΡΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠ΅ΠΉ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΠ·ΠΌΠ° ΡΡΠ΅ΡΠΎΠΈΠ΄ΠΎΠ² ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΠ₯-ΠΠ‘ Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ ΠΈ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠΠ Π²ΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅ Π΄Π΅ΡΠ΅ΠΊΡΠ° 21-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΠ»Π°Π·Ρ Ρ ΠΠ.
Π¦Π΅Π»Ρ ΡΡΡΠ°Π½ΠΎΠ²ΠΈΡΡ ΠΎΠ±ΡΠΈΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΠ·ΠΌΠ° ΡΡΠ΅ΡΠΎΠΈΠ΄ΠΎΠ² ΠΈ Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΠΎ-Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΡ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ ΠΈ Ρ ΠΠΠΠ Π²ΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅ Π΄Π΅ΡΠ΅ΠΊΡΠ° 21-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΠ»Π°Π·Ρ Ρ ΠΠ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΠ₯-ΠΠ‘.
ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ 41 ΠΏΠ°ΡΠΈΠ΅Π½Ρ Ρ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡΠΌΠΈ ΠΊΠΎΡΡ Π½Π°Π΄ΠΏΠΎΡΠ΅ΡΠ½ΠΈΠΊΠΎΠ² Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ ΠΎΡ 18 Π΄ΠΎ 65 Π»Π΅Ρ Π±Π΅Π· ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² ΡΠ½Π΄ΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ Π³ΠΈΠΏΠ΅ΡΠΊΠΎΡΡΠΈΠ·ΠΎΠ»ΠΈΠ·ΠΌΠ°: 23 Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ Π±Π΅Π· ΠΌΠ΅ΡΠ°ΡΡΠ°Π·ΠΎΠ² ΠΈ 18 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠΠ Π²ΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅ Π΄Π΅ΡΠ΅ΠΊΡΠ° 21-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΠ»Π°Π·Ρ. ΠΡΡΠΏΠΏΡ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ 26 Π·Π΄ΠΎΡΠΎΠ²ΡΡ
Π΄ΠΎΠ½ΠΎΡΠΎΠ² Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ ΠΎΡ 20 Π΄ΠΎ 59 Π»Π΅Ρ. ΠΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΠ₯-ΠΠ‘ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π»ΠΈ ΡΡΠ΅ΡΠΎΠΈΠ΄Π½ΡΠ΅ ΠΏΡΠΎΡΠΈΠ»ΠΈ ΠΌΠΎΡΠΈ Π½Π° Π³Π°Π·ΠΎΠ²ΠΎΠΌ Ρ
ΡΠΎΠΌΠ°ΡΠΎ-ΠΌΠ°ΡΡ-ΡΠΏΠ΅ΠΊΡΡΠΎΠΌΠ΅ΡΡΠ΅ Shimadzu GCMS-QP2020.
Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π£ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΡΠΊΡΠΊΡΠ΅ΡΠΈΠΈ Ρ ΠΌΠΎΡΠΎΠΉ ΡΠ΅ΡΡΠ°Π³ΠΈΠ΄ΡΠΎ-11-Π΄Π΅Π·ΠΎΠΊΡΠΈΠΊΠΎΡΡΠΈΠ·ΠΎΠ»Π°, Π΄Π΅Π³ΠΈΠ΄ΡΠΎΡΠΏΠΈΠ°Π½Π΄ΡΠΎΡΡΠ΅ΡΠΎΠ½Π°, Π°Π½Π΄ΡΠΎΡΡΠ΅Π½Π΄ΠΈΠΎΠ»Π°-17, ΡΡΠΈΠΎΡ
ΠΎΠ»Π°Π½ΠΎΠ»ΠΎΠ½Π°, ΠΏΡΠ΅Π³Π½Π°Π½Π΄ΠΈΠΎΠ»Π° ΠΈ 3,16,20-ΠΏΡΠ΅Π³Π½Π΅Π½ΡΡΠΈΠΎΠ»Π° (3,16,20-dP3), ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ 3,16,20-dP3/3,16,20-dP3 Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠΠ Ρ Π΄Π΅ΡΠΈΡΠΈΡΠΎΠΌ 21-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΠ»Π°Π·Ρ; ΠΏΠΎΠ»ΡΡΠ΅Π½Ρ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΈ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ 21-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΠ»Π°Π·Ρ, 11-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΠ»Π°Π·Ρ, 5-ΡΠ΅Π΄ΡΠΊΡΠ°Π·Ρ ΠΈ 11-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΡΡΠ΅ΡΠΎΠΈΠ΄Π΄Π΅Π³ΠΈΠ΄ΡΠΎΠ³Π΅Π½Π°Π·Ρ 2-Π³ΠΎ ΡΠΈΠΏΠ° ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ ΡΠΎ Π·Π΄ΠΎΡΠΎΠ²ΡΠΌΠΈ Π΄ΠΎΠ½ΠΎΡΠ°ΠΌΠΈ. ΠΠ»Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠΠ Ρ Π΄Π΅ΡΠ΅ΠΊΡΠΎΠΌ 21-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΠ»Π°Π·Ρ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ½ΠΎ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ Π±ΠΎΠ»ΡΠ½ΡΠΌΠΈ ΠΠΠ ΡΠΊΡΠΊΡΠ΅ΡΠΈΠΈ Ρ ΠΌΠΎΡΠΎΠΉ 11-ΠΎΠΊΡΠΎ-ΠΏΡΠ΅Π³Π½Π°Π½ΡΡΠΈΠΎΠ»Π° (11-ΠΎΡ
ΠΎ-Π 3), 21-Π΄Π΅Π·ΠΎΠΊΡΠΈ-ΡΠ΅ΡΡΠ°Π³ΠΈΠ΄ΡΠΎΠΊΠΎΡΡΠΈΠ·ΠΎΠ»Π° ΠΈ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΠ΅ ΡΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ (5-Π’ΠF+5-THF+THE)/11-ΠΎΡ
ΠΎ-Π 3 ΠΌΠ΅Π½Π΅Π΅ 9,0, ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ 11-ΠΎΡ
ΠΎ-dP3, ΠΏΡΠΈΠ·Π½Π°ΠΊΠΈ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ 5-ΡΠ΅Π΄ΡΠΊΡΠ°Π·Ρ ΠΈ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ 11-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΡΡΠ΅ΡΠΎΠΈΠ΄Π΄Π΅Π³ΠΈΠ΄ΡΠΎΠ³Π΅Π½Π°Π·Ρ 1-Π³ΠΎ ΡΠΈΠΏΠ°. Π£ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ ΠΈ ΠΠΠΠ Ρ Π΄Π΅ΡΠ΅ΠΊΡΠΎΠΌ 21-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΠ»Π°Π·Ρ Π²ΡΡΠ²Π»Π΅Π½Ρ ΠΎΠ±ΡΠΈΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ Π² ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΠ·ΠΌΠ΅ ΡΡΠ΅ΡΠΎΠΈΠ΄ΠΎΠ²: ΠΏΡΠΈΠ·Π½Π°ΠΊΠΈ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ 21-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΠ»Π°Π·Ρ, 3-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΡΡΠ΅ΡΠΎΠΈΠ΄Π΄Π΅Π³ΠΈΠ΄ΡΠΎΠ³Π΅Π½Π°Π·Ρ ΠΈ 11-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΠ»Π°Π·Ρ, ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ ΡΠ°Π·Π»ΠΈΡΠΈΠΉ ΡΠΊΡΠΊΡΠ΅ΡΠΈΠΈ Ρ ΠΌΠΎΡΠΎΠΉ ΡΡΠ΄Π° Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² ΠΠΠ (Π°Π½Π΄ΡΠΎΠ³Π΅Π½ΠΎΠ², ΠΏΡΠ΅Π³Π½Π°Π½Π΄ΠΈΠΎΠ»Π°, 5-Π΅ne-ΠΏΡΠ΅Π³Π½Π΅Π½ΠΎΠ²).
ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠΊΡΠΊΡΠ΅ΡΠΈΠΈ Ρ ΠΌΠΎΡΠΎΠΉ Π°Π½Π΄ΡΠΎΠ³Π΅Π½ΠΎΠ², ΠΏΡΠΎΠ³Π΅ΡΡΠ°Π³Π΅Π½ΠΎΠ² ΠΈ Π³Π»ΡΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΠΈΠ΄ΠΎΠ² ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΠ₯-ΠΠ‘ Π΄Π°Π»ΠΎ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΡΡΡΠ°Π½ΠΎΠ²ΠΈΡΡ ΠΎΠ±ΡΠΈΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ Π² ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΠ·ΠΌΠ΅ ΡΡΠ΅ΡΠΎΠΈΠ΄ΠΎΠ² Ρ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ ΠΈ ΠΠΠΠ Π²ΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅ Π΄Π΅ΡΠ΅ΠΊΡΠ° 21-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΠ»Π°Π·Ρ, ΡΡΠΎ ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π°Π΅Ρ ΡΠΎΠ»Ρ Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ ΡΡΠ΅ΡΠΎΠΈΠ΄ΠΎΠ³Π΅Π½Π΅Π·Π° Π² ΠΏΡΠΎΡΠ΅ΡΡΠ΅ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΎΠΏΡΡ
ΠΎΠ»Π΅ΠΉ ΠΊΠΎΡΡ Π½Π°Π΄ΠΏΠΎΡΠ΅ΡΠ½ΠΈΠΊΠΎΠ²
ΠΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΡ sPD-1/sPD-L1 ΠΏΡΠΈ ΡΠ°ΠΊΠ΅ ΠΏΠΈΡΠ΅Π²ΠΎΠ΄Π° ΠΈ Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠΌ ΡΠ°ΠΊΠ΅ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ
Π‘Π΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΠ΅ ΠΈ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ β ΡΠΎΠΊΡΡ Π½Π° ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΡΠ΅ΠΌΡΡ ΡΠ°ΠΊΡΠΎΡΠ°Ρ ΡΠΈΡΠΊΠ° ΠΈ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π°ΡΠΏΠ΅ΠΊΡΡ
Currently, in modern medicine, there has been a sharp increase in interest in the combined pathology of cardiovascular diseases (CVD) with other nosologies, such as diabetes mellitus, chronic kidney disease, and oncopathology. Over the past decades, there have been large positive shifts in survival in this cohort of patients. An integral specialty of cardio-oncology is rapidly developing, which is aimed at improving the results of treatment of oncological patients. Due to increased life expectancy and improved long-term prognosis in cancer patients, in particular, the adverse effects of anticancer therapy have attracted great attention from researchers. The causal relationship between cancer and CVD can be partly explained by a common profile of modifiable and non-modifiable risk factors. There is also strong evidence that a systemic inflammatory response is a common pathophysiological determinant of cancer and CVD. General risk factors for development and progression, as well as pathogenetic mechanisms, contribute to high mortality rates. Increasing knowledge of pathophysiological mechanisms will help elucidate the general molecular aspects of carcinogenesis and cardiovascular disease. This review presents general modifiable risk factors and current pathogenetic aspects of cardiovascular and oncological diseases.Π Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ Π² ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½Π΅ ΡΠ΅Π·ΠΊΠΎ Π²ΡΡΠΎΡ ΠΈΠ½ΡΠ΅ΡΠ΅Ρ ΠΊ ΡΠΎΡΠ΅ΡΠ°Π½Π½ΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ (Π‘Π‘Π) Ρ Π΄ΡΡΠ³ΠΈΠΌΠΈ Π½ΠΎΠ·ΠΎΠ»ΠΎΠ³ΠΈΡΠΌΠΈ, ΡΠ°ΠΊΠΈΠΌΠΈ ΠΊΠ°ΠΊ ΡΠ°Ρ
Π°ΡΠ½ΡΠΉ Π΄ΠΈΠ°Π±Π΅Ρ, Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ Π±ΠΎΠ»Π΅Π·Π½Ρ ΠΏΠΎΡΠ΅ΠΊ ΠΈ ΠΎΠ½ΠΊΠΎΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡ. ΠΠ° ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΈΠ΅ Π΄Π΅ΡΡΡΠΈΠ»Π΅ΡΠΈΡ ΠΏΡΠΎΠΈΠ·ΠΎΡΠ»ΠΈ Π±ΠΎΠ»ΡΡΠΈΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ ΡΠ΄Π²ΠΈΠ³ΠΈ Π² Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ Ρ Π΄Π°Π½Π½ΠΎΠΉ ΠΊΠΎΠ³ΠΎΡΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². Π‘ΡΡΠ΅ΠΌΠΈΡΠ΅Π»ΡΠ½ΠΎ ΡΠ°Π·Π²ΠΈΠ²Π°Π΅ΡΡΡ ΠΈΠ½ΡΠ΅Π³ΡΠ°Π»ΡΠ½Π°Ρ ΡΠΏΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΡΡΡ ΠΊΠ°ΡΠ΄ΠΈΠΎΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡ, ΠΊΠΎΡΠΎΡΠ°Ρ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π° Π½Π° ΡΠ»ΡΡΡΠ΅Π½ΠΈΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². Π ΡΠ²ΡΠ·ΠΈ Ρ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΆΠΈΠ·Π½ΠΈ ΠΈ ΡΠ»ΡΡΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΎΡΠ΄Π°Π»Π΅Π½Π½ΠΎΠ³ΠΎ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° Ρ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Π² ΡΠ°ΡΡΠ½ΠΎΡΡΠΈ, Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΠ΅ ΡΡΡΠ΅ΠΊΡΡ ΠΏΡΠΎΡΠΈΠ²ΠΎΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΡΠΈΠ²Π»Π΅ΠΊΠ»ΠΈ ΠΎΠ³ΡΠΎΠΌΠ½ΠΎΠ΅ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»Π΅ΠΉ. ΠΡΠΈΡΠΈΠ½Π½ΠΎ-ΡΠ»Π΅Π΄ΡΡΠ²Π΅Π½Π½Π°Ρ ΡΠ²ΡΠ·Ρ ΠΌΠ΅ΠΆΠ΄Ρ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ Π±ΠΎΠ»Π΅Π·Π½ΡΠΌΠΈ ΠΈ Π‘Π‘Π ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΡΠ°ΡΡΠΈΡΠ½ΠΎ ΠΎΠ±ΡΡΡΠ½Π΅Π½Π° ΠΎΠ±ΡΠΈΠΌ ΠΏΡΠΎΡΠΈΠ»Π΅ΠΌ ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΡΠ΅ΠΌΡΡ
ΠΈ Π½Π΅ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΡΠ΅ΠΌΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ°. Π’Π°ΠΊΠΆΠ΅ ΡΡΡΠ΅ΡΡΠ²ΡΡΡ ΡΠ±Π΅Π΄ΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ Π΄ΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΡΡΠ²Π°, ΡΡΠΎ ΡΠΈΡΡΠ΅ΠΌΠ½Π°Ρ Π²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½Π°Ρ ΡΠ΅Π°ΠΊΡΠΈΡ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΠ±ΡΠ΅ΠΉ ΠΏΠ°ΡΠΎΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½Π°Π½ΡΠΎΠΉ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Π±ΠΎΠ»Π΅Π·Π½Π΅ΠΉ ΠΈ Π‘Π‘Π. ΠΠ±ΡΠΈΠ΅ ΡΠ°ΠΊΡΠΎΡΡ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΈ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΡΡΡ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΡΠ°ΠΌ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΠΈ. Π Π°ΡΡΠΈΡΠ΅Π½ΠΈΠ΅ Π·Π½Π°Π½ΠΈΠΉ ΠΎ ΠΏΠ°ΡΠΎΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠ°Ρ
ΠΏΠΎΠΌΠΎΠΆΠ΅Ρ ΠΏΡΠΎΡΡΠ½ΠΈΡΡ ΠΎΠ±ΡΠΈΠ΅ ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΡΠ΅ Π°ΡΠΏΠ΅ΠΊΡΡ ΠΊΠ°Π½ΡΠ΅ΡΠΎΠ³Π΅Π½Π΅Π·Π° ΠΈ Π‘Π‘Π. Π Π½Π°ΡΡΠΎΡΡΠ΅ΠΌ ΠΎΠ±Π·ΠΎΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΠΎΠ±ΡΠΈΠ΅ ΠΌΠΎΠ΄ΠΈΡΠΈΡΠΈΡΡΠ΅ΠΌΡΠ΅ ΡΠ°ΠΊΡΠΎΡΡ ΡΠΈΡΠΊΠ° ΠΈ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π°ΡΠΏΠ΅ΠΊΡΡ Π‘Π‘Π ΠΈ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ