actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.29413/ABS.2025-10.5.3actabiomedica-5658Research ArticleАКУШЕРСТВО И ГИНЕКОЛОГИЯOBSTETRICS AND GYNAECOLOGYПатогенетические механизмы дисфункции гематоэнцефалического барьера при преэклампсииPathogenetic mechanisms of blood-brain barrier dysfunction in preeclampsiahttps://orcid.org/0000-0002-6223-8888ТаскинаЕ. С.TaskinaE. S.

Таскина Елизавета Сергеевна – кандидат медицинских наук, доцент кафедры офтальмологии

672000, Чита, ул. Горького, 39а, Россия

Elizaveta S. Taskina – Cand. Sc. (Med.), Associate Professor at the Department of Ophthalmology

Gorkiy str., 39a, 672000 Chita, Russian Federation

taskins@yandex.ruhttps://orcid.org/0000-0002-0975-2351ЦыбиковН. Н.TsybikovN. N.

Цыбиков Намжил Нанзатович – доктор медицинских наук, профессор, заведующий кафедрой патологической физиологии

672000, Чита, ул. Горького, 39а, Россия

Namzhil N. Tsybikov – Dr. Sc. (Med.), Professor, Head of the Department of Pathological Physiology

Gorkiy str., 39a, 672000 Chita, Russian Federation

thybikov@mail.ruhttps://orcid.org/0000-0003-4390-183XКибалинаИ. В.KibalinaI. V.

Кибалина Ирина Владимировна – доктор медицинских наук, доцент, директор НИИ Молекулярной медицины, заведующий кафедрой нормальной физиологии имени профессора Б.И. Кузника 

672000, Чита, ул. Горького, 39а, Россия

Irina V. Kibalina – Dr. Sc. (Med.), Associate Professor, Director of the Research Institute of Molecular Medicine, Head of the Department of Normal Physiology named after Professor B.I. Kuznik

Gorkiy str., 39a, 672000 Chita, Russian Federation

physiology_chgma@mail.ruhttps://orcid.org/0000-0002-5961-5400МудровВ. А.MudrovV. A.

Мудров Виктор Андреевич – доктор медицинских наук, доцент, профессор кафедры акушерства и гинекологии педиатрического факультета и факультета дополнительного профессионального образования

672000, Чита, ул. Горького, 39а, Россия

Viktor A. Mudrov – Dr. Sc. (Med.), Associate Professor, Professor of the Department of Obstetrics and Gynecology, Faculty of Pediatrics and Faculty of Additional Professional Education

Gorkiy str., 39a, 672000 Chita, Russian Federation

mudrov_viktor@mail.ruhttps://orcid.org/0000-0001-6690-7391ДавыдовС. О.DavydovS. O.

Давыдов Сергей Олегович – доктор медицинских наук, профессор кафедры травматологии и ортопедии

672000, Чита, ул. Горького, 39а, Россия

Sergey O. Davydov – Dr. Sc. (Med.), Professor of the Department of Traumatology and Orthopedics

Gorkiy str., 39a, 672000 Chita, Russian Federation

davydov-so@mail.ruФГБОУ ВО «Читинская государственная медицинская академия» Минздрава РФРоссияChita State Medical AcademyRussian Federation2025171220251052437Copyright © Таскина Е.С., Цыбиков Н.Н., Кибалина И.В., Мудров В.А., Давыдов С.О., 20252025Таскина Е.С., Цыбиков Н.Н., Кибалина И.В., Мудров В.А., Давыдов С.О.Taskina E.S., Tsybikov N.N., Kibalina I.V., Mudrov V.A., Davydov S.O.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/5658

Гипертензивные расстройства во время беременности относятся к наиболее сложным и нерешенным проблемам современного акушерства. На сегодняшний день их частота составляет от 12 до 40 % и не имеет тенденции к снижению. Около 60–70 % материнских смертей при гипертензивных расстройствах происходят из-за церебральных осложнений, вследствие развития эклампсии, отека головного мозга и инсульта. Недооценка степени тяжести состояния, неадекватное лечение и запоздалое родоразрешение являются основной причиной материнской заболеваемости и смертности. Несмотря на значительные успехи в понимании основных этапов патогенеза преэклампсии, механизмы повреждения эндотелиальных клеток сосудов головного мозга, а также особенности локальной паракринной и аутокринной регуляции цереброваскулярного кровотока в провоспалительных и гипоксических условиях, остаются актуальными для дальнейшего изучения. Данный литературный обзор посвящен изучению основных механизмов нарушения и/или повреждения гематоэнцефалического барьера при преэклампсии. Проведен систематический анализ современной отечественной и зарубежной литературы с использованием информационных баз eLibrary, Scopus, PubMed, MEDLINE и Cochrane Library за период с января 2010 г. по декабрь 2024 г. Представлена информация о роли фактора роста эндотелия сосудов и системы его рецепторов в увеличении трансклеточного транспорта, а также белков плотных контактов в усилении параклеточного пути. Описаны механизмы нарушения ауторегуляции мозгового кровотока, ведущие к развитию вазогенного отека головного мозга при преэклампсии и эклампсии. Понимание ключевых звеньев патогенеза повреждения гематоэнцефалического барьера при преэклампсии позволит в дальнейшем определить надежные и доступные ранние предикторы развития церебральной дисфункции при данном осложнении беременности.

Hypertensive disorders during pregnancy are the most difficult and unresolved problems of modern obstetrics. Today, their frequency ranges from 12 to 40 % and has no downward trend. About 60–70 % of maternal deaths in hypertensive disorders occur due to cerebral complications, due to the development of eclampsia, cerebral edema and stroke. Underestimating the severity of the condition, inadequate treatment and delayed delivery are the main causes of maternal morbidity and mortality. Despite significant advances in understanding the main stages of the pathogenesis of preeclampsia, the mechanisms of damage to cerebral vascular endothelial cells, as well as the features of local paracrine and autocrine regulation of cerebrovascular blood flow in proinflammatory and hypoxic conditions remain relevant for further study. This literature review is devoted to the study of the main mechanisms of disruption and/or damage to the blood-brain barrier in preeclampsia. A systematic analysis of modern Russian and foreign literature was carried out using the information databases eLibrary, Scopus, PubMed, MEDLINE and Cochrane Library for the period from January 2010 to December 2024. Information is provided on the role of vascular endothelial growth factor and its receptor system in increasing transcellular transport, as well as close contact proteins in enhancing the paracellular pathway. The mechanisms of impaired autoregulation of cerebral blood flow leading to the development of vasogenic cerebral edema in preeclampsia and eclampsia are described. Understanding the key links in the pathogenesis of damage to the blood-brain barrier in preeclampsia will allow us to further identify reliable and accessible early predictors of the development of cerebral dysfunction in this complication of pregnancy.

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