Мезенхимальные стволовые клетки или внеклеточные везикулы в выборе лечения ревматоидного артрита

Обоснование. Ревматоидный артрит (РА) – это длительное аутоиммунное заболевание, характеризующееся системной иммуновоспалительной реакцией, приводящей к отёку суставов, синовиальной гиперплазии, повреждению хрящей и костной ткани. Эффективного лечения данного заболевания в настоящее время не существует.

Цель обзора литературы. Анализ описанных на сегодняшний день механизмов, лежащих в  основе эффектов мезенхимальных стволовых клеток (МСК) и внеклеточных везикул (ВВ) на патогенетические звенья ревматоидного артрита.

Материалы и  методы исследования. Проанализированы базы данных PubMed и eLibrary за период 2011–2023 гг. с использованием следующих ключевых слов: ревматоидный артрит; гемопоэтические стволовые клетки; мезенхимальные стволовые клетки; ревматоидный фактор; внеклеточные везикулы; клеточная терапия.

Результаты и  обсуждение. В  обзоре описаны современные аспекты этиологии и  патогенеза ревматоидного артрита, его  потенциальные биомаркеры и известные на сегодняшний день терапевтические стратегии. Изучено влияние МСК на T- и В-лимфоциты, а также на других клеточных участников заболевания в экспериментальных и клинических исследованиях. Обзор расширяет понимание картины механизмов терапевтического воздействия постнатальных прогениторных клеток и  их  внеклеточных везикул в лечении ревматоидного артрита, что в аспекте сравнения открывает преимущества и недостатки каждого метода. Можно сделать вывод о  том, что  МСК и  ВВ являются перспективным направлением в  лечении ревматоидного артрита, однако необходимы дальнейшие исследования взаимодействий молекул, влияющих на звенья патогенеза РА. Также необходимы дополнительные исследования, построенные на патогенетически ранжированном подходе в  терапии заболевания, позволяющем выявить закономерности эффектов каждого метода с  последующей рекомендацией в выборе применения прогенитоных клеток или, преимущественно, их секретома в персонифицированной терапии РА, а также необходимо более детальное изучение дозировки, времени и способа их введения.

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