rpmjResearch'n Practical Medicine JournalResearch and Practical Medicine Journal2410-1893"QUASAR", LLC10.17709/2409-2231-2018-5-3-4rpmj-292Research ArticleОбзорыReviewРоль тромбоцитов в воспалении и иммунитетеThe role of platelets in inflammation and immunityСвиридоваС. П.SviridovaS. P.

Свиридова Светлана Петровна - доктор медицинских наук, профессор, ведущий научный сотрудник отделения реанимации и интенсивной терапии №1.

115478, Москва, Каширское шоссе, д. 24

Svetlana P. Sviridova - MD, PhD, DSc, professor, leading researcher of the ICU №1.

24 Kashirskoe sh., Moscow 115478

СомоноваО. В.SomonovaO. V.

Сомонова Оксана Васильевна - доктор медицинских наук, ведущий научный сотрудник клинико-диагностической лаборатории.

115478, Москва, Каширское шоссе, д. 24

Oksana V. Somonova - MD, PhD, DSc, leading researcher of the clinical diagnostic laboratory.

24 Kashirskoe sh., Moscow 115478

КашияШ. Р.KashiyaSh. R.

Кашия Шалва Робертович, кандидат медицинских наук, заведующий отделом функциональной диагностики, интенсивной терапии и реабилитации.

115478, Москва, Каширское шоссе, д. 24

Shalva R. Kashiya - MD, PhD, head of the department of functional diagnosis, intensive care and rehabilitation.

24 Kashirskoe sh., Moscow 115478

ОбуховаО. А.ObukhovaO. A.

Обухова Ольга Аркадьевна - кандидат медицинских наук, научный сотрудник отдела функциональной диагностики, интенсивной терапии и реабилитации.

115478, Москва, Каширское шоссе, д. 24

Olga A. Obukhova - MD, PhD, researcher of the department of functional diagnosis, intensive care and rehabilitation.

24 Kashirskoe sh., Moscow 115478

obukhova0404@yandex.ruСотниковА. В.SotnikovA. V.

Сотников Анатолий Вячеславович - доктор медицинских наук, заведующий отделением анестезиологии и реанимации.

127299, Москва, ул. Приорова, д. 10

Anatolii V. Sotnikov - MD, PhD, DSc, head of the department of ICU.

10 Priorova str., Moscow 127299

ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н.Блохина» Министерства здравоохранения Российской ФедерацииРоссияN.N.Blokhin National Medical Research Center of Oncology of Ministry of Health of RussiaRussian FederationФГБУ Научно-медицинский исследовательский центр травматологии и ортопедии им. Н.Н.ПриороваРоссияN.N.Priorov National Medical Research Center of Traumatology and OrthopedicsRussian Federation201810092018534052Copyright © Свиридова С.П., Сомонова О.В., Кашия Ш.Р., Обухова О.А., Сотников А.В., 20182018Свиридова С.П., Сомонова О.В., Кашия Ш.Р., Обухова О.А., Сотников А.В.Sviridova S.P., Somonova O.V., Kashiya S.R., Obukhova O.A., Sotnikov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpmj.ru/rpmj/article/view/292

В последние десятилетия достигнут существенный прогресс в понимании механизмов функционирования тромбоцитов и коррекции тромбоцитарного гемостаза. Тромбоциты рассматриваются как важнейшие участники и нормального, и патологического тромботического процесса, характерного для самых разных заболеваний и состояний. В представленном обзоре освещены патофизиологические механизмы синтеза тромбоцитами различных медиаторов с паракринными эффектами, которые могут влиять на функцию других клеток. Подробно рассмотрена физиология тромбоцитов. Показана ведущая роль тромбоцитов в патогенезе большинства заболеваний сердечно-сосудистой системы как модуляторов воспалительных реакций иммунного ответа, которые сегодня рассматриваются как ведущий механизм развития атеросклероза. Обсуждена способность тромбоцитов кодировать воспалительные белки, позволяющая им влиять на функции адаптивного иммунитета. Представлена роль тромбоцитов как ключевого компонента врожденной иммунной системы, что подтверждается наличием на тромбоцитах Toll-подобных рецепторов (TLR) и гликопротеинов, таких как интегрин αIIbβ3, гликопротеин Ib-IX и FcγRIIa, вовлеченных во взаимодействие с бактериальными клетками. Представлен патогенез формирования тромбоцитарно-лейкоцитарных агрегатов за счет быстрого обратимого взаимодействия P-селектина (CD62P) на поверхности тромбоцита с лигандом-1 гликопротеина Р-селектина (PSGL-1) на плазмолемме лейкоцитов и механизм образования внеклеточных ловушек нейтрофилов (NETs), а также влияние тромбоцитов на функцию лимфоцитов. Рассмотрена роль тромбоцитов в прогрессировании рака, метастазировании и тромбозе, а также проанализирована взаимосвязь тромбозов и метастазирования при злокачественных заболеваниях. Обсуждается эффективность использования антитромбоцитарных препаратов для профилактики тромбозов, поражения сердечно-сосудистой системы и онкологических заболеваний.

In recent decades, significant progress has been made in understanding the mechanisms of platelet function and platelet hemostasis correction. Platelets are considered as the most important participants of both normal, and pathological thrombotic process characteristic of the most different diseases and states. In the present review pathophysiological mechanisms of platelet synthesis of various mediators with paracrine effects, which can influence the function of other cells, are consecrated. The physiology of platelets was considered in detail. The leading role of platelets in pathogenesis of the majority of diseases of cardiovascular system as modulators of inflammatory reactions of the immune response which are considered as the leading mechanism of development of atherosclerosis was shown. The ability of platelets to encode inflammatory proteins allowing them to influence adaptive immunity functions was discussed. The role of platelets as a key component of the innate immune system was presented, which is confirmed by the presence of Tolllike receptors (TLR) and glycoproteins, such as integrin αIIbβ3, glycoprotein Ib-IX and FcγRIIa, involved in interaction with bacterial cells. The pathogenesis of the formation of platelet-leukocyte aggregates due to the rapid reversible interaction of P-selectin (CD62P) on the platelet surface with ligand-1 glycoprotein P-selectin (PSGL-1) on the plasma of leukocytes and the mechanism of extracellular neutrophil traps (NETs), as well as the influence of platelets on the function of lymphocytes was presented. The role of platelets in cancer progression, metastasis and thrombosis is considered, and the interrelation of thrombosis and metastasis in malignant diseases was analyzed. The efficiency of the use of antithrombotic drugs in the prevention of thrombosis and, as a consequence, in the prevention of cardiovascular diseases and cancer was discussed.

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