Нейтрофилы при раке и сепсисе: перекрестные механизмы иммунной дисрегуляции

Нейтрофилы, преобладающие лейкоциты врожденной иммунной системы, все чаще рассматриваются как потенциальные участники процессов, способствующих развитию опухоли или подавляющих его, в зависимости от биологических особенностей опухоли.
Цель исследования. Анализ и обобщение современных данных о функциональной пластичности и гетерогенности нейтрофилов, их двойственной роли в патогенезе онкологических заболеваний и сепсиса. Особое внимание уделено перекрестным механизмам нейтрофильной дисрегуляции при этих патологиях и перспективам разработки таргетных терапевтических стратегий.
Материалы и методы. При подготовке обзора проведен выборочный поиск публикаций в базах данных PubMed, Elibrary.ru и Scopus за последние 15 лет по ключевым словам: «нейтрофилы, «рак», «нейтрофилы при раке и сепсисе», «иммунная дисрегуляция при раке и сепсисе», «пластичность нейтрофилов при опухолях и инфекциях», «иммунотерапия и сепсис у онкологических больных», «окислительный стресс в нейтрофилах», «нейтрофильно-лимфоцитарное соотношение», «опухолевый рост индуцированный сепсисом». Критериями отбора публикаций были их научная значимость, релевантность тематике исследования и соответствие современным стандартам доказательной медицины.
Результаты. Результаты анализа выявили двойственную роль нейтрофилов при раке, и их сложные взаимодействия, происходящие в микроокружении опухоли. Представлен анализ двух подтипов нейтрофилов N1 и N2, оказывающих противоположное влияние на биологию опухоли. Рассматривается участие нейтрофилов в формировании и функционировании внеклеточных ловушек нейтрофилов (NETs), играющих ключевую роль в прогрессировании рака через участие в процессах воспаления, ангиогенеза и метастазирования. В обзоре рассматриваются общие механизмы участия нейтрофилов в прогрессировании рака и сепсиса у онкологических больных, в частности, это касается активированных нейтрофилов и внеклеточных ловушек нейтрофилов.
Заключение. Систематизация данных об участии нейтрофилов в прогрессировании рака и сепсиса у онкологических больных направит будущие исследования в этой области на разработку точных и эффективных терапевтических стратегий при раке, осложненном сепсисом, улучшая прогноз для пациента.

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