Роль тромбоцитов в воспалении и иммунитете

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.

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