fcmedicineФундаментальная и клиническая медицинаFundamental and Clinical Medicine2500-07642542-0941КемГМУfcmedicine-21Research ArticleСтатьиНЕЙРОВОСПАЛЕНИЕ В КРИТИЧЕСКИХ СОСТОЯНИЯХ: МЕХАНИЗМЫ И ПРОТЕКТИВНАЯ РОЛЬ ГИПОТЕРМИИNEUROINFLAMMATION IN CRITICAL CARE: MECHANISMS AND PROTECTIVE ROLE OF HYPOTHERMIAГригорьевЕ. В.Evgeniy V. Grigorievnoemail@neicon.ruШукевичД. Л.Dmitriy L. Shukevichnoemail@neicon.ruПлотниковГ. П.Georgiy P. Plotnikovnoemail@neicon.ruХуторнаяМ. В.Maria V. Khutornayanoemail@neicon.ruЦепокинаА.В.Anna V. Tsepokinanoemail@neicon.ruРадивилкоА. С.Artem S. Radivilkonoemail@neicon.ruФГБНУ «НИИ комплексных проблем сердечно-сосудистых заболеваний»РоссияResearch Institute for Complex Issues of Cardiovascular DiseasesRussian FederationФГБОУ ВО «Кемеровский государственный медицинский университет» Минздрава РоссииРоссияKemerovo State Medical UniversityRussian Federation201630092016138896Copyright © Григорьев Е.В., Шукевич Д.Л., Плотников Г.П., Хуторная М.В., Цепокина А., Радивилко А.С., 20162016Григорьев Е.В., Шукевич Д.Л., Плотников Г.П., Хуторная М.В., Цепокина А., Радивилко А.С.Григорьев Е.В., Шукевич Д.Л., Плотников Г.П., Хуторная М.В., Цепокина А., Радивилко А.С.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://fcm.kemsmu.ru/jour/article/view/21

Факторы стерильного и неспецифического нейровоспаления как проявления системного воспалительного ответа наблюдаются во всех критических состояниях. Предложено множество прогностических и диагностических кандидатов-маркеров тяжести нейровоспаления, исходя из вовлечения в реализацию неспецифического нейровоспалительного ответа при инсульте, тяжелой травме, сепсисе. Как фокальное, так и глобальное повреждение головного мозга любого происхождения вызывает экспрессию генов воспалительного ответа, активацию микроглии, выброс и нарушение соотношения про- и противовоспалительных цитокинов, активацию молекул межклеточной адгезии, клеток врожденного и адаптивного компонентов иммунитета. Терапевтическая гипотермия демонстрирует эффективность в отношении воздействия на компоненты как собственно нейровоспаления, так и на другие факторы патогенеза критического состояния (нормализация функции нейроваскулярной единицы, снижением экспрессии молекул адгезии, стабилизация межклеточного матрикса, модуляция про- и противовоспалительных цитокинов). Терапевтические возможности гипотермии в условиях системного воспалительного ответа с целью его ограничения весьма привлекательны, что обуславливает потенциальные возможности использования индуцированной коррекции температурного режима в интенсивном лечении критических больных.

Sterile and nonspecific neuroinflammation can be detected in all critical care conditions as a part of systemic inflammatory response. A large number of prognostic and diagnostic candidate markers of severe neuroinflammation have been suggested for stroke, severe trauma and sepsis. Expression of inflammatory genes, glial activation, release of pro- and anti-inflammatory cytokines, and activation of cell adhesion molecules can be induced by both focal and diffuse brain injury. Therapeutic hypothermia is now considered as an efficient way to control neuroinflammation, normalize neurovascular units, reduce expression of cell adhesion molecules, stabilize extracellular matrix, and adjust cytokine response. Therefore, therapeutic hypothermia can be used for the treatment of systemic inflammatory response in intensive care units.

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