ПАТОФИЗИОЛОГИЧЕСКАЯ РОЛЬ ОСТЕОПРОТЕГЕРИНА ПРИ АТЕРОСКЛЕРОЗЕ И САХАРНОМ ДИАБЕТЕ

  • А. Р. Обухович Гродненская университетская клиника, Гродно, Беларусь https://orcid.org/0000-0001-5842-0209
  • Н. Н. Иоскевич Гродненский государственный медицинский университет, Гродно, Беларусь https://orcid.org/0000-0002-2954-0452
Ключевые слова: остеопротегерин, RANKL, RANK, атеросклероз, кальциноз, диабетическая ангиопатия, костный метаболизм

Аннотация

Сахарный диабет справедливо называют неинфекционной эпидемией 21 века. Вместе с тем сердечно-сосудистые заболевания по-прежнему лидируют среди причин смертности в мире. При сочетании сахарного диабета и облитерирующего атеросклероза периферических артерий риск потери нижней конечности и смерти увеличивается многократно. Существует множество концепций механизма развития этих заболеваний. В последние годы появляется все больше данных о схожести процессов развития атеросклероза и костного остеопороза. Связующим звеном может быть остеопротегерин (OPG). Получены сведения о остеопротегерине как антирезорбтивном факторе, участвующем в системе RANKL-RANK-OPG. В патофизиологических условиях OPG экспрессируется в сосудистой стенке, в том числе обнаруживается на разных этапах формирования атеросклеротической бляшки. Сигнальный путь RANKL-RANK-OPG участвует в процессе ремоделирования костной ткани. Механизмы развития атеросклероза и остеопороза схожи, однако требуют дальнейшего изучения.

Литература

VOZ publikuet statistiku o vedushhih prichinah smertnosti i invalidnosti vo vsem mire za period 2000-2019 gg. [Internet]. Available from: https://www.who.int/ru/news/item/09-12-2020-who-reveals-leading-causes-of-deathand-disability-worldwide-2000-2019. (Russian).

Biscetti F, Ferraro PM, Hiatt WR, Angelini F, Nardella E, Cecchini AL, Santoliquido A, Pitocco D, Landolfi R, Flex A. Inflammatory cytokines associated with failure of lower-extremity endovascular revascularization (LER): a prospective study of a population with diabetes. Diabetes Care. 2019;42(10):1939-1945. https://doi.org/10.2337/dc19-0408.

Vasilyeva EM. Analiz vlijanija razlichnyh faktorov riska na vozniknovenie serdechno-sosudistyh oslozhnenij u bolnyh saharnym diabetom 2 tipa [Analysis of impact of different risk factors on the occurrence of cardiovascular complications in patients with 2 diabetes mellitus]. Vestnik novyh medicinskih tehnologij [Journal of New Medical Technologies]. 2010;17(2):77-78. (Russian).

Jureva EA, Suhorukov VS, Vozdvizhenskaja ES, Novikova NN. Ateroskleroz: gipotezy i teorii [Atherosclerosis: Hypotheses and theories]. Rossijskij vestnik perinatologii i pediatrii [Russian Bulletin of Perinatology and Pediatrics]. 2014;59(3):6-16. (Russian).

Ragino JuI, Volkov AM, Chernjavskij AM. Stadii razvitija ateroskleroticheskogo ochaga i tipy nestabil’nyh bljashek – patofiziologicheskaja i gistologicheskaja harakteristika [Stages of atherosclerotic plaque development and unstable plaque types: pathophysiologic and histologic characteristics]. Rossijskij kardiologicheskij zhurnal [Russian Journal of Cardiology]. 2013;5(103):88-95. https://doi.org/10.15829/1560-4071-2013-5-88-95. (Russian).

Doherty TM, Fitzpartick LA, Inoue D, Qiao J-H, Fishbein MC, Detrano RC, Shan PK, Rajavashisth TB. Molecular, endocrine, and genetic mechanisms of arterial calcification. Endocrine reviews. 2004;25(4):629-672. https://doi.org/10.1210/er.2003-0015.

Sinicyn PA, Shherbakova MJu, Larionova VI, Petrjajkina EE. Metabolicheskij sindrom u detej [Metabolic syndrome in children]. Pediatrija [Pediatrics]. 2008;5:124-127. (Russian).

Sarkisova MK, Sobolev VV, Piruzjan JeS, Goluhova EZ, Bokerija LA. Patogeneticheskie puti razvitija ateroskleroza. Rol transkripcionnogo faktora AR-1. Kreativnaja kardiologija [Creative Cardiology]. 2009;2:90-98. (Russian).

Gurevich VS. Sovremennye predstavlenija o patogeneze ateroskleroza. Bolezni serdca i sosudov [Heart and vascular diseases]. 2006;4:4-8. (Russian).

Partovi S, Loebe M, Noon GP, Davies MG, Karimi S, Zipp L, Feinstein FB, Staub D. Detection of adventitial vasa vasorum and intraplaque neovascularization in carotid atherosclerotic lesions with contrast-enhanced ultrasound and their role in atherosclerosis. Methodist Debakey Cardiovasc J. 2011;7(4):37-40. https://doi.org/10.14797/mdcj-7-4-37.

Kontush A, Chapman MJ. Functionally defective high-density lipoprotein: a new therapeutic target at the crossroads of dyslipidemia, inflammation, and atherosclerosis. Pharmacol Rev. 2006;58(3):342-374. https://doi.org/10.14797/mdcj-7-4-37.

Pykhteev VS, Lashevich KA, Bogdan AP, Belash SA. Osobennosti koronarnogo ateroskleroza [Specific Characteristics of Coronary Atherosclerosis]. Kardiologija [Cardiology]. 2017;57(7):61-65. https://doi.org/10.18087/cardio.2017.7.10007. (Russian).

Virella G, Colglazier J, Chassereau C, Hunt KJ, Baker NL, Lopes-Virella MF. Immunoassay of modified forms of human low density lipoprotein in isolated circulating immune complexes. J Immunoassay Immunochem. 2013;34(1):61-74. https://doi.org/10.1080/15321819.2012.683500.

Arabidze GG. Klinicheskaja immunologija ateroskleroza – ot teorii k praktike [Clinical immunology of atherosclerosis – from the theory to practice]. Ateroskleroz i dislipidemii [Journal Atherosclerosis and Dyslipidemias]. 2013;10(1):4-19. (Russian).

Birjukova EV, Shinkin MV. Diabeticheskie mikroangiopatii: mehanizmy razvitija, podhody k terapii [Diabetic microangiopathies: mechanisms of development, approaches to the therapy]. RMZh “Klinicheskaja Oftalmologija” [RMJ “Clinical ophthalmology”]. 2018;2:91-96. https://doi.org/10.21689/2311-7729-2018-18-2-91-96. (Russian).

Verbovoj AF, Pashenceva AV, Verbovaja NI. Diabeticheskaja makroangiopatija [Diabetic macroangiopathy]. Terapevticheskij arhiv [Therapeutic Archive]. 2019;91(10):139-143. https://doi.org/10.26442/00403660.2019.10.000109. (Russian).

Kendall M, Sobel BE, Coulston AM. The insulin resistance syndrome and coronary artery disease. Coron Artery Dis. 2003;14(4):335-348. https://doi.org/10.1097/01.mca.0000076512.29238.2a.

Tokmakova AJu, Egorova DN, Doronina LP. Porazhenija nizhnih konechnostej pri saharnom diabete [Foot disorders in diabetes mellitus]. Ozhirenie i metabolizm [Obesity and metabolism]. 2017;14(1):41-47. https://doi.org/10.14341/OMET2017141-47. (Russian).

Ragino JuI, Kashtanova EV, Murashov IS, Volkov AM, Kurguzov AV, Sadovskij EV, Maslacov NA, Shherbakova LV, Chernjavskij AM, Polonskaja JaV. Issledovanie biohimicheskih faktorov kalcifikacii stabilnyh i nestabil’nyh bljashek v koronarnyh arterijah cheloveka [The Study of Biochemical Factors of Calcification of Stable and Unstable Plaques in the Coronary Arteries of Man]. Kardiologija [Cardiology]. 2020;60(2):83-88. https://doi.org/10.18087/cardio.2020.2.n775. (Russian).

Strobescu-Ciobanu C, Giusca SE, Caruntu ID, Amalinei C, Rusu A, Cojocaru E, Popa RF, Lupascu CD. Osteopontin and оsteoprotegerin in atherosclerotic plaque – are they significant markers of plaque vulnerability? Rom J Morphol Embryol. 2020;61(3):793-801. https://doi.org/10.47162/RJME.61.3.17.

Dolzhenko A, Rihter T, Sagalovski S. Ateroskleroz, kalcifikacija sosudov i ponizhenie plotnosti kostnoj tkani (osteoporoz): obshhnost’ patofiziologicheskih mehanizmov razvitija zabolevanij i poisk novyh sredstv dvojnoj terapii [Аtherosclerosis, vascular calcification and bone loss (osteoporosis): common pathophysiological mechanisms development of the diseases and research novel drugs for dual therapie]. Ateroscleroz. 2016;12(4):44-60. (Russian). https://doi.org/10.18786/2072-0505-2016-44-4-513-534.

Demer LL. Cholesterol in vascular and valvular calcification. Circulation. 2001;104(16):1881-1883. https://doi.org/10.1161/circ.104.16.1881.

Kielch S, Schett G, Wenning G, Redlich K, Oberhollenzer M, Mayr A, Santer P, Smolen J, Poewe W, Willeit J. Osteoprotegerin is a risk factor for progressive atherosclerosis and cardiovascular disease. Circulation. 2004;109(18):2175-2180. https://doi.org/10.1161/01.CIR.0000127957.43874.BB.

Zwankenberg SR, van der Schouw YT, Schalkwijk C, Spijkerman AMW, Beulens JWJ. Bone markers and cardiovascular risk in type 2 diabetes patients. Cardiovascular diabetology. 2018;17(1):45. https://doi.org/10.1186/s12933-018-0691-2.

Jeffcoate WJ, Rassmussen ML, Hofbauer LC, Game FL. Medial arterial calcification in diabetes and its relationship to neuropathy. Diabetologia. 2009;52(12):2478-2488. https://doi.org/10.1007/s00125-009-1521-6.

O’Sullivan EP, Ashley DT, Davenport C, Crowley R, Agha A, Thompson CJ, O’Gorman D, Smith D. Osteoprotegerin and biomarkers of vascular inflammation in type 2 diabetes. Diabetes metabolism research and reviews. 2010;26(6):496-502. https://doi.org/10.1002/dmrr.1109.

Harper EM, Forde H, Davenport C, Rochfort KD, Smith D, Cummins PM. Vascular calcification in type-2 diabetes and cardiovascular disease: integrative roles for OPG, RANKL and TRAIL. Vascular Pharmacology. 2016;82:30-40. https://doi.org/10.1016/j.vph.2016.02.003.

Moon AR, Park Y, Chang JH, Lee SS. Inverse regulation of serum osteoprotegerin and tumor necrosis factor-related apoptosis-inducing ligand levels in patients with leg lesional vascular calcification. Medicine (Baltimore). 2019;98(10):e14489. https://doi.org/10.1097/MD.0000000000014489.

Zhou S, Fang X, Xin H, Li W, Qui H, Guan S. Osteoprotegerin inhibits calcification of vascular smooth muscle cell via down regulation of the Notch1-RBP-Jk/Msx2 signaling pathway. PLOS ONE. 2013;8:e68987. https://doi.org/10.1371/journal.pone.0068987.

Fehérvári L, Frigy A, Kocsis L, Szabó IA, Szabo TM, Urkon M, Jakó Z, Nagy EE. Serum osteoprotegerin and carotid intima-media thickness are related to high arterial stiffness in heart failure with reduced ejection fraction. Diagnostics. 2021;11(5):764. https://doi.org/10.3390/diagnostics11050764.

Komitety jekspertov i issledovatelskie gruppy. Doklad Sekretariata. Profilaktika i vedenie osteoporoza [Internet]. Available from: https://apps.who.int/gb/archive/pdf_files/EB114/B114_13-ru.pdf (Russian).

International Osteoporosis Foundation. Audit sostojanija problemy osteoporoza v stranah Vostochnoj Evropy i Centralnoj Azii 2010 [Internet]. Available from: https://www.osteoporosis.foundation/sites/iofbonehealth/files/2019-06/2010_Eastern_European_Central_Asian_Audit_Russian.pdf (Russian).

Panasjuk GD, Filjustin AE. Osteoporoz: sovremennye podhody k diagnostike i lecheniju. Gomel; 2017. 116 р. (Russian).

Hygum K, Starup-Linde J, Haslef T, Vestergaad P, Langdahl BL. Diabetes mellitus, a state of low bone turnover – a systematic review and meta-analysis. European Journal of Endocrinology. 2017;176(3):R137-R157. https://doi.org/10.1530/EJE-16-0652.

Sassi F, Buondonno I, Luppi C, Spertino E, Stratta E, Stefano MD, Ravazzoli M, Isaia G, Trento M, Passera P, Porta M, Isaia GC, D’Amelio P. Type 2 diabetes affects bone cells precursors and bone turnover. BMC Endocrine disorders. 2018;18:55. https://doi.org/10.1186/s12902-018-0283-x.

Berezin AE, Kremzer AA. Osteoprotegerin kak potencialnyj marker vaskuljarnogo remodelirovanija i serdechno-sosudistogo riska. Serce і sudini.2013;1:108-114. (Russian).

Szymańska M, Michałus I, Kaszkowiak M, Wyka K, Chlebna-Sokół D, Fendler W, Jakubowska-Pietkiewicz E, Młynarski W, Szadkowska A, Zmysłowska A. Metabolic bone markers can be related to preserved insulin secretion in children with newly diagnosed type 1 diabetes. Pediatric Endocrinology, Diabetes and Metabolism. 2020;26(1):10-16. https://doi.org/10.5114/pedm.2020.94391.

Kelesidis T, Currier JS, Yang OO, Brown TT. Role of RANKL-RANK/Osteoprotegerin pathway in cardiovascular and bone disease associated with HIV infection. AIDS review. 2014;16(3):123-133.

Nakamichi Y, Udagawa N, Kobayashi Y, Nakamura M, Yamamoto Y, Yamashita T, Mizoguchi T, Sato M, Mogi M, Penninger JM, Takahashi N. Osteoprotegerin reduces the serum level of receptor activator of NF-kB ligand derived from osteoblasts. Journal of Immunology. 2007;178(1):192-200. https://doi.org/10.4049/jimmunol.178.1.192.

Shibanova IA, Hrjachkova ON. Ispolzovanie biomarkerov fosforno-kal’cievogo obmena dlja diagnostici risk-stratifikacii bol’nyh ishemicheskoj bolezn’ju serdca [Use of biomarkers of phosphoric-calcium metabolism for the diagnosis and risk stratification of patients with coronary artery disease]. RMZh “Kardiologija” [RMJ “Cardiology”]. 2017;25(20):1409-1414. (Russian).

Shvarc GJa. Molekuljarno-biologichekie osnovy sozdanija novyh lekarstvennyh sredstv dlja lechenija osteoporoza: osteoprotegerin, LOPG (RANKL) i RANK: fiziologicheskij mehanizm(y) reguljacii kostnoj rezorbcii. Osteoporoz i osteopatii [Оsteoporosis and bone diseases]. 2003;2:17-20. (Russian).




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2022-05-04
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Обухович АР, Иоскевич НН. ПАТОФИЗИОЛОГИЧЕСКАЯ РОЛЬ ОСТЕОПРОТЕГЕРИНА ПРИ АТЕРОСКЛЕРОЗЕ И САХАРНОМ ДИАБЕТЕ. Журнал ГрГМУ (Journal GrSMU) [Интернет]. 4 май 2022 г. [цитируется по 21 ноябрь 2024 г.];20(2):129-36. доступно на: http://journal-grsmu.by/index.php/ojs/article/view/2773