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Том 16 №3 2014 год - Нефрология и диализ

Склеростин в контексте хронической болезни почек (Обзор литературы)


Гуревич Е.А.

Аннотация: Расстройство костного метаболизма и сосудистая кальцификация в значительной степени способствуют развитию сердечно-сосудистых осложнений у пациентов со сниженной функцией почек и являются предикторами худшей выживаемости этой группы больных. В последнее время все больше внимания уделяется поиску и исследованию маркеров костного повреждения, которые ассоциируются с развитием ряда системных осложнений у больных с хронической болезнью почек (ХБП), включая пациентов, находящихся на заместительной почечной терапии. Wnt-сигнальный путь состоит из ряда сложных белков, постоянно взаимодействующих между собой и определяющих не только нормальный эмбриогенез, но и метаболизм костной ткани. Склеростин, ингибируя Wnt-сигнальный путь, нарушает образование костной ткани путем подавления пролиферации и дифференциации остеобластов. У пациентов с нарушением функции почек уровень склеростина в крови повышен за счет усиленного образования. Однако до сих пор неизвестно, является ли склеростин предиктором неблагоприятного прогноза у больных с ХБП, либо он выступает в роли своеобразного защитника сосудистой стенки от кальцификации, тем самым обеспечивая лучшую выживаемость как сосудистого доступа, так и пациентов в целом. В обзоре представлены современные данные о роли склеростина в метаболизме костной ткани, его участии в процессах ремоделирования кости у больных с почечной недостаточностью, а также о потенциальных терапевтических стратегиях, направленных на изменение концентрации этого белка.

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Ключевые слова: склеростин, Wnt-сигнальный путь, хроническая болезнь почек, sclerostin, Wnt-signaling pathway, chronic kidney disease

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