nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-3189Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESСовременные подходы к лечению волчаночного нефритаModern approach to treatment of lupus nephritisЗахароваЕ. В.ZakharovaE. V.noemail@neicon.ruМихайловаН. А.MikhaylovaN. A.noemail@neicon.ruМосковская городская клиническая больница имени С.П. Боткина, кафедра нефрологии и гемодиализа РМАПОRussian Federation200228062025428286Copyright © Захарова Е.В., Михайлова Н.А., 20252025Захарова Е.В., Михайлова Н.А.Zakharova E.V., Mikhaylova N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/3189

Системная красная волчанка (СКВ) представляет собой яркий пример аутоиммунного заболевания, характеризующегося выработкой широкого спектра аутоантител к компонентам клеточного ядра, цитоплазмы и мембран и развитием иммунокомплексного воспаления. Фундаментальным нарушением в иммунной системе у больных с СКВ в настоящее время представляется генетически обусловленный дефект апоптоза аутореактивных клонов Т- и В-клеток, следствием которого является В-клеточная гиперреактивность и антиген-специфическая Т-зависимая стимуляция синтеза аутоантител [2, 4]. В индукции заболевания, помимо генетических факторов, важную роль играет уровень половых гормонов [4, 40]. Отрицательное влияние эстрогенов подтверждается преимущественным развитием заболевания у женщин детородного возраста, высокой частотой дебюта и/или обострения заболевания после родов и абортов, а также низким уровнем тестостерона и повышенным - эстрадиола у мужчин с СКВ. Среди экзогенных факторов большое значение придается ультрафиолетовому облучению, провоцирующему появление антител к ДНК, бактериальным липополисахаридам, различным группам вирусов, активирующим В-клетки, некоторым лекарственным препаратам [4, 17].

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