Окислительный стресс при шизофрении: связь с нейрохимическими патогенетическими гипотезами

   Обоснование: гетерогенность шизофрении отражается в разнообразии клинических проявлений и биологических нарушений, изучение которых послужило основой для выдвижения нейрохимических гипотез патогенеза шизофрении. Обзор современных гипотез патогенеза шизофрении показывает, что окислительный стресс не является основной причиной развития заболевания, но влияет на его течение и вносит вклад в ухудшение состояния больного.

   Цель: проанализировать связь нарушений окислительно-восстановительного баланса и окислительного стресса с развитием патологических процессов при шизофрении в рамках нейрохимических гипотез патогенеза заболевания.

   Материалы и методы: по сочетаниям ключевых слов «окислительный стресс», «окислительно-восстановительный дисбаланс», «шизофрения», «гипотезы патогенеза шизофрении», «антиоксиданты», «нейромедиаторы», «глутатион», «нейровоспаление» проведен поиск источников по базам данных Medline/PubMed, Scopus и РИНЦ.

   Заключение: данные многочисленных исследований головного мозга больных шизофренией, плазмы и сыворотки крови, форменных элементов крови и изучение моделей шизофрении на животных указывают на наличие окислительно-восстановительного дисбаланса и окислительного стресса при этом заболевании. В совокупности эти данные свидетельствуют, что генетические факторы и факторы окружающей среды влияют на проявление разных патологических
механизмов при шизофрении (нарушения нейромедиаторных систем, гипофункцию рецепторов N-метил-D-аспарата (NMDAR), нейровоспаление, нарушение сигнальных каскадов белкового фосфорилирования). Они приводят к окислительному стрессу, который усиливает первоначальные патологические изменения, вследствие чего нарушаются процессы синхронизации и межклеточные связи в головном мозге. В качестве лекарственных препаратов, снижающих вредное воздействие окислительного стресса, могут быть использованы соединения с антиоксидантными и противовоспалительными свойствами, соединения для коррекции митохондриальной дисфункции и модуляторы передачи сигналов, опосредованных NMDAR. Эффективность этих соединений может различаться у разных пациентов, поэтому большое значение имеет разработка системы биомаркеров, нацеленных на выявление лиц, с большей вероятностью реагирующих на конкретный препарат.

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