mimmunМедицинская иммунологияMedical Immunology (Russia)1563-06252313-741XSPb RAACI10.15789/1563-0625-CMO-3169mimmun-3169Research ArticleОБЗОРЫREVIEWSЦеребральные маркеры нейровоспаления и нейродегенерации при гипертензивных расстройствах во время беременностиCerebral markers of neuroinflammation and neurodegeneration in hypertensive disorders during pregnancyhttps://orcid.org/0000-0002-6223-8888ТаскинаЕ. С.TaskinaE. S.

Таскина Елизавета Сергеевна – к.м.н., доцент кафедры офтальмологии

Чита

PhD (Medicine), Associate Professor, Department of Ophthalmology

Chita

taskins@yandex.ruhttps://orcid.org/0000-0003-4390-183XКибалинаИ. В.KibalinaI. V.

Кибалина Ирина Владимировна – д.м.н., доцент, директор Научно-исследовательского института молекулярной медицины, заведующая кафедрой нормальной физиологии имени профессора Б.И. Кузника 

Чита

 

PhD, MD (Medicine), Associate Professor, Director, Research Institute of Molecular Medicine, Head, B. Kuznik Department of Normal Physiology

Chita

 

physiology_chgma@mail.ruhttps://orcid.org/0000-0002-5961-5400МудровВ. А.MudrovV. A.

Мудров Виктор Андреевич – д.м.н., доцент, профессор кафедры акушерства и гинекологии педиатрического факультета и факультета дополнительного профессионального образования 

Чита

PhD, MD (Medicine), Associate Professor, Professor, Department of Obstetrics and Gynecology, Faculty of Pediatrics and Faculty of Additional Professional Education

Chita

mudrov_viktor@mail.ruhttps://orcid.org/0000-0001-6690-7391ДавыдовС. О.DavydovS. O.

Давыдов Сергей Олегович – д.м.н., профессор кафедры травматологии и ортопедии ФГБОУ ВО «Читинская государственная медицинская академия» Министерства здравоохранения РФ; генеральный директор инновационной клиники «Академия здоровья»

Чита

PhD, MD (Medicine), Professor, Department of Traumatology and Orthopedics, Chita State Medical Academy, General Director

Chita

davydov-so@mail.ruФГБОУ ВО «Читинская государственная медицинская академия» Министерства здравоохранения РФРоссияChita State Medical AcademyRussian Federation202507072025274713722Copyright © Таскина Е.С., Кибалина И.В., Мудров В.А., Давыдов С.О., 20252025Таскина Е.С., Кибалина И.В., Мудров В.А., Давыдов С.О.Taskina E.S., Kibalina I.V., Mudrov V.A., Davydov S.O.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mimmun.ru/mimmun/article/view/3169

Преэклампсия/эклампсия во время беременности и послеродового периода являются основными факторами риска материнской и младенческой заболеваемости и смертности во всем мире. При этом более 70% материнских смертельных исходов имеют неврологическую причину, обусловленную эклампсией, отеком головного мозга, внутричерепным кровоизлиянием и инсультом. Генерализованная эндотелиальная дисфункция, обусловленная плацентарными антиангиогенными факторами, приводит к повышению проницаемости гематоэнцефалического барьера и нарушению ауторегуляции мозгового кровообращения. Результаты проведенных исследований показали, что преэклампсия повышает риск цереброваскулярных и сердечно-сосудистых заболеваний, а также когнитивных нарушений вплоть до развития деменции в будущем. Согласно недавно предложенной нейропатофизиологической гипотезе, преэклапсия рассматривается как протеинопатия с нарушением аутофагии, что способствует отложению патологических неправильно свернутых белковых агрегатов и антител к ним в головном мозге. Доклинические и клинические исследования выявили, что маркеры нейровоспаления и нейродегенерации могут отражать поражение головного мозга до появления выраженной неврологической симптоматики, но как эти результаты коррелируют с долгосрочными неврологическими осложнениями, не совсем ясно. Несмотря на то что в последние годы получено значительное понимание патофизиологии преэклампсии в более широком смысле, этиология и механизмы развития дисфункции центральной нервной системы при этом заболевании остаются актуальными для изучения. Проведен детальный систематический анализ современной отечественной и зарубежной литературы, посвященной изучению маркеров нейровоспаления и нейродегенерации при гипертензивных расстройствах во время беременности. В исследовании использовались информационные базы: PubMed, Scopus, eLibrary, Cochrane Library, MEDLINE за период с января 2015 г. по декабрь 2024 г. В приведенном литературном обзоре представлена информация о патогенетической роли при преэклампсии следующих нейроспецифических биомаркеров: моноцитарный хемотаксический белок-1 (MCP-1), мозговой нейротрофический фактор (BDNF), фракталкин (CX3CL1), нейроспецифическая енолаза (NSE), S100 кальций-связывающий белок B (S100B), визининоподобный белок-1 (VILIP-1), тау-белок (тau), фосфорилированный тау-белок по треонину 181 (p-tau181), a-синуклеин (a-syn), амилоид b-40/42 (Ab40/42), глиальный фибриллярный кислый белок (GFAP), легкие цепи нейрофиламентов (NfL). Использование церебральных биомаркеров позволит выявлять пациенток высокой группы риска по развитию тяжелых церебральных осложнений, оптимизировать тактику их ведения и лечения во время беременности, а также разрабатывать эффективные стратегии профилактики развития неврологических изменений в будущем.

Preeclampsia/eclampsia during pregnancy and postpartum are the major risk factors for maternal and infant morbidity and mortality worldwide. At the same time, more than 70% of maternal deaths are of neurological origin, i.e., eclampsia, cerebral edema, intracranial hemorrhage and stroke. Generalized endothelial dysfunction caused by placental antiangiogenic factors leads to increased permeability of the blood-brain barrier and impaired autoregulation of cerebral circulation. Previous studies have shown that preeclampsia increases the risk of cerebrovascular and cardiovascular diseases, as well as cognitive impairments, up to evolving dementia in the future. According to a recently proposed neuropathophysiological hypothesis, preeclampsia is considered proteinopathy with impaired autophagy, thus contributing to brain depositions of wrongly folded pathological protein aggregates and antibodies to these proteins. Preclinical and clinical studies have shown that markers of neuroinflammation and neurodegeneration may reflect brain damage before the onset of severe neurological symptoms. However, is not entirely clear if these results correlate with long-term neurological complications. Over recent years, a certain understanding of preeclampsia pathophysiology in a broader sense has been gained. However, etiology and mechanisms of development of central nervous system dysfunction in this disease remain relevant for studies. A detailed systematic analysis of modern literature has been carried out, concerning the search for neuroinflammation and neurodegeneration markers in hypertensive pregnancy-associated disorders. The presented study used the following information databases: PubMed, Scopus, eLibrary, Cochrane Library, MEDLINE for the period from January 2015 to December 2024. This literature review provides information on pathogenetic role of the following neural biomarkers in preeclampsia: monocyte chemotactic protein 1 (MCP-1), brain-derived neurotrophic factor (BDNF), fractalkine (CX3CL1), neurospecific enolase (NSE), S100 calcium-binding protein B (S100B), visinin-like protein-1 (VILIP-1), tau protein (tai), phosphorylated tau protein for threonine 181 (p-tau181), a-synuclein (a-syn), amyloid b-40/42 (A 40/42), glial fibrillary acid protein (GFAP), light chains of neurofilaments (NfL). Usage of appropriate cerebral biomarkers will enable identification of patients at high risk for severe cerebral complications, optimization of their management and treatment during pregnancy, and development of effective strategies to prevent the development of neurological changes in the future.

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