Биомаркеры нейровоспаления и микроциркуляторной дисфункции при болезни Альцгеймера: комплексная оценка патогенетической и диагностической роли

Цель исследования – определение лабораторных биомаркеров БА, которые могли бы быть перспективны для исследования в качестве диагностических инструментов.

Материалы и методы. Были обследованы 111 пациентов (52 пациента с БА и 59 пациентов контрольной группы без когнитивных нарушений), у которых изучались концентрация 103 потенциальных биомаркеров в плазме крови (111 человек) и ЦСЖ (24 человека).

 Результаты. Получены статистически значимые различия (p≤0,01) в плазменной концентрации 43 биомаркеров у пациентов с БА и контрольной группы, в корреляционной матрице, отражающей взаимодействия между биомаркерами в ЦСЖ (17 маркеров) и в плазме крови (13 маркеров).

 Заключение. Полученные нами результаты свидетельствуют о значительной роли нейровоспаления, сосудистой патологии, ангиогенеза, дисфункции ГЭБ в патологическом процессе, происходящем при БА, которые ранее были подтверждены различными исследователями. Были выявлены патогенетически обоснованные плазменные биомаркеры, аффилированные с различными звеньями патогенеза БА. Биомаркеры липидного обмена, такие как Apo-A1, Apo-CII, в периферическом кровотоке могут рассматриваться как индикаторы сосудисто-нейродегенеративного процесса. Провоспалительные цитокины (IFNα, IFNγ, IL-15, IL-1а, IL-8, sTNFR-1, sTNFR-2, IL-12p70, включая его субъединицу IL-12p40, IL-17a, sCD 40L, sgp130, IP10, эндоглин) и противовоспалительные биомаркеры (G-CSF1, BMP9, комплемент С4, Д-димер, EFG1, эотаксин, фракталкин, G-CSF, GM–CSF, GDF-15, IL-1RA, IL-4, MDC, MIP1 β, MIP4, P-селектин, PEDF, sCD 30, sICAM-1, sNCAM-1, sIL2ra, sIL-4r, TGFα VEGF-C, альфа-1антитрипсин) в плазме крови являются перспективными кандидатами в будущие эффективные диагностические лабораторные биомаркеры. Наиболее перспективным биомаркером представляется субъединица 40 интерлейкина 12 (IL-12p40) в связи с ее повышением в плазме пациентов с БА в отличие от контрольной группы и наибольшим количеством корреляций ее плазменного уровня с другими биомаркерами в ЦСЖ.

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