rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2014-430-437rsp-1966Research ArticleПРОГРЕСС В РЕВМАТОЛОГИИ В XXI ВЕКЕPROGRESS IN RHEUMATOLOGY IN THE XXI CENTURYТ-регуляторные клетки при ревматоидном артритеT-REGULATORY CELLS IN RHEUMATOID ARTHRITISНасоновЕ. Л.NasonovE. L.

директор ФГБНУ «НИИР им. В.А. Насоновой», академик РАН, докт. мед. наук, профессор 

sokrat@irramn.ruАлександроваЕ. Н.AleksandrovaE. N.

заведующая лабораторией иммунологии и молекулярной биологии ревматических заболеваний ФГБНУ НИИР им. В.А. Насоновой, докт. мед. наук

АвдееваА. С.AvdeevaA. S.

научный сотрудник лаборатории иммунологии и молекулярной биологии ревматических заболеваний ФГБНУ НИИР им. В.А. Насоновой, канд. мед. наук

РубцовЮ. П.RubtsovYu. P.ФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой, МоскваРоссияV.A. Nasonova Research Institute of Rheumatology, MoscowRussian FederationГБОУ ВПО «Московский государственный университет им. М.В. Ломоносова», МоскваРоссияM.V. Lomonosov Moscow State University, MoscowRussian Federation201402092014524430437Copyright © Насонов Е.Л., Александрова Е.Н., Авдеева А.С., Рубцов Ю.П., 20142014Насонов Е.Л., Александрова Е.Н., Авдеева А.С., Рубцов Ю.П.Nasonov E.L., Aleksandrova E.N., Avdeeva A.S., Rubtsov Y.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/1966

Аутоиммунные (иммуновоспалительные) ревматические болезни определяются как клинические синдромы, развитие которых связано с «патологической» активацией Т-клеток, В-клеток и других клеток иммунной системы, приводящей к прогрессирующему воспалению и деструкции внутренних органов. Несмотря на высокую эффективность комбинированной терапии геннонженерными биологическими препаратами (ГИБП) и стандартными базисными противовоспалительными препаратами, в первую очередь метотрексатом, менее чем у половины пациентов с ревматоидным артритом (РА) удается достигнуть значимого клинического эффекта и крайне редко – стойкой ремиссии. Комбинированное действие генетических и внешнесредовых факторов может приводить к потере иммунной толерантности, в основе которой лежит нарушение баланса между эффекторными и регуляторными компонентами иммунной системы. Восстановление толерантности без хронической неспецифической иммуносупрессии, наблюдаемой на фоне приема большинства современных противовоспалительных препаратов (включая ГИБП), рассматривается как важнейшая задача фармакотерапии РА. Целью обзора является, во-первых, обсуждение роли так называемых Т-регуляторных клеток (Трег) как одного из критических компонентов поддержания толерантности и, во-вторых, перспективы фармакотерапии РА, связанных с коррекцией функциональной активности Трег.

Autoimmune (immunoinflammatory) rheumatic diseases are defined as clinical syndromes whose development is associated with the abnormal activation of T cells, B cells, and many other cells of the immune system, which gives rise to the progressive inflammation and destruction of the viscera. In spite of the high efficiency of combined therapy with biologic agents and standard disease-modifying antirheumatic drugs, primarily methotrexate, less than half of patients with rheumatoid arthritis (RA) could achieve a significant clinical effect and, very rarely, sustained remission. The combined influence of genetic and environmental factors may lead to loss of immunological tolerance, the basis for which is an imbalance between the effector and regulatory components of the immune system. To restore tolerance without chronic nonspecific immunosuppression observed in the use of majority of current anti-inflammatory drugs (including GEBAs) is regarded as the most important task of pharmacotherapy for RA. The aim of the review is to discuss firstly the role of the so-called T regulatory (Treg) cells as one of the critical components for the maintenance of tolerance and secondly promises for the pharmacotherapy of RA associated with the correction of the functional activity of Treg cells.

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