References

rsp

Научно-практическая ревматология

Rheumatology Science and Practice

1995-44841995-4492

IMA-PRESS, LLC

10.14412/1995-4484-2014-451-457

rsp-1969

Research Article

ОБЗОР

REVIEW

Поражение легких при ревматоидном артрите

PULMONARY INVOLVEMENT IN RHEUMATOID ARTHRITIS

Бестаев

Д. В.

Bestaev

D. V.

davidbestaev@rambler.ru

Каратеев

Д. Е.

Karateev

D. E.

Насонов

Е. Л.

Nasonov

E. L.

ФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой, МоскваРоссияV.A. Nasonova Research Institute of Rheumatology, MoscowRussian Federation

2014

02092014

524451457

2014

Бестаев Д.В., Каратеев Д.Е., Насонов Е.Л.

Bestaev D.V., Karateev D.E., Nasonov E.L.

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/1969

Ревматоидный артрит (РА) – аутоиммунное заболевание с эрозивно-деструктивным полиартритом и системными проявлениями. При РА нередко встречается поражение легких (ПЛ). С помощью компьютерной томографии высокого разрешения выявляемость ПЛ при РА достигает 50%. ПЛ является непосредственной причиной смерти у 10–20% пациентов с РА. В развитии ПЛ при РА основную роль играют аутоиммунные механизмы. Согласно гипотезе, выдвинутой M. Selman и соавт., основой патогенеза развития фиброза легких является не воспаление, а нарушение процессов регенерации альвеолоцитов после повреждения. Патологический процесс запускается поврежденными альвеолоцитами и характеризуется миграцией и пролиферацией фибробластов и миофибробластов, угнетением апоптоза миофибробластов и повышением активности цитокинов, стимулирующих пневмофиброз. В результате происходит ремоделирование внеклеточного матрикса, включая деструкцию базальной мембраны, ангиогенез и фиброз. В статье рассматриваются типы поражения легких при РА, основные методы диагностики и терапии.

Rheumatoid arthritis (RA) is an autoimmune disease with erosive and destructive polyarthritis and systemic manifestations. Pulmonary involvement (PI) is common in RA. With high-resolution computed tomography, the detection rate of PI in RA is as high as 50%. PI is a direct cause of death in 10–20% of patients with RA. Autoimmune mechanisms play a leading part in the development of PI in RA. Under the hypothesis advanced by M. Selman et al., that impaired alveolocyte regeneration processes after injury rather inflammation underlie the pathogenesis of pulmonary fibrosis. The pathological process is triggered by damaged alveolocytes and characterized by the migration and proliferation of fibroblasts and myofibroblasts, the suppressed apoptosis of the latter, and the enhanced activity of pneumofibrosis-stimulating cytokines. This gives rise to remodeling of the extracellular matrix, including destruction of the basement membrane, angiogenesis, and fibrosis. The paper considers the types of lung injury in RA and main methods for diagnosis and therapy.

ревматоидный артритпоражение легких

rheumatoid arthritislung injury

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