rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2020-716-724rsp-2973Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESПсихиатрические аспекты спондилоартритовPsychiatric aspects of spondyloarthritishttps://orcid.org/0000-0001-9437-406XЛисицынаТ. А.LisitsynaT. A.

Лисицына Татьяна Андреевна

115522, Москва, Каширское шоссе, 34А

Tatiana A. Lisitsyna

115522, Moscow, Kashirskoye Highway, 34A

talisitsyna@rambler.ruhttps://orcid.org/0000-0001-5210-2605ВельтищевД. Ю.VeltishchevD. Yu.

107076, Москва, ул. Потешная, 3, корп. 10; 117997, Москва, ул. Островитянова, 1

Dmitrii Yu. Veltishchev

107076, Moscow, Poteshnaya str., 3, building; 117997, Moscow, Ostrovitianova str., 1

https://orcid.org/0000-0002-1598-8360НасоновЕ. Л.NasonovE. L.

115522, Москва, Каширское шоссе, 34А; 119991, Москва, ул. Трубецкая, 8, стр. 2

Evgenii L. Nasonov

115522, Moscow, Kashirskoye Highway, 34A; 119991, Moscow, Trubetskaya str., 8, building 2

https://orcid.org/0000-0002-6068-3080ЛилаА. М.LilaA. M.

125993, Москва, ул. Баррикадная, 2/1, стр. 1; 115522, Москва, Каширское шоссе, 34А

Alexander M. Lila

115522, Moscow, Kashirskoye Highway, 34A; 125993, Moscow, Barrikadnaya str., 2/1, building 1

ФГБНУ Научно-исследовательский институт ревматологии им. В.А. НасоновойРоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationМосковский научно-исследовательский институт психиатрии - филиал ФГБУ Национальный медицинский исследовательский центр психиатрии и наркологии им. В.П. Сербского Минздрава России; ФГАОУ ВО Российский национальный исследовательский медицинский университет им. Н.И. Пирогова Минздрава РоссииРоссияMoscow Research Institute of Psychiatry -Branch of the «National Medical Research Center for Psychiatry and Narcology» of the Ministry of Health of the Russian Federation; N.I. Pirogov Russian National Research Medical UniversityRussian FederationФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой; ФГБОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)РоссияV.A. Nasonova Research Institute of Rheumatology; I.M. Sechenov First Moscow State Medical University of the Ministry of Health Care of Russian Federation (Sechenovskiy University)Russian FederationФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой; ФГБОУ ДПО Российская медицинская академия непрерывного профессионального образования Минздрава РоссииРоссияV.A. Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian FederationRussian Federation202014012021586716724Copyright © Лисицына Т.А., Вельтищев Д.Ю., Насонов Е.Л., Лила А.М., 20212021Лисицына Т.А., Вельтищев Д.Ю., Насонов Е.Л., Лила А.М.Lisitsyna T.A., Veltishchev D.Y., Nasonov E.L., Lila A.M.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/2973

Спондилоартриты относятся к иммуновоспалительным ревматическим заболеваниям, характеризующимся выраженной болью, воспалительной активностью и инвалидизацией пациентов трудоспособного возраста. Одними из наиболее частых коморбидных спондилоартритам заболеваний, утяжеляющих течение и исходы, являются расстройства тревожно-депрессивного спектра. Хроническое воспаление с гиперпродукцией цитокинов оси интерлейкин-23/интерлейкин-17 и нарушением внутриклеточной сигнализации этих цитокинов, развивающееся на фоне нарушения стрессового и иммунного ответа, является ключевым патогенетическим механизмом, объединяющим спондилоартрит и расстройства тревожно-депрессивного спектра и диктующим подходы к их терапии. В статье обсуждаются современные представления о распространенности психических расстройств среди больных спондилоартритом и их негативном влиянии на течение и исходы ревматического заболевания, общности их патогенеза и провоцирующих факторов, влиянии антидепрессантов на исходы спондилоартрита и противовоспалительных препаратов, прежде всего ингибиторов интерлейкина-17 и фактора некроза опухоли альфа, на симптомы расстройств тревожно-депрессивного спектра.

Spondyloarthritis refers to immune-mediated inflammatory rheumatic diseases characterized by the most pronounced pain, inflammatory activity and disability of patients of working age. One of the most frequent comorbid to spondy-loarthritis diseases that weigh down the course and outcomes are anxiety-depressive spectrum disorders. Chronic inflammation with hyperproduction of cytokines of the interleukin-23/interleukin-17 axis and violation of intracellular signaling of these cytokines, developing against the background of a violation of the stress and immune response, is a key pathogenetic mechanism that combines spondyloarthritis and anxiety-depressive spectrum disorders, and dictates approaches to their therapy. The article discusses the current understanding of the prevalence of mental disorders among patients with spondyloarthritis and their negative impact on the course and outcomes of the rheumatic disease, the common pathogenesis and provoking factors, the influence of antidepressants on spondyloarthritis outcomes and anti-inflammatory drugs, primarily interleukin-17 inhibitors and tumor necrosis factor alpha inhibitors on the symptoms of anxiety-depressive spectrum disorders.

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