rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2009-588rsp-726Research ArticleСтатьиArticlesМикофенолата мофетил и атеросклерозMycophenolate mofetil and atherosclerosisАлекбероваЗемфира СадуллаевнаAlekberovaZ S-ПопковаТ. В.PopkovaT V-НасоновЕвгений ЛьвовичNasonovE L-200915102009475№5 (2009)4851Copyright © Алекберова З.С., Попкова Т.В., Насонов Е.Л., 20092009Алекберова З.С., Попкова Т.В., Насонов Е.Л.Alekberova Z.S., Popkova T.V., 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/726

Акселерация атеросклероза, приводящего к коронарной болезни и другим кардиальным нарушениям, повышает значимость адекватно подобранной терапии в улучшении исходов системной красной волчанки (СКВ). Нарастание летальности от кардиоваскулярных заболеваний (КВЗ) при СКВ впервые было описано в 1976г [1]. Риск развития коронарных болезней при СКВ в 4-8 раз выше по сравнению с имеющимся в общей популяции [2]. Показано, что относительный риск развития инфаркта миокарда (ИМ) у женщин с СКВ в возрасте 35-44 года в 50 раз превышает риск ИМ в популяции [3]. При проведении любой терапии СКВ базисными препаратами должно осуществлять постоянный контроль ее влияния на традиционные факторы риска атеросклероза [4]. Приводим таблицу, в которой наряду с уже хорошо известными традиционными и иммуно-воспалительными факторами, определенное место отводится лекарственным препаратам, ускоряющим развитие атеросклероза – это глюкокортикоиды (ГК) и метотрексат (табл. 1) [5]. В то же время в таблице не указаны препараты, используемые в лечении СКВ и одновременно обладающие протективным действием в отношении атеросклероза.

References<div><p>Urowitz M., Bookman A., Koehler B. et al. The bimodal pattern in systemic lupus erythematosus. Am.J.Med. 1976, 60, 221-5</p><p>Petri M. Systemic lupus erythematosus: clinical aspects. In Koopman W.J (Ed.) Arthritis and allied condition. 6th edition, 2001, vol 2. Lippincott, Williams and Wilkins Philadelphia: 1455-79 50 3. Manzi S., Meilahn E., Rairie J. et al. Age-specific incidence rates of myocardial infarction and angina in woman with SLE. Am.J. Epidemiol., 1997,145, 408-</p><p>Bruce J.N. Cardiovascular disease in lupus patients: should all patients be treated with statins and aspirin? Best Pract. Res. Clin. Rheumatol, 2005, 19, 823-8</p><p>Szekanecz Z., Shoenfeld Y. Lupus and cardiovascular disease: the facts. Lupus, 2006, 15, 3-10.</p><p>La Rosa J.C. Atherosclerotic vascular disease in systemic lupus erythematosus and related disorders. Lupus, 2006, 15, 35-8</p><p>Miller L.W. Cardiovascular toxicities of immunosuppressive agent. Am.J.Transpl., 2002, 2, 807-18</p><p>O’Hair DP., Mc Mannus R.P, Komorowsi R. Inhibition of chronic vascular rejection in primate cardiac xenografts using mycophanolate mofetil. Ann. Thorac Surg., 1994, 58,1311-5</p><p>Raisanen-Sokolowski A., Myllarniemi M. et al. Mycophanolate mofetil (MMF, rs-61443) inhibits inflammation and smooth muscle proliferation in rat aortic allografts. Transpl. Immunol., 1995, 3, 342-351</p><p>Hosenpud J., Bennet L. Mycophanolate mofetil versus azathioprine in patients surviving the initial cardiac transplant hospitalization: an analysis of the joint UNOS/JSHLT thoracid registry. Transplantation, 2001, 72, 1662-5</p><p>Richter M.,Zahns, Kraus M. et al. Mycophanolate mofetil significantly reduces leukocyte graft infiltration after heterotopic cardiac transplantation in rat model: Comparative study with cyclosporine and FK 506. J. Heart Lung Transplant., 2003, 22, 1107-16</p><p>Boots J., Christians M., Van Hooff J. Effect of immunosuppressive agents on long-term survival of renal transplant recipients: focus on the cardiovascular risk. Drugs., 2004, 64, 2047-73</p><p>Illison A., Kowalski W., Muller C. et al. Mycophenolic asid and brequinar ingibitors of purine and pyrimidine synthesis, block the glycosylation of adhesiom molecules. Transplant. Proc., 1993, 25, 67-70</p><p>Briggs W., Choi M., Scheel P. Successful mycophanolate mofetil treatment of glomerular disease. Am. J. Kidney Dis., 1998, 31, 213-7</p><p>Chan T. Li F., Tang C. et al. Efficacy of mycophanolate mofetil in patients with diffuse proliferative lupus nephritis. N.Engl. J. Med., 2000, 343, 1156-62</p><p>Шекшина С.В., Клюквина Н.Г., Насонов Е.Л., Насонова В.А. Мофетила микофенолат - от онкологии до ревматологии. Фарматека, 2003, 5, 15-9.</p><p>Kasiske B.L. Risk factors for accelerated atherosclerosis in renal transplant recipients. Am. J. Med., 1988, 84, 985-92</p><p>Eisen H., Kobashigawa J., Keogh A. et al. Three-years results of a randomized double-blind controlled trial of mycophanolate mofetil versus azathioprine in cardial transplant recipients. J. Heart Lung Transplant., 2005, 24, 517-25</p><p>Mc Mannus R., O’Hair D., Komorovski R. et al. Immunosupressant combination in primate cardiac xenografts. A review. N.Y. Acad. Sci., 1993, 696, 281-4</p><p>Schreiber T., Greenstein S., Kim D. et al. Effect of mycophanolate mofetil on atherosclerosis in rabbit model: initial histological and immunohistochemical analyses. Transpl. Proc., 1998, 30, 961-2</p><p>Mamelok R.D. Effect of mycophanolate mofetil on transplant coronary artery disease and survival following cardiac transplantation. Lupus, 2006, 15, 18-22</p><p>Gibson W., Hayden M. Mycophanolate mofetil and animal models. Lupus, 2006, 15, 27-34</p><p>Romero F. Rodriguez, Iturbe B., et al. Mycophanolate mofetil tratment reduce cholesterol-induced atherosclerosis in the rabbit. Atheroscler., 2000, 152, 127-33</p><p>Greenstein S., Sun S., Calderon T. et al. Mycophanolate mofetil tratment reduce atherosclerosis in cholesterol- fed rabbit. J. Surg.Res., 2000, 91, 123-9</p><p>Solinger H.W. Mycophanolate mofetil for the prevention of acute rejection on primary cadaveric renal allograft recipients. U.S. Renal Transplant Mycophanolate mofetil study group. Transplantation, 1995, 60, 225-32</p><p>Richter M., Zahn S., Kraus M. Mycophanolate mofetil significantly reduces leukocyte graft infiltration after heterotopic cardiac transplantation in rat model: Comparative study with cyclosporine and FK 506. J. Heart Lung Transplant., 2003, 22, 1107-16</p><p>Van Leuven S.J., Kastellin J., Hayden M. et al. Mycophanolate mofetil as an immunomodulatory silver bullet in atherogenesis? Lupus, 2006, 15, 11-7</p><p>Sinclair A., Baildon R. Mycophanolate mofetil: an overview. Lupus, 2006, 15, 70-7</p><p>Glicklich D., Acharya A. Mycophanolate mofetil therapy for lupus nephritis refractory to intravenous cyclophosphamide. Am. J. Kidney, 1998, 32, 318-22.</p><p>Goyal S., Nousari H. Treatment of resistant discoid erythematosus of the palms and soles with mycophanolate mofetil. J. Am. Acad. Dermatol., 2001, 45, 142-4</p><p>Vasoo S., Thumboo J., Fong K. Refractory immune thrombocytopenia in systemic lupus erythematosus: response to mycophanolate mofetil. Lupus, 2003, 12, 630-2</p><p>Doria A., Iaccarino L., Artenti S. et al. Mycophanolate mofetil and systemic lupus erythematosus. Lupus, 2006, 15, 44-54</p><p>Kasitanon N., Petri M., Haas M. Mycophanolate mofetil as the primary treatment of membranous lupus nephritis with and without concurrent prolipherative disease: retrospective study of 29 cases. Lupus, 2008, 17, 40-5</p><p>Goldblum R. Therapy of rheumatoid arthritis with mycophanolate mofetil. Clin. Exp. Rheum., 1993, 11, 117-9</p><p>Gelber C., Nousari H., Wigley F. Mycophanolate mofetil in treatment of severe skin manifestations of dermatomyositis: a series of 4 cases. J. Rheumatol., 200, 27, 1542-5</p><p>Strallon R., Willson H., Black C. Pilot study of antithymocyte globulin plus mycophanolate mofetil in resent-onset diffuse scleroderma. J. Rheumatol., 2001, 40, 84-8</p><p>Nowack R., Gobel U., Klooker P et al. Mycophanolate mofetil for maintenance therapy of Wegener’s granulomatosis and microscopic polyangiitis: a pilot study in 11 patients with renal involvement. J. Am. Soc. Nephrol., 1999, 10 (9), 1965-71</p><p>Weiser J., Braasch E., Neumayer H. Treatment of acute cANCA-positive vasculitis with mycophanolate 51 mofetil. Am. J. Kidney Dis., 1999, 34, 9</p><p>Kappen J., Van Loar J., Mensink P. et al. Case report: mycophanolate sodium effective treatment for severe intestinal Behcet disease. Clin. Exp. Rheum., 2008, 26 (3), suppl.50, S-30.</p></div><br /><div><p>Urowitz M., Bookman A., Koehler B. et al. The bimodal pattern in systemic lupus erythematosus. Am.J.Med. 1976, 60, 221-5</p><p>Petri M. Systemic lupus erythematosus: clinical aspects. In Koopman W.J (Ed.) Arthritis and allied condition. 6th edition, 2001, vol 2. Lippincott, Williams and Wilkins Philadelphia: 1455-79 50 3. Manzi S., Meilahn E., Rairie J. et al. Age-specific incidence rates of myocardial infarction and angina in woman with SLE. Am.J. Epidemiol., 1997,145, 408-</p><p>Bruce J.N. Cardiovascular disease in lupus patients: should all patients be treated with statins and aspirin? Best Pract. Res. Clin. Rheumatol, 2005, 19, 823-8</p><p>Szekanecz Z., Shoenfeld Y. Lupus and cardiovascular disease: the facts. Lupus, 2006, 15, 3-10.</p><p>La Rosa J.C. Atherosclerotic vascular disease in systemic lupus erythematosus and related disorders. Lupus, 2006, 15, 35-8</p><p>Miller L.W. Cardiovascular toxicities of immunosuppressive agent. Am.J.Transpl., 2002, 2, 807-18</p><p>O’Hair DP., Mc Mannus R.P, Komorowsi R. Inhibition of chronic vascular rejection in primate cardiac xenografts using mycophanolate mofetil. Ann. Thorac Surg., 1994, 58,1311-5</p><p>Raisanen-Sokolowski A., Myllarniemi M. et al. Mycophanolate mofetil (MMF, rs-61443) inhibits inflammation and smooth muscle proliferation in rat aortic allografts. Transpl. Immunol., 1995, 3, 342-351</p><p>Hosenpud J., Bennet L. Mycophanolate mofetil versus azathioprine in patients surviving the initial cardiac transplant hospitalization: an analysis of the joint UNOS/JSHLT thoracid registry. Transplantation, 2001, 72, 1662-5</p><p>Richter M.,Zahns, Kraus M. et al. Mycophanolate mofetil significantly reduces leukocyte graft infiltration after heterotopic cardiac transplantation in rat model: Comparative study with cyclosporine and FK 506. J. Heart Lung Transplant., 2003, 22, 1107-16</p><p>Boots J., Christians M., Van Hooff J. Effect of immunosuppressive agents on long-term survival of renal transplant recipients: focus on the cardiovascular risk. Drugs., 2004, 64, 2047-73</p><p>Illison A., Kowalski W., Muller C. et al. Mycophenolic asid and brequinar ingibitors of purine and pyrimidine synthesis, block the glycosylation of adhesiom molecules. Transplant. Proc., 1993, 25, 67-70</p><p>Briggs W., Choi M., Scheel P. Successful mycophanolate mofetil treatment of glomerular disease. Am. J. Kidney Dis., 1998, 31, 213-7</p><p>Chan T. Li F., Tang C. et al. Efficacy of mycophanolate mofetil in patients with diffuse proliferative lupus nephritis. N.Engl. J. Med., 2000, 343, 1156-62</p><p>Шекшина С.В., Клюквина Н.Г., Насонов Е.Л., Насонова В.А. Мофетила микофенолат - от онкологии до ревматологии. Фарматека, 2003, 5, 15-9.</p><p>Kasiske B.L. Risk factors for accelerated atherosclerosis in renal transplant recipients. Am. J. Med., 1988, 84, 985-92</p><p>Eisen H., Kobashigawa J., Keogh A. et al. Three-years results of a randomized double-blind controlled trial of mycophanolate mofetil versus azathioprine in cardial transplant recipients. J. Heart Lung Transplant., 2005, 24, 517-25</p><p>Mc Mannus R., O’Hair D., Komorovski R. et al. Immunosupressant combination in primate cardiac xenografts. A review. N.Y. Acad. Sci., 1993, 696, 281-4</p><p>Schreiber T., Greenstein S., Kim D. et al. Effect of mycophanolate mofetil on atherosclerosis in rabbit model: initial histological and immunohistochemical analyses. Transpl. Proc., 1998, 30, 961-2</p><p>Mamelok R.D. Effect of mycophanolate mofetil on transplant coronary artery disease and survival following cardiac transplantation. Lupus, 2006, 15, 18-22</p><p>Gibson W., Hayden M. Mycophanolate mofetil and animal models. Lupus, 2006, 15, 27-34</p><p>Romero F. Rodriguez, Iturbe B., et al. Mycophanolate mofetil tratment reduce cholesterol-induced atherosclerosis in the rabbit. Atheroscler., 2000, 152, 127-33</p><p>Greenstein S., Sun S., Calderon T. et al. Mycophanolate mofetil tratment reduce atherosclerosis in cholesterol- fed rabbit. J. Surg.Res., 2000, 91, 123-9</p><p>Solinger H.W. Mycophanolate mofetil for the prevention of acute rejection on primary cadaveric renal allograft recipients. U.S. Renal Transplant Mycophanolate mofetil study group. Transplantation, 1995, 60, 225-32</p><p>Richter M., Zahn S., Kraus M. Mycophanolate mofetil significantly reduces leukocyte graft infiltration after heterotopic cardiac transplantation in rat model: Comparative study with cyclosporine and FK 506. J. Heart Lung Transplant., 2003, 22, 1107-16</p><p>Van Leuven S.J., Kastellin J., Hayden M. et al. Mycophanolate mofetil as an immunomodulatory silver bullet in atherogenesis? Lupus, 2006, 15, 11-7</p><p>Sinclair A., Baildon R. Mycophanolate mofetil: an overview. Lupus, 2006, 15, 70-7</p><p>Glicklich D., Acharya A. Mycophanolate mofetil therapy for lupus nephritis refractory to intravenous cyclophosphamide. Am. J. Kidney, 1998, 32, 318-22.</p><p>Goyal S., Nousari H. Treatment of resistant discoid erythematosus of the palms and soles with mycophanolate mofetil. J. Am. Acad. Dermatol., 2001, 45, 142-4</p><p>Vasoo S., Thumboo J., Fong K. Refractory immune thrombocytopenia in systemic lupus erythematosus: response to mycophanolate mofetil. Lupus, 2003, 12, 630-2</p><p>Doria A., Iaccarino L., Artenti S. et al. Mycophanolate mofetil and systemic lupus erythematosus. Lupus, 2006, 15, 44-54</p><p>Kasitanon N., Petri M., Haas M. Mycophanolate mofetil as the primary treatment of membranous lupus nephritis with and without concurrent prolipherative disease: retrospective study of 29 cases. Lupus, 2008, 17, 40-5</p><p>Goldblum R. Therapy of rheumatoid arthritis with mycophanolate mofetil. Clin. Exp. Rheum., 1993, 11, 117-9</p><p>Gelber C., Nousari H., Wigley F. Mycophanolate mofetil in treatment of severe skin manifestations of dermatomyositis: a series of 4 cases. J. Rheumatol., 200, 27, 1542-5</p><p>Strallon R., Willson H., Black C. Pilot study of antithymocyte globulin plus mycophanolate mofetil in resent-onset diffuse scleroderma. J. Rheumatol., 2001, 40, 84-8</p><p>Nowack R., Gobel U., Klooker P et al. Mycophanolate mofetil for maintenance therapy of Wegener’s granulomatosis and microscopic polyangiitis: a pilot study in 11 patients with renal involvement. J. Am. Soc. Nephrol., 1999, 10 (9), 1965-71</p><p>Weiser J., Braasch E., Neumayer H. Treatment of acute cANCA-positive vasculitis with mycophanolate 51 mofetil. Am. J. Kidney Dis., 1999, 34, 9</p><p>Kappen J., Van Loar J., Mensink P. et al. Case report: mycophanolate sodium effective treatment for severe intestinal Behcet disease. Clin. Exp. Rheum., 2008, 26 (3), suppl.50, S-30.</p></div><br />

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