Блокада сигнального пути интерлейкина 6 при ревматоидном артрите: влияние на ожирение, адипоцитокины и метаболизм глюкозы

Интерлейкин (ИЛ) 6 – один из ключевых цитокинов, роль которого в развитии воспаления при ревматоидном артрите (РА) хорошо доказана. Гораздо хуже изучены плейотропные эффекты самого цитокина и генно-инженерных препаратов (ГИБП), ингибирующих его биологическое действие. В обзоре представлены сведения о воздействии ИЛ-6 и ГИБП, блокирующих его сигнальный путь, на жировую ткань, метаболизм глюкозы и уровень адипоцитокинов при РА. Показано, что длительная блокада рецепторов ИЛ-6 не приводит к накоплению жировой ткани и улучшает контроль гликемии, хотя не ясно, связан ли подобный эффект только с противовоспалительными свойствами тоцилизумаба и сарилумаба. Более того, до конца не понятен механизм такого благоприятного действия, поскольку данные о повышении чувствительности периферических тканей к инсулину на фоне терапии тоцилизумабом неоднозначны. Возможно, определенную роль играют изменения взаимоотношений адипоцитокинов или гормонов.

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