Цитокиновые факторы роста в регуляции ангиогенеза и атерогенного воспаления в сосудистой стенке. Аналитический обзор. Часть 1

Целью обзора является оценка терапевтических возможностей локальной активации ангиогенеза и прерывания атерогенного воспаления при реконструкции слоев артериальной стенки методом введения полисахаридных полимеров в пара-адвентициальную зону кровеносных сосудов. Концепция обзора строится на гипотезе восстановления баланса провоспалительных и атеропротекторных цитокиновых факторов роста при использовании биополимеров. Согласно данным литературы реконструкция адвентициального слоя артериальной стенки с применением гидрогелей полисахаридного ряда, обладающих высоким сродством к холестерину, обусловливает формирование дополнительного внеклеточного матрикса за пределами интимальной и средней зон магистральной артерии и перехода холестериновой массы из интимальной зоны в околоадвентициальное пространство. Создание продуктивного воспаления в зоне адвентиции с помощью биополимеров может служить одним из эффективных способов деградации ранних мягких атеросклеротических бляшек. Рассматривается возможность удаления мягких атеросклеротических бляшек из интимального пространства магистральных артерий методом обширной имплантации в фасциальный футляр сосудов полисахаридных гидрогелей, образующих внеклеточный матрикс второго уровня. Анализ литературы, соответствующей концепции, проводился с использованием баз данных WoS, Scopus, PubMed, DOAJ, Embase, Ei Compendex, преимущественно за последние 8 лет. Обзор позволяет составить представление о молекулярных процессах, протекающих в стенке сосуда при развитии атерогенного воспаления и выявить признаки реконструкции сосудистой стенки при экзогенной имплантации биополимеров. В сосудистой стенке цитокиновые факторы роста сопряжены с природными или синтетическими биоматериалами. Иммобилизованные факторы доступны для клеток, которые вступают в контакт с матрицей, и обеспечивают точно локализованный сигнал для контроля судьбы клеток. Многообещающим подходом для стимулирования ангиогенеза являются биополимерные инъекционные каркасы. Клеточная миграция из интимы и медии может быть активирована благодаря электростатическому градиенту в присутствии сульфатированного полимера, образующего аффинные комплексы с холестерином и липопротеинами низкой плотности (ЛПНП). Высокая аффинность полисахаридных полимеров к холестерину и ЛПНП, а также активная васкуляризация дополнительного экстраклеточного матрикса провоцируют концентрационный градиент холестерина, направленный в сторону гидрогелевой «рубашки». Эффект оттока холестерина может стать основой нового подхода в терапии патологии магистральных сосудов.

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