Физиологические и патофизиологические предпосылки репаративного потенциала эпикарда

Е. В. Тимофеев; Я. Э. Булавко

doi:10.32415/jscientia_2024_10_6_37-49

Авторы

Е. В. Тимофеев Санкт-Петербургский государственный педиатрический медицинский университет https://orcid.org/0000-0001-9607-4028
Я. Э. Булавко Университет Западного Онтарио https://orcid.org/0000-0003-0879-846X

https://doi.org/10.32415/jscientia_2024_10_6_37-49

Ключевые слова:

эпикард, стимуляция, инфаркт миокарда, цитокины, трансформирующий фактор роста, прогениторные клетки эпикарда, эпителиально-мезенхимальная трансформация, морфогенез сердца

Аннотация

Сердечно-сосудистые заболевания и, в частности, инфаркт миокарда, занимают главенствующее место в структуре смертности и инвалидизации во всём мире. Отдалённые осложнения инфаркта — ремоделирование миокарда, хроническая сердечная недостаточность, нарушения ритма, аневризмы левого желудочка существенно снижают качество жизни больных, приводят к повышению уровня инвалидизации и к серьёзным финансовым затратам. Актуальным направлением медицины является поиск механизмов кардиальной регенерации после случившегося инфаркта миокарда.
Предположение о регенеративном потенциале эпикарда основано на результатах прицельного изучения его свойств и характеристик. В процессе эмбриогенеза эпикард продуцирует большое количество мультипотентных клеток-предшественников, которые в дальнейшем подвергаются эпителиально-мезенхимальной трансформации. Эти клетки мигрируют в толщу миокарда и дают начало различным кардиальным типам клеток, в том числе — кардиомиоцитам. Эпикард участвует в синтезе паракринных факторов, которые обеспечивают рост коронарных сосудов, а также дифференцировку и развитие миокарда в целом. В основе разрабатываемых механизмов восстановления миокарда лежат различные способы стимуляции активности эпикарда по эмбриональному пути.
В статье структурируется имеющаяся в настоящее время информация о репаративном потенциале эпикарда — физиологические аспекты в эмбриогенезе, а также его реакции на повреждение миокарда.

Биография автора

Е. В. Тимофеев, Санкт-Петербургский государственный педиатрический медицинский университет

Доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней

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