ИММУНОПАТОГЕНЕЗ МИАСТЕНИИ ГРАВИС (ОБЗОР ЛИТЕРАТУРЫ)

Миастения гравис — тяжелое прогрессирующее аутоиммунное заболевание, характеризующееся выработкой антител к структурам нервно-мышечного соединения. Высокая клиническая гетерогенность аутоиммунной миастении и инициализирующее течение повышают актуальность изучения ее патогенеза, поиска специфичных методов маркерной диагностики, разработки алгоритмов для прогнозирования особенностей развития заболевания. На сегодняшний день существуют разные подходы в изучении этиологии и патогенеза заболевания, в числе которых серологические, биохимические и генетические теории развития болезни. На протяжении десятков лет ведутся исследования, направленные на поиск новых патогенетических звеньев миастении гравис. На сегодняшний день уже описан ряд антител, которые возможно применять при диагностике миастении гравис; серологическая диагностика миастении стала применяться в клинической практике в качестве «золотого стандарта». Уже разработаны прогностические критерии, описывающие характер течения миастении гравис и типы антител, выделенных в сыворотке крови пациента, описаны механизмы срыва аутотолерантности, запускающие выработку антител к собственным структурам, их генетические основы. С развитием биотехнологических методов, исследователи смогли идентифицировать подтип лимфоцитов, участвующих в развитии миастении. Стало доступно выделение отдельных субпопуляций лимфоцитов. Исследователи продолжают поиски новых мишеней, которые позволят усовершенствовать диагностику миастении гравис, разработать новые направления в терапии заболевания. Однако несмотря на активное изучения различных механизмов развития миастении, еще остается множество нерешенных задач. В статье кратко описаны основные изученные механизмы развития миастении гравис, что облегчит практикующим врачам понимание сложных механизмов ее патогенеза.

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