Медицинская литература. Новинки

 

 

 

 

 

 

Микрохимеризм и патология щитовидной железы: перспективы дальнейшего изучения

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В обзоре обсуждается новый феномен в медицине и эндокринологии - микрохимеризм (МХ), представляющий собой присутствие в тканях и/или кровеносной системе организма-хозяина небольшого количества генетически отличных клеток, способных к длительному персистированию. Данное состояние может развиться вследствие двустороннего клеточного обмена во время нормально протекающей беременности между организмом матери и плода. Помимо этого, МХ может возникнуть в результате фетофетальных взаимодействий и ятрогенных влияний, таких как гемотрансфузия и трансплантация органов. Отдаленные последствия этого феномена стали предметом пристального внимания сравнительно недавно. Имеющиеся на сегодняшний день данные свидетельствуют о широком диапазоне биологических эффектов микрохимерных клеток на организм. Согласно одной из гипотез, МХ рассматривается как одно из ключевых звеньев патогенеза аутоиммунных заболеваний. Предполагается, что клетки-химеры способны провоцировать реакции по типу ''''трансплантат против хозяина'''' и ''''хозяин против трансплантата''''. Ряд исследований посвящен изучению роли МХ в патогенезе аутоиммунных тиреопатий. Данная теория могла бы объяснить преобладание заболеваемости среди женщин репродуктивного возраста и частую манифестацию в послеродовом периоде. Другая гипотеза рассматривает способность микрохимерных клеток участвовать в процессах регенерации тканей и оказывать протективное воздействие на ряд онкологических заболеваний. Группой итальянских исследователей проводится активное изучение роли МХ при папиллярном раке щитовидной железы. Более глубокое понимание природы МХ и его роли в развитии рака щитовидной железы может способствовать расширению терапевтического диапазона, выявлению новых профилактических мишеней и прогностических критериев в отношении данного заболевания.

Ключевые слова:
микрохимеризм, рак щитовидной железы, болезнь Грейвса, тиреоидит Хашимото, microchimerism, thyroid cancer, Hashimoto''s thyroiditis, Graves'' disease

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Microchimerism and thyroid disorders: current knowledge and future prospects

This review will provide an overview of a novel phenomenon in medicine and endocrinology known as microchimerism (MC). MC is defined as the long-term presence of genetically distinct populations of cells in peripheral blood and tissues of individual. This condition may be caused by the transplacental bidirectional cell trafficking between mother and fetus during pregnancy. Other sources are the passage from a twin or a vanished twin and iatrogenic interventions such as organ transplantation and blood transfusion. Long-term consequences of MC and its influence on woman''s health are under active investigation. Recent studies have shown a broad spectrum of its biological effects either beneficial or adverse. MC has been suggested to play a key role in the pathogenesis of autoimmune diseases. It is assumed that microchi-meric cells could initiate a ''''graft versus host'''' or ''''host versus graft'''' reactions. MC has been extensively studied in autoimmune thyroid diseases (AITD). MC could explain the higher prevalence of AITD in females and frequent manifestation during the postpartum period. It is proposed that microchimeric cells could reduce the risk of cancer development and be a part of tissue repair. MC has also been investigated in papillary thyroid cancer. Further studies of this phenomenon are mandatory to get more insights about its role in thyroid cancer and AITD development. This could provide novel therapeutic, preventive or prognostic perspectives regarding these diseases.

Keywords:
микрохимеризм, рак щитовидной железы, болезнь Грейвса, тиреоидит Хашимото, microchimerism, thyroid cancer, Hashimoto''s thyroiditis, Graves'' disease