Перспективы лечения острой и хронической почечной недостаточности с использованием стволовых клеток и «клеточной терапии без клеток»

Несмотря на общемировую тенденцию к возрастанию объемов помощи больным с терминальной стадией хронической почечной недостаточности (ХПН), потребности в заместительной почечной терапии по-прежнему превышают возможности мировой медицины, что требует разработки инновационных методов предупреждения перехода острого повреждения почки (ОПП) в хроническую болезнь почки (ХБП) и в ее прогрессирование до ХПН. Таким направлением является использование терапии стволовыми клетками (СК), выделенными из разных тканей, или продуктами их секреции (секретомом СК). В обзоре проанализированы данные литературы о возможности стимуляции регенерации поврежденных клеточных структур с использованием клеточных технологий за счет активации адаптивных компенсаторно-приспособительных реакций и ингибирования дезадаптивных патологических реакций при разных вариантах повреждения почек. Показано, что, по данным экспериментальных исследований, терапия СК оказывает выраженный терапевтический эффект, способствуя как уменьшению и более быстрому восстановлению показателей функционального состояния почки при ОПП, так и уменьшению риска перехода ОПП в ХБП. При этом терапия секретомом СК обладает такой же эффективностью, как и самими СК. Обсуждена значимость факторов, ограничивающих эффективность клеточной терапии, и пути их преодоления.

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