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Журнал общей биологии, 2023, T. 84, № 2, стр. 83-97

Роль человеческого сывороточного альбумина в профилактике и лечении болезни Альцгеймера

М. П. Шевелёва 1, Е. И. Дерюшева 1, Е. Л. Немашкалова 1, А. В. Мачулин 2, Е. А. Литус 1, *

1 Институт биологического приборостроения с опытным производством РАН, обособленное подразделение ФИЦ “Пущинский научный центр биологических исследований РАН”
142290 Московская обл., Пущино, Пр-т Науки, 3, Россия

2 Институт биохимии и физиологии микроорганизмов им. Г.К. Скрябина РАН, обособленное подразделение ФИЦ “Пущинский научный центр биологических исследований РАН”
142290 Московская обл., Пущино, Пр-т Науки, 3, Россия

* E-mail: ealitus@gmail.com

Поступила в редакцию 19.08.2022
После доработки 08.01.2023
Принята к публикации 22.03.2023

Аннотация

Болезнь Альцгеймера (БА) была и остается основной причиной развития деменции у возрастных пациентов. Данное нейродегенеративное заболевание характеризуется прогрессивным течением и относится к группе социально значимых. Существует несколько гипотез развития БА: тау-гипотеза, амилоидная гипотеза, холинергическая гипотеза, гипотезы окислительного стресса и воспаления. Отсутствие общепринятого представления об этиологии и патогенезе БА препятствует разработке новых эффективных способов ее лечения и профилактики. В клинической практике широко используются ингибиторы холинэстеразы, облегчающие симптомы заболевания, но не влияющие на его течение. В 2021 г. впервые был одобрен препарат для проведения патогенетической терапии БА (адуканумаб), способствующий снижению содержания β-амилоидного пептида (Аβ) в головном мозге пациентов. Другим перспективным подходом к терапии БА, направленным на выведение Аβ из центральной нервной системы пациента, является воздействие на человеческий сывороточный альбумин (ЧСА), который переносит 90% Аβ в сыворотке крови и 40–90% Аβ в цереброспинальной жидкости. В клинической практике уже был апробирован и показал свою эффективность плазмаферез с заменой собственного ЧСА на очищенный терапевтический препарат альбумина. Еще одним вариантом такого подхода является усиление взаимодействия ЧСА с Аβ посредством воздействия экзогенных и эндогенных лигандов ЧСА, таких как серотонин, ибупрофен и некоторые ненасыщенные жирные кислоты. Исследования in vivo подтверждают ассоциацию данной группы лигандов с патогенезом БА. Перечисленные вещества относятся к хорошо изученным естественным метаболитам или лекарственным препаратам, что существенно упрощает разработку новых методов терапии и профилактики БА с их использованием. В целом, новое направление научных исследований, посвященных изучению ЧСА в качестве переносчика и депо Аβ в крови и цереброспинальной жидкости, позволит расширить наши представления о метаболизме Аβ и его роли в патогенезе БА.

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