Современное состояние анти-амилоидной терапии и поиск новых векторов комплексной терапии болезни Альцгеймера
DOI:
https://doi.org/10.48612/pfiet/0031-2991.2026.02.180-186Ключевые слова:
болезнь Альцгеймера, терапевтические стратегии, антиамилоидные моноклональные антитела, нейровоспаление, бета-амилоидный пептид, тау-белок, сенесценция, нейрорепарацияАннотация
В условиях глобального старения населения болезнь Альцгеймера (БА) становится серьезным вызовом для здравоохранения вследствие отсутствия эффективной патогенетической терапии и ограниченных возможностей симптоматического лечения. В начале 2000-х годов была предложена перспективная болезнь-модифицирующая стратегия лечения БА, направленная на удаление патологических агрегатов β-амилоидного пептида (Aβ) посредством анти-амилоидных моноклональных антител (anti-Aβ mAbs). Несмотря на сопутствующую симптоматическую терапию, ряд препаратов группы anti-Aβ mAbs продемонстрировал низкую эффективность, в то время как другие провалили III фазу клинических испытаний. Кроме того, существенным ограничением данной стратегии стала высокая частота нежелательных явлений, наиболее значимыми из которых являются амилоид-связанные аномалии визуализации (ARIA): вазогенный отёк и микрокровоизлияния. Таким образом, мультитаргетный подход, сочетающий удаление Aβ, активацию микроглии и модуляцию нейромедиаторных систем, не продемонстрировал ожидаемой клинической пользы. Данные обстоятельства указывают на необходимость пересмотра текущих терапевтических стратегий и поиск новых фундаментальных подходов к лечению БА. В представленном обзоре мы не только критически оцениваем эффективность терапии БА анти-амилоидными антителами, но также предлагаем концептуальные основы для дальнейшего развития терапевтических подходов, направленных на комплексное патогенетическое лечение БА.
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Copyright (c) 2026 Валерия Владимировна Голоборщева, Виктор Сергеевич Кохан
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