ЛИГАНД-РЕЦЕПТОРНАЯ СИСТЕМА RANK/RANKL/OPG И ЕЕ РОЛЬ ПРИ ПЕРВИЧНЫХ НОВООБРАЗОВАНИЯХ КОСТЕЙ (АНАЛИЗ ЛИТЕРАТУРЫ И СОБСТВЕННЫЕ РЕЗУЛЬТАТЫ)

Лиганд-рецепторная система RANK/RANKL/OPG – ключевое звено гомеостаза костной ткани, непосредственно регулирующее дифференцировку остеокластов и остеолиз. Дисбаланс костного гомеостаза, связанный с нарушениями в системе RANK/RANKL/ OPG, лежит в основе онкологических процессов, таких как разрушение костей, развитие метастазов, прогрессирование опухоли. Участие системы RANK/RANKL/OPG в формировании костных метастазов различных опухолей практически доказано, однако ее влияние на развитие первичных новообразований костей все еще недостаточно изучено.
В статье суммированы имеющиеся в литературе экспериментальные и клинико-лабораторные данные об участии системы RANK/ RANKL/OPG в патогенезе первичных опухолей костей, в первую очередь – гигантоклеточной опухоли (ГКО), в лечении которой уже используется ингибитор RANK/RANKL-взаимодействия деносумаб. Приведены также результаты собственного исследования содержания растворимых форм компонентов системы RANK/RANKL/OPG в сыворотке крови 101 больного саркомой кости (остеосаркома – 37 пациентов, хондросаркома – 41, хордома – 12, саркома Юинга – 7, плеоморфная недифференцированная саркома – 2, фибросаркома – 2), 32 больных пограничной ГКО кости и 30 пациентов с доброкачественными поражениями костей. Продемонстрированы нарушения баланса активаторов и ингибиторов остеолиза при первичных опухолях костей, зависящие как от характера новообразования (злокачественное, пограничное или доброкачественное), так и от гистологического строения злокачественной опухоли. Наибольшие изменения в системе RANK/RANKL/OPG, выражающиеся в увеличении сывороточной концентрации всех 3 ее компонентов и усилении взаимосвязи между уровнями растворимого рецептора и его природного ингибитора OPG в сыворотке крови, отмечены у больных ГКО.
Изучение роли системы RANK/RANKL/OPG при первичных новообразованиях костей представляет актуальную задачу для исследования на клиническом материале, а также открывает перспективы для разработки новых методов диагностики и адресного назначения молекулярно-направленных препаратов, ингибирующих ее активность.

рецептор-активатор NF-κB (RANK), RANK-лиганд (RANKL), остеопротегерин, костный гомеостаз, остеокластогенез, саркомы костей, гигантоклеточная опухоль кости, таргетная терапия, деносумаб, сыворотка крови

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