medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-10-40-45medsovet-6906Research ArticleСАХАРНЫЙ ДИАБЕТDIABETES MELLITUSИнгибиторы дипептидилпептидазы-4: очевидное и вероятное (обзор литературы)Inhibitors of dipeptidyl-peptidase-4: obvious and probable (literature review)https://orcid.org/0000-0002-7359-0238ОртенбергЭ. А.OrtenbergE. A.

Ортенберг Эдуард Анатольевич, доктор медицинских наук, профессор, заведующий курсом клинической фармакологии кафедры госпитальной терапии с курсами эндокринологии и клинической фармакологии

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Eduard A. Ortenberg, Dr. Sci. (Med.), Professor, Head of the Clinical Pharmacology Course of the Department of Hospital Therapy with Endocrinology and Clinical Pharmacology courses

54, Odesskaya St., Tyumen, 625023

https://orcid.org/0000-0001-9253-8075СуплотоваЛ. А.SuplotovaL. A.

Суплотова Людмила Александровна, доктор медицинских наук, профессор, заведующая курсом эндокринологии кафедры терапии Института непрерывного профессионального развития

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Lyudmila A. Suplotova, Dr. Sci. (Med.), Professor, Head of the Course of Endocrinology, Department of Therapy, Institute for Continuous Professional Development

54, Odesskaya St., Tyumen, 625023

suplotovala@mail.ruТюменский государственный медицинский университетРоссияTyumen State Medical UniversityRussian Federation2022180620220104045Copyright © Ортенберг Э.А., Суплотова Л.А., 20222022Ортенберг Э.А., Суплотова Л.А.Ortenberg E.A., Suplotova L.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6906

Целью данного обзора литературы является необходимость суммировать актуальные оценки влияния использования ингибиторов дипептидилпептидазы-4 (иДПП-4) в алгоритмах традиционной (сахарный диабет) и альтернативной нозологий, в частности при лечении онкологической и неврологической патологий и новой коронавирусной инфекции (COVID-19). Проанализированы наиболее масштабные публикации 2018–2021 гг., посвященные изучаемым проблемам, поиск которых проводился по ключевым словам в информационной базе Pubmed (ncbi.nlm.nih.gov). Значимыми факторами, способствующими широкому распространению иДПП-4 в клинической практике, является фармакологически ясный механизм их действия, эффективность, возможность перорального использования, удачный фармакокинетический профиль, низкая токсичность, в частности, низкий риск развития гипогликемии. Также рассмотрены данные о механизмах ренопротективного действия и различные взгляды на наличие кардиопротекции. В статье обсуждаются биохимические предпосылки возможной эффективности иДПП-4 в качестве блокаторов развития гипериммунной реакции, обусловливающей, в частности, тяжелое течение новой коронавирусной инфекции. При этом детально сопоставляются результаты исследований различного дизайна, свидетельствующие как в пользу применения иДПП-4 у пациентов с COVID-19, так и не отметившие его целесообразности. В заключении указано на то, что благодаря значимой биохимической роли ДПП-4 представляется важным продолжать активное использование его ингибитора при сахарном диабете и расширять способ его применения при других нозологиях, включая COVID-19.

The purpose of the presented literature review was an attempt to sum up current estimates of the effect of the use of dipeptidyl peptidase-4 inhibitors (iDPP-4) in the algorithms of both traditional (diabetes mellitus) and a number of alternative nosologies, in particular, oncological and neurological pathology, as well as a new coronavirus infection (COVID-19). To do this, the most large-scale (as a rule) publications of 2018–2021 devoted to the problems under consideration were analyzed. The search was carried out by keywords in the Pubmed information base (ncbi.nlm.nih.gov). Factors contributing to the widespread use of IDP-4 in clinical practice are both pharmacologically clear mechanism of action and efficacy, as well as the possibility of oral use, a successful pharmacokinetic profile, low toxicity, in particular, a low risk of hypoglycemia. Newly obtained data on the mechanisms of mechanisms are discussed. Renoprotective action, the presence of cardioprotection is debated. The biochemical prerequisites for the possible effectiveness of iDPP-4 as blockers of the development of a hyperimmune reaction that causes, in particular, the severe course of the new coronavirus infection are discussed. At the same time, the results of studies of various designs are categorically compared, indicating both in favor of the use of iDPP-4 in patients with COVID-19, and not noticing its expediency. It is concluded that, given the large-scale biochemical role of DPP-4, it is important both to continue the active use of its inhibitors in diabetes mellitus, and to expand attempts to use them in a number of other nosologies, including COVID-19.

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The authors declare that there are no conflicts of interest present.