medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-159medsovet-7604Research ArticleСАХАРНЫЙ ДИАБЕТDIABETES MELLITUSНейропротективный потенциал агонистов рецепторов глюкагоноподобного пептида 1-го типаNeuroprotective potential of incretinomimeticshttps://orcid.org/0000-0002-9093-7985КокинА. С.KokinA. S.

Кокин Артем Сергеевич, ординатор кафедры терапии с курсом эндокринологии, функциональной и ультразвуковой диагностики

625023, Тюмень, ул. Одесская, д. 54

Artem S. Kokin, Clinical Resident of the Endocrinology Course of the Institute of CPD with the Courses of Endocrinology, Functional and Ultrasound Diagnostics

54, Odesskaya St., Tyumen, 625023

Kokin.artem45@gmail.comhttps://orcid.org/0000-0001-9253-8075СуплотоваЛ. А.SuplotovaL. A.

Суплотова Людмила Александровна, д.м.н., профессор, заведующая курсом эндокринологии кафедры терапии

625023, Тюмень, ул. Одесская, д. 54

Lyudmila A. Suplotova, Dr. Sci. (Med.), Professor, Head of the Endocrinology Course of the Institute of CPD with the Courses of Endocrinology, Functional and Ultrasound Diagnostics

54, Odesskaya St., Tyumen, 625023

suplotovala@mail.ruhttps://orcid.org/0000-0002-6329-593XДушинаТ. С.DushinaT. S.

Душина Татьяна Сергеевна, ассистент кафедры клинической лабораторной диагностики

625023, Тюмень, ул. Одесская, д. 54

Tatyana S. Dushina, Assistant of the Department the Course Clinical and Laboratory Diagnostics

54, Odesskaya St., Tyumen, 625023

dr.dushina@mail.ruhttps://orcid.org/0000-0003-4663-0289МакароваО. Б.MakarovaO. B.

Макарова Ольга Борисовна, к.м.н., доцент, доцент курса эндокринологии кафедры терапии

625023, Тюмень, ул. Одесская, д. 54

Olga B. Makarova, Cand. Sci. (Med.), Assistant Professor of the Endocrinology Course of the Institute of CPD with the Courses of Endocrinology, Functional and Ultrasound Diagnostics

54, Odesskaya St., Tyumen, 625023

dr.makarova@yahoo.comТюменский государственный медицинский университетРоссияTyumen State Medical UniversityRussian Federation2023240620231794046Copyright © Кокин А.С., Суплотова Л.А., Душина Т.С., Макарова О.Б., 20232023Кокин А.С., Суплотова Л.А., Душина Т.С., Макарова О.Б.Kokin A.S., Suplotova L.A., Dushina T.S., Makarova O.B.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/7604

В назначениях врача-эндокринолога пациентам с сахарным диабетом 2 типа (СД2) в последнее время все чаще фигурируют агонисты рецепторов глюкагоноподобного пептида-1 (арГПП-1), относящиеся к группе, воздействующей на инкретиновую систему организма. Помимо выраженного сахароснижающего эффекта и  безопасности, эти препараты также обладают множеством плейотропных свойств, ввиду наличия рецепторов к  глюкагоноподобному пептиду первого типа (ГПП-1Р) в эндотелии сосудов, почках, сердце и нервной ткани. Целью настоящей работы является описание наиболее изученных нейропротекторных эффектов этого класса препаратов. В качестве материалов в ходе работы использовались исследования отечественных и зарубежных коллег, опубликованные в период 2008–2022 гг. Анализ работ показал, что нейропротективное действие арГПП-1 связано с активацией соответствующих рецепторных систем в ЦНС, которая ведет к  повышению клеточной выживаемости в  условиях ишемии путем снижения активных форм кислорода, стимуляции бета-окисления митохондриями, снижения синтеза провоспалительных цитокинов. Кроме того, при анализе литературы также установлена положительная роль арГПП-1  и  при нейродегенеративных заболеваниях  – препараты уменьшают количество аномальных белков (альфа-синуклеина, микротубулярного Т-пептида и др.), снижают активность неферментативного гликирования белков в  условиях гипергликемии, а  также снижают инсулинорезистентность. Описанные выше эффекты были получены в ходе доклинических испытаний арГПП-1, в то же время они продемонстрировали свою эффективность и в ходе некоторых клинических испытаний. Однако полученных данных пока недостаточно для формирования четких показаний для этого класса препаратов в  неврологии, поэтому тема требует дальнейшего изучения и  больших клинических испытаний.

In the prescriptions of an endocrinologist to patients with diabetes mellitus, glucagon-like peptide agonists, belonging to the group that affects the incretin system of the body, have recently been increasingly appearing. In addition to the pronounced hypoglycemic effect and high safety, these drugs also have many pleiotropic properties due to the presence of glucagon-like peptide receptors in the vascular endothelium, kidneys, heart and nervous tissue. The purpose of this work is to describe the  most studied neuroprotective effects of  this class of  drugs. As materials in  the course of  the work, studies of domestic and foreign colleagues published in the period from 2008 to 2022 were used. Our work has shown that the neuroprotective effect of GLP-1 is associated with the activation of the corresponding receptor systems in the central nervous system, which leads to increased cellular survival in ischemic conditions by reducing reactive oxygen species, stimulating beta-oxidation by mitochondria, and reducing pro-inflammatory cytokines. In addition, the analysis of the literature also established the positive role of GLP-1 in neurodegenerative diseases – drugs reduce the amount of unnormal proteins (alphasynuclein, microtubular T-peptide, etc.), reduce the activity of non-enzymatic glycation of proteins in hyperglycemia, as well as reduce insulin resistance. The effects described above were analyzed during preclinical trials of GLP-1, and also demonstrated their validity in human models during some clinical trials. However, the data obtained is not yet sufficient to form clear indications for this class of drugs in neurology, so the topic requires further study and large clinical trials.

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