medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-521medsovet-8717Research ArticleНЕФРОЛОГИЯ / УРОЛОГИЯNEPHROLOGY / UROLOGYВрожденный иммунитет уротелия: новый шаг в расшифровке патогенеза и совершенствовании терапевтической стратегии при рецидивирующих инфекциях мочевыводящих путей у детейInnate immunity of the urothelium: A new step in decoding pathogenesis and improving therapeutic strategy for recurrent urinary tract infections in childrenhttps://orcid.org/0000-0002-9524-8724КасьяноваА. Н.KasyanovaA. N.

Касьянова Анна Николаевна - к.м.н., доцент кафедры факультетской педиатрии, Ставропольский государственный медицинский университет; заведующая отделением нефрологии, Краевая детская клиническая больница;

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Anna N. Kasyanova - Cand. Sci. (Med.), Associate Professor of the Department of Faculty Pediatrics, Stavropol SMU; Head of the Department of Nephrology, RCCH.

310, Mira St., Stavropol, 355017; 3, Semashko St., Stavropol, 355029

a.nicolaevnakasjanova@yandex.ruhttps://orcid.org/0000-0001-7248-1614КлимовЛ. Я.KlimovL. Ya.

Климов Леонид Яковлевич - д.м.н., профессор, заведующий кафедрой факультетской педиатрии.

355017, Ставрополь, ул. Мира, д. 310

Leonid Ya. Klimov - Dr. Sci. (Med.), Professor, Head of the Department of Faculty Pediatrics.

310, Mira St., Stavropol, 355017

klimov_leo@mail.ruhttps://orcid.org/0000-0002-2056-153XДолбняС. В.DolbnyaS. V.

Долбня Светлана Викторовна - к.м.н., доцент кафедры факультетской педиатрии, Ставропольский государственный медицинский университет; врач-пульмонолог, Краевая детская клиническая больница;

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Svetlana V. Dolbnya - Dr. Sci. (Med.), Associate Professor of the Department of Faculty Pediatrics, Stavropol SMU; Pulmonologist, RCCH.

310, Mira St., Stavropol, 355017; 3, Semashko St., Stavropol, 355029

svet-lana.dolbnya@yandex.ruhttps://orcid.org/0000-0001-8562-651XКарайкозоваА. А.KaraikozovaA. A.

Карайкозова Алена Алексеевна - студент педиатрического факультета.

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Alena A. Karaikozova - Student of the Pediatric Faculty.

310, Mira St., Stavropol, 355017

caraickozova@yandex.ruhttps://orcid.org/0000-0001-7519-8646МинасянА. К.MinasyanA. K.

Минасян Артем Камоевич - аспирант кафедры факультетской педиатрии.

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Artem K. Minasyan - Postgraduate Student of the Department of Faculty Pediatrics.

310, Mira St., Stavropol, 355017

artem.minasyan@inbox.ruhttps://orcid.org/0000-0002-0311-4068ФедькоН. А.FedkoN. A.

Федько Наталья Александровна - д.м.н., профессор, заведующая кафедрой поликлинической педиатрии.

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Natalya A. Fedko - Dr. Sci. (Med.), Professor, Head of the Department of Outpatient Pediatrics.

310, Mira St., Stavropol, 355017

fedko_natalya@mail.ruhttps://orcid.org/0009-0009-9178-1634ЗарытовскаяН. В.ZaritovskayaN. V.

Зарытовская Наталья Владимировна - д.м.н., доцент, профессор кафедры пропедевтики детских болезней с курсом ДПО.

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Natalia V. Zaritovskaya - Dr. Sci. (Med.), Associate Professor, Professor of the Department of Propaedeutics of Children Diseases with the Course of Further Professional Education.

310, Mira St., Stavropol, 355017

leda54@mail.ruhttps://orcid.org/0000-0003-4155-0896ПоповаЕ. В.PopovaE. V.

Попова Елена Викторовна - к.м.н., доцент кафедры поликлинической педиатрии.

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Elena V. Popova - Cand. Sci. (Med.), Associate Professor of the Department of Outpatient Pediatrics.

310, Mira St., Stavropol, 355017

peva26@yandex.ruhttps://orcid.org/0000-0003-4200-4598ЗахароваИ. Н.ZakharovaI. N.

Захарова Ирина Николаевна - д.м.н., профессор, заслуженный врач Российской Федерации, заведующая кафедрой педиатрии имени академика Г.Н. Сперанского.

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Irina N. Zakharova - Dr. Sci. (Med.), Professor, Honored Doctor of the Russian Federation, Head of the Department of Pediatrics named after Academician G.N. Speransky.

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

zakharova-rmapo@yandex.ruКраевая детская клиническая больница; Ставропольский государственный медицинский университетРоссияRegional Children’s Clinical Hospital; Stavropol State Medical UniversityRussian FederationСтавропольский государственный медицинский университетРоссияStavropol State Medical UniversityRussian FederationРоссийская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuous Professional EducationRussian Federation202427112024019152158Copyright © Касьянова А.Н., Климов Л.Я., Долбня С.В., Карайкозова А.А., Минасян А.К., Федько Н.А., Зарытовская Н.В., Попова Е.В., Захарова И.Н., 20242024Касьянова А.Н., Климов Л.Я., Долбня С.В., Карайкозова А.А., Минасян А.К., Федько Н.А., Зарытовская Н.В., Попова Е.В., Захарова И.Н.Kasyanova A.N., Klimov L.Y., Dolbnya S.V., Karaikozova A.A., Minasyan A.K., Fedko N.A., Zaritovskaya N.V., Popova E.V., Zakharova I.N.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/8717

Регуляция иммунных и воспалительных процессов организма необходима для ограничения патогенного процесса, индуцированного уропатогенной кишечной палочкой в мочевом пузыре и почках, при одновременном ограничении повреждения эпителиальных барьеров. В данном обзоре представлены современные представления об особенностях врожденного иммунитета эпителия мочевыделительной системы (уротелия) как первого барьера на пути инфекционных агентов. Поскольку природа иммунных реакций в мочевыводящих путях становится более ясной, эти знания могут быть использованы для разработки новых и эффективных стратегий лечения и/или профилактики инфекции мочевыводящих путей. Некоторые из этих стратегий направлены на усиление врожденных иммунных реакций, а некоторые – на адаптивные иммунные реакции. Однако эффективность этих стратегий основана почти исключительно на данных, полученных на экспериментальных моделях мышей. В целом эти недавние результаты продолжают лучше освещать процессы в организме, которые повышают восприимчивость к инфекции мочевыводящих путей и их тяжести. В дополнение к выделению и характеристике уропатогена ключевым требованием в диагностике инфекции мочевыводящих путей может стать определение природы дефекта локальной иммунной системы мочевыводящих путей. Эта информация в конечном итоге может послужить основой для разработки новых возможных терапевтических подходов к лечению острой и рецидивирующей инфекции мочевыводящих путей и позволить в будущем адаптировать методы лечения для отдельных пациентов таким образом, чтобы они были патогенетически обоснованными, максимально индивидуализированными и снижали риски рецидивирования и хронизации инфекций мочевыводящих путей.

Regulation of immune and inflammatory processes of the body is necessary to limit the pathogenic process induced by uropathogenic E. coli in the bladder and kidneys while limiting damage to epithelial barriers. This review presents modern ideas about the features of innate immunity of the epithelium of the urinary system (urothelium) as the first barrier to infectious agents. As the nature of immune responses in the urinary tract becomes clearer, this knowledge can be used to develop new and effective strategies for the treatment and/or prevention of urinary tract infection. Some of these strategies are aimed at enhancing innate immune responses, and some at adaptive immune responses. However, the effectiveness of these strategies is based almost exclusively on data obtained from experimental mouse models. Overall, these recent results continue to better illuminate the processes in the body that increase susceptibility to urinary tract infections and their severity. In addition to the isolation and characterization of the uropathogen, a key requirement in the diagnosis of urinary tract infection may be to determine the nature of a defect in the local urinary tract immune system. This information can eventually serve as a basis for the development of new possible therapeutic approaches to the treatment of acute and recurrent urinary tract infections and allow in the future to adapt treatment methods for individual patients in such a way that they are pathogenetically justified, as individualized as possible and reduce the risks of recurrence and chronization of urinary tract infections.

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