medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-519medsovet-8747Research ArticleХРОНИЧЕСКИЕ ЗАБОЛЕВАНИЯ ЛЕГКИХCHRONIC PULMONARY DISEASESТаргетная терапия как новая перспектива в лечении ХОБЛTargeted therapy as a new perspective in the treatment of COPDhttps://orcid.org/0000-0002-0685-4133ТрушенкоН. В.TrushenkoN. V.

Трушенко Наталья Владимировна - к.м.н., доцент кафедры пульмонологии, ПМГМУ им. И.М. Сеченова (Сеченовский Университет); научный сотрудник, НИИ пульмонологии ФМБА.

119048, Москва, ул. Трубецкая, д. 8, стр. 2; 115682, Москва, Ореховый бульвар, д. 28

Natalia V. Trushenko - Cand. Sci. (Med.), Associate Professor, Department of Pulmonology, Sechenov First Moscow State Medical University (Sech- enov University); Researcher, Research Institute for Pulmonology of the Federal Medical Biological Agency.

8, Bldg. 2, Trubetskaya St., Moscow, 119991; 8, Orekhovy Boulevard, Moscow, 115682

trushenko.natalia@yandex.ruhttps://orcid.org/0000-0003-1254-6863ЛавгиноваБ. Б.LavginovaB. B.

Лавгинова Баина Баатровна - клинический ординатор кафедры пульмонологии.

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Baina B. Lavginova - Clinical Resident of the Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119991

bapus15@yandex.ruhttps://orcid.org/0009-0003-1847-4159БелкинаО. С.BelkinaO. S.

Белкина Олеся Сергеевна - студент Клинического института детского здоровья имени Н.Ф. Филатова.

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Olesia S. Belkina - Student of the Clinical Institute of Child Health named after. N.F. Filatov, Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119991

olesia.belkina2016@yandex.ruhttps://orcid.org/0000-0002-5999-2150АвдеевС. Н.AvdeevS. N.

Авдеев Сергей Николаевич - академик РАН, д.м.н., профессор, заведующий кафедрой пульмонологии, ПМГМУ им. И.М. Сеченова (Сеченовский Университет); руководитель клинического отдела, НИИ пульмонологии ФМБА.

119048, Москва, ул. Трубецкая, д. 8, стр. 2; 115682, Москва, Ореховый бульвар, д. 28

Sergey N. Avdeev - Dr. Sci. (Med.), Professor, Acad. RAS, Head of the Pulmonology Department, Sechenov First Moscow State Medical University (Sechenov University); Head of the Clinical Department, Research Institute for Pulmonology of the Federal Medical Biological Agency.

8, Bldg. 2, Trubetskaya St., Moscow, 119991; 8, Orekhovy Boulevard, Moscow, 115682

serg_avdeev@list.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет); Научно-исследовательский институт пульмонологии Федерального медико-биологического агентстваРоссияSechenov First Moscow State Medical University (Sechenov University); Research Institute for Pulmonology of the Federal Medical Biological AgencyRussian FederationПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation2024101220240201016Copyright © Трушенко Н.В., Лавгинова Б.Б., Белкина О.С., Авдеев С.Н., 20242024Трушенко Н.В., Лавгинова Б.Б., Белкина О.С., Авдеев С.Н.Trushenko N.V., Lavginova B.B., Belkina O.S., Avdeev S.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8747

Хроническая обструктивная болезнь легких (ХОБЛ) представляет собой гетерогенное заболевание с персистирующим ограничением воздушного потока, вызванное хроническим воспалением дыхательных путей в ответ на воздействие вредных частиц и газов. Разнообразие клинических проявлений и патофизиологических механизмов требует индивидуализированного подхода к лечению. В основе болезни лежат воспалительные процессы, которые включают активацию макрофагов, нейтрофилов и Т-клеток, а также высвобождение различных медиаторов воспаления, способствующих хроническому повреждению дыхательных путей. В последние годы внимание привлекает Т2-воспаление, традиционно ассоциированное с бронхиальной астмой, которое выявляется у значительной части пациентов с ХОБЛ. Эозинофилия выявляется у значительной доли пациентов с ХОБЛ и ассоциируется с более тяжелым течением и повышенным риском обострений. Данные о роли эозинофилов при ХОБЛ неоднозначны: в некоторых исследованиях не выявлено различий в тяжести течения между группами с высокой и низкой эозинофилией, тогда как другие подтверждают повышенный риск обострений у пациентов с высоким уровнем эозинофилов. Многообещающим средством в этой области стал дупилумаб - моноклональное антитело, блокирующее рецепторы интерлейкинов-4 и -13, которое демонстрирует способность снижать частоту обострений и улучшать показатели легочной функции у пациентов с ХОБЛ, воздействуя на Т2-воспаление. Результаты клинических испытаний показывают, что дупилумаб обеспечивает значительное клиническое улучшение и может стать важным инструментом в терапии ХОБЛ с признаками Т2-воспаления, обеспечивая новый подход к лечению, основываясь на понимании молекулярных механизмов заболевания. В настоящей публикации представлены последние данные об использовании дупилумаба в лечении ХОБЛ.

Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition characterized by persistent airflow limitation caused by chronic airway inflammation in response to harmful particles and gases. The diversity of clinical manifestations and pathophysiological mechanisms necessitates an individualized approach to treatment. The disease is driven by inflammatory processes, including the activation of macrophages, neutrophils, and T-cells, as well as the release of various inflammatory mediators that contribute to chronic airway damage. In recent years, attention has turned to eosinophilic inflammation, traditionally associated with asthma, which is also found in a significant portion of COPD patients. Eosinophilia is observed in a considerable number of COPD patients and is associated with more severe disease and an increased risk of exacerbations. However, data on the role of eosinophils in COPD are mixed: some studies find no difference in disease severity between high- and low-eosinophil groups, while others confirm an elevated risk of exacerbations in patients with high eosinophil levels. A promising therapeutic agent in this area is dupilumab — a monoclonal antibody that blocks interleukin-4 and -13 receptors, demonstrating the ability to reduce exacerbation frequency and improve lung function in COPD patients by targeting eosinophilic inflammation. Clinical trial results indicate that dupilumab provides significant clinical improvement and may become an important tool in treating eosinophilic COPD, offering a new approach based on the molecular understanding of the disease. This publication presents the latest data on the use of dupilumab in COPD treatment.

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