Ингибиторы дипептидилпептидазы-4: очевидное и вероятное (обзор литературы)

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.

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