Нейропротективный потенциал агонистов рецепторов глюкагоноподобного пептида 1-го типа

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.

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