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Коморбідний ендокринологічний пацієнт
Коморбідний ендокринологічний пацієнт

Международный эндокринологический журнал Том 20, №6, 2024

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Посттравматичний стресовий розлад і метаболічний синдром: роль деяких антиоксидантів у лікуванні

Посттравматичний стресовий розлад і метаболічний синдром: роль деяких антиоксидантів у лікуванні

Авторы: Сергієнко В.О. (1), Олійник А.Ю. (1), Павловський Я.І. (1), Крук О.С. (2), Сергієнко О.О. (1)
(1) - Львівський національний медичний університет імені Данила Галицького, м. Львів, Україна
(2) - Перше територіальне медичне об’єднання міста Львова, м. Львів, Україна

Рубрики: Эндокринология

Разделы: Справочник специалиста

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Резюме

Основою патогенезу серцево-судинних, онкологічних, метаболічних захворювань, хронічного запалення низької інтенсивності (ХЗНІ) та багатьох інших розладів є дисбаланс між прооксидантами і системою антиоксидантного захисту. Вважається, що в основі зв’язку між посттравматичним стресовим розладом (ПТСР) і метаболічним синдромом (МС) є оксидантний стрес (ОС), підвищена активність вегетативної нервової системи, активація синтезу глюкокортикоїдів або імунологічна дисрегуляція. Більше того, патофізіологічні зміни шляхів системного ХЗНІ, які виникають внаслідок модифікацій у реактивності рецепторів глюкокортикоїдів (вторинних до емоційного та фізіологічного збудження), можуть бути основою для неадекватної соціальної поведінки, що відповідає ПТСР та проявам МС. Нещодавно з’явилися дані, які свідчать про те, що важлива роль в патогенезі ПТСР належить поєднанню високого рівня системного ОС із активацією ХЗНІ. З іншого боку, ПТСР — це тип рецидивуючої та довготривалої травми, яка посилює ОС і прискорює старіння клітин. ХЗНІ супроводжується вивільненням активних форм кисню та азоту, прозапальних цитокінів та інших біологічно активних речовин, що викликають ОС. Метою цього огляду було обговорити роль окремих антиоксидантів, зокрема поліфенолів, флавоноїдів, каротиноїдів, N-ацетилцистеїну, мелатоніну, L-аргініну, вітамінів С і Е, цинку, міді та селену, у профілактиці/лікуванні коморбідної патології ПТСР і МС, а також проаналізувати нові тенденції та напрямки майбутніх досліджень. Пошук проводився в Scopus, Science Direct (від Elsevier) і PubMed, включно з базами даних Medline. Використані ключові слова «посттравматичний стресовий розлад», «метаболічний синдром», «антиоксиданти». Для виявлення результатів дослідження, які не вдалося знайти під час онлайн-пошуку, використовувався ручний пошук бібліографії публікацій.

The basis for the pathogenesis of cardiovascular, cancer, metabolic diseases, low-grade chronic inflammation (LGCI) and many other disorders is an imbalance between prooxidants and the antioxidant defense system. It is believed that the link between post-traumatic stress disorder (PTSD) and metabolic syndrome (MetS) is based on oxidative stress (OS), increased autonomic nervous system activity, glucocorticoid synthesis activation, or immunological dysregulation. Moreover, pathophysiological changes in the systemic LGCI pathways that result from modifications in glucocorticoid receptor reactivity (secondary to emotional and physiological arousal) may be the basis for inappropriate social behavior consistent with PTSD and MetS manifestations. Recently, evidence has emerged suggesting that a combination of high levels of systemic OS and activation of LGCI plays an important role in the pathogenesis of PTSD. On the other hand, PTSD is a type of recurrent and long-term trauma that exacerbates OS and accele­rates cellular aging. LGCI is accompanied by the release of reactive oxygen and nitrogen species, proinflammatory cytokines, and other biologically active substances that cause OS. The purpose of this review was to discuss the role of individual antioxidants, in particular polyphenols, flavonoids, carotenoids, N-acetylcysteine, melatonin, L-arginine, C and E vitamins, zinc, copper, and selenium, in the prevention/treatment of comorbid pathology of PTSD and MetS, as well as to analyze new trends and directions for future research. The search was conducted in Scopus, Science Direct (from Else­vier) and PubMed, including MEDLINE databases. The keywords used were “post-traumatic stress disorder,” “metabolic syndrome,” and “antioxidants.” To identify research results that could not be found during the online search, a manual search of the bibliography of publications was used.


Ключевые слова

посттравматичний стресовий розлад; метаболічний синдром; антиоксиданти; огляд літератури

post-traumatic stress disorder; metabolic syndrome; antioxidants; literature review

doi: http://dx.doi.org/10.22141/2224-0721.20.6.2024.1445

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