Перспективы применения перампанела в лечении эпилепсии у больных со злокачественными глиомами головного мозга
- Авторы: Ванг Ю.1, Муфазалова Н.А.2, Муфазалова Л.Ф.2, Ильясова Н.В.2, Мурадова Р.Р.3, Киёмов И.Э.3, Давурова Л.Ш.3, Самородов А.В.2
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Учреждения:
- Ханчжоуский педагогический университет
- Башкирский государственный медицинский университет
- Самаркандский государственный медицинский университет
- Выпуск: Том 22, № 3 (2024)
- Страницы: 223-236
- Раздел: Научные обзоры
- URL: https://bakhtiniada.ru/RCF/article/view/292616
- DOI: https://doi.org/10.17816/RCF629243
- ID: 292616
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Аннотация
Эпилепсия встречается у 35–95 % больных злокачественными глиомами головного мозга низкой степени злокачественности и у 29–71 % больных глиомами высокой степени злокачественности. Судороги могут быть как первым проявлением злокачественной глиомы головного мозга, так и появиться в постоперационном периоде и в процессе химиолучевой терапии. Это требует применения противоэпилептических препаратов, которые способны купировать судорожный синдром, обеспечить контроль и вторичную профилактику судорог, не снижая эффективности противоопухолевой терапии и качество жизни пациента. Процессы эпилептогенеза и онкогенеза тесно взаимосвязаны между собой посредством общих механизмов развития, ключевую роль в которых играет глутамат. Повышенная секреция глутамата сопровождается увеличением экспрессии и активацией его рецепторов, что повышает судорожную готовность. Этому сопутствует повышение уровня нейротрофического фактора роста головного мозга, числа синапсов между перитуморальными нейронами и клетками глиомы, увеличение экспрессии ряда ростовых факторов, что способствует опухолевой прогрессии. В связи с этим особое внимание в лечении эпилепсии у больных злокачественными глиомами головного мозга занимает перампанел — блокатор рецепторов глутамата, противоэпилептический препарат III поколения. Показано, что перампанел не только эффективно контролирует судороги у пациентов со злокачественными глиомами головного мозга, но и подавляет опухолевую прогрессию. Перампанел способен дозозависимо усиливать апоптоз, нарушать миграцию клеток в клеточных линиях злокачественной глиомы. Выявлен синергетический эффект перампанела в комбинации с темозоламидом. В условиях химиолучевой терапии перампанел оказывает защитное действие на здоровые перитуморальные ткани. Нежелательные лекарственные реакции при применении перампанела возникают нечасто и являются незначительными. Необходимы дополнительные исследования для дальнейшего изучения противосудорожной и противоопухолевой эффективности перампанела для лечения эпилепсии у больных злокачественными опухолями головного мозга.
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Юи Ванг
Ханчжоуский педагогический университет
Email: makval81@rambler.ru
ORCID iD: 0000-0001-9048-0092
Scopus Author ID: 55969091300
профессор
Китай, ХанчжоуНаталья Альбертовна Муфазалова
Башкирский государственный медицинский университет
Email: mufazalovanatalya@yandex.ru
ORCID iD: 0000-0002-0656-3459
SPIN-код: 4053-2051
д-р мед. наук, профессор
Россия, УфаЛяйсан Фагимовна Муфазалова
Башкирский государственный медицинский университет
Email: lya-mufazalova@yandex.ru
ORCID iD: 0000-0001-8129-9320
SPIN-код: 1542-2210
канд. мед. наук, доцент
Россия, УфаНаиля Варисовна Ильясова
Башкирский государственный медицинский университет
Email: Na1lyasova@yandex.ru
ORCID iD: 0009-0008-1774-9831
SPIN-код: 4459-6602
Россия, Уфа
Раиля Рустамовна Мурадова
Самаркандский государственный медицинский университет
Email: ismagilovaln@rambler.ru
ORCID iD: 0000-0001-9202-0479
Узбекистан, Самарканд
Ихтиёр Эргашович Киёмов
Самаркандский государственный медицинский университет
Email: lukmanova.gulnur@mail.ru
ORCID iD: 0009-0004-7387-7740
Узбекистан, Самарканд
Лайло Шокир кизи Давурова
Самаркандский государственный медицинский университет
Email: anikolaev1957@rambler.ru
ORCID iD: 0009-0009-1396-1744
Узбекистан, Самарканд
Александр Владимирович Самородов
Башкирский государственный медицинский университет
Автор, ответственный за переписку.
Email: avsamorodov@gmail.com
ORCID iD: 0000-0001-9302-499X
д-р мед. наук, доцент
Россия, УфаСписок литературы
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