diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM12746diaendo-12746Research ArticleОбзорыReviewНекоторые механизмы развития воспаления при сахарном диабете 2 типаSome mechanisms of inflammation development in type 2 diabetes mellitusБочкареваЛ. А.BochkarevaL. A.

Бочкарева Лейла Азимовна, аспирант

Москва

Leyla A. Bochkareva, MD, PhD student 

Moscow

lejlani@mail.ruhttps://orcid.org/0000-0002-6823-2487НедосуговаЛ. В.NedosugovaL. V.

Недосугова Людмила Викторовна, д.м.н., профессор 

119991, Москва, ул. Трубецкая, д. 8, стр. 2

eLibrary SPIN: 1853-0215; e-mail:  

Ludmila V. Nedosugova, MD, PhD, Professor

8/2 Trubetskaya, 119991 Moscow

eLibrary SPIN: 1853-0215 

profmila@mail.ruhttps://orcid.org/0000-0001-9390-1200ПетунинаН. А.PetuninaN. A.

Петунина Нина Александровна, д.м.н., профессор, член-корр. РАН

eLibrary SPIN: 9784-3616 

Москва

Nina A. Petunina, MD, PhD, Professor

eLibrary SPIN: 9784-3616 

Moscow

napetunina@mail.ruhttps://orcid.org/0000-0001-8007-9721ТельноваМ. Э.ТеlnovaM. Е.

Тельнова Милена Эдуардовна, к.м.н., доцент

eLibrary SPIN: 1007-4617 

Москва

Milena Е. Теlnova, MD, PhD, associate Professor

eLibrary SPIN: 1007-4617 

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milena.telnova@mail.ruhttps://orcid.org/0000-0001-7025-8427ГончароваЕ. В.GoncharovaE. V.

Гончарова Екатерина Валерьевна, к.м.н., доцент 

eLibrary SPIN: 7148-4669 

Москва

Ekaterina V. Goncharova, MD, PhD, associate Professor

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goncharova_ev@inbox.ruПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical UniversityRussian Federation202110082021244334341Copyright © Бочкарева Л.А., Недосугова Л.В., Петунина Н.А., Тельнова М.Э., Гончарова Е.В., 20212021Бочкарева Л.А., Недосугова Л.В., Петунина Н.А., Тельнова М.Э., Гончарова Е.В.Bochkareva L.A., Nedosugova L.V., Petunina N.A., Теlnova M.Е., Goncharova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/12746

Воспаление играет ключевую роль в развитии и прогрессировании сахарного диабета 2 типа (СД2) — заболевания, характеризующегося периферической инсулинорезистентностью и системной глюколипотоксичностью. Основным источником воспаления на ранних стадиях заболевания является висцеральная жировая ткань (ЖT). Макрофаги — врожденные иммунные клетки, которые присутствуют во всех периферических тканях, включая ЖТ. Нарушение реакции макрофагов ЖT (МЖT) на изменения микросреды лежат в основе аберрантного воспаления и развития местной и системной инсулинорезистентности. Воспалительная активация макрофагов регулируется на нескольких уровнях: стимуляция рецепторов клеточной поверхности, внутриклеточная передача сигналов, транскрипция и метаболические уровни, которые активируются трансформацией макрофагов по провоспалительному либо по противовоспалительному пути. Такая поляризация макрофагов в современной иммунологии разделяется на классическую воспалительную М1 поляризацию и альтернативную противовоспалительную М2 поляризацию макрофагов. Соотношение М1/М2 макрофагов в процессе воспаления обеспечивает разрешение воспаления на разных стадиях его развития. В обзоре рассмотрены основные механизмы, участвующие в воспалении ЖT и развитии инсулинорезистентности при СД2, поддерживаемые с участием иммунокомпетентных клеток, М1/M2, а также выделяемых при этом факторов роста и гуморальных факторов иммунитета.

Inflammation plays a key role in the development and progression of type 2 diabetes (T2DM), a disease characterized by peripheral insulin resistance and systemic glucolipotoxicity. The main source of inflammation in the early stages of the disease is visceral adipose tissue (VT). Macrophages are innate immune cells that are present in all peripheral tissues, including VT. Violation of the response of VT (MT) macrophages to changes in the microenvironment underlies aberrant inflammation and the development of local and systemic insulin resistance. The inflammatory activation of macrophages is regulated at several levels: stimulation of cell surface receptors, intracellular signaling, transcription, and metabolic levels. Which are activated by the transformation of macrophages along the pro-inflammatory or anti-inflammatory pathways. Such polarization of macrophages in modern immunology is divided into classical anti-inflammatory M1 polarization and alternative anti-inflammatory M2 polarization of macrophages. The M1 / M2 ratio of macrophages in the process of inflammation ensures the resolution of inflammation at different stages of its development. The review considers the main mechanisms involved in VT inflammation and the development of insulin resistance in T2DM, supported with the participation of immunocompetent cells, M1 / M2, as well as growth factors and humoral immunity factors secreted during this process.

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