Туберкулезная инфекция у ревматологических больных, получающих ингибиторы фактора некроза опухоли – альфа
https://doi.org/10.54921/2413-0346-2025-13-1-59-73
Аннотация
В лечении ревматических заболеваний широко внедрена генно-инженерная биологическая терапия, длящаяся десятилетиями до достижения стойкой ремиссии. Для блокады аутоиммунного воспаления используются ингибиторы ключевого цитокина – фактора некроза опухоли альфа (ФНО-α) или его рецепторов. Прерывание реакций цитокинового каскада может приводить к дефектам иммунной защиты, неполноценности новых или дестабилизации ранее существовавших гранулем и развитию туберкулезной инфекции. Без проведения скрининговых процедур риски развития туберкулеза существенно возрастают. В связи с этим требуется регулярное фтизиатрическое сопровождение на весь срок терапии ингибиторами ФНО-α.
В обзоре детально рассмотрены роль ФНО-α в иммунологическом ответе при туберкулезе, влияние препаратов, блокирующих этот цитокин, риски развития туберкулеза на фоне их приема у больных с ревматологической патологией, возможности снижения этого риска за счет скрининга, мониторинга и превентивной терапии.
Об авторе
Н. В. Макарова
ГБУЗ города Москвы «Московский городской научно-практический центр борьбы с туберкулезом Департамента здравоохранения города Москвы»
Россия
Россия
Макарова Наталья Владимировна – врач-пульмонолог, врач-фтизиатр отделения легочного туберкулеза Городского клинико-диагностического центра
105005, г. Москва, ул. Радио, д. 18
Тел. +7 (499) 267-57-92
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Рецензия
Для цитирования:
Макарова Н.В. Туберкулезная инфекция у ревматологических больных, получающих ингибиторы фактора некроза опухоли – альфа. Туберкулез и социально значимые заболевания. 2025;13(1):59-73. https://doi.org/10.54921/2413-0346-2025-13-1-59-73
For citation:
Makarova N.V. Tuberculosis infection in rheumatological patients receiving tumor necrosis factor – alpha inhibitors. Tuberculosis and socially significant diseases. 2025;13(1):59-73. (In Russ.) https://doi.org/10.54921/2413-0346-2025-13-1-59-73
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