ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2006-1-67-72ssmu-3045Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWМеханизмы нарушения контроля бронхиальной астмы при применении β2-агонистовMechanisms of bronchial asthma control disturbance in using 2-agonistsВаськовскийН. В.Vas'kovskyN. V.noemail@neicon.ruКуликовЕ. С.KoulikovYe. S.noemail@neicon.ruСибирский государственный медицинский университетRussian FederationСибирский государственный медицинский университет, г. ТомскRussian Federation200630032006516772Copyright © Васьковский Н.В., Куликов Е.С., 20062006Васьковский Н.В., Куликов Е.С.Vas'kovsky N.V., Koulikov Y.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/3045

Несмотря на исключительно высокую клиническую эффективность β2-агонистов при бронхоспазме, регулярное их применение ассоциировано со снижением уровня контроля бронхиальной астмы и развитием тяжелых и жизнеугрожающих состояний, что связано с повышением бронхиальной гиперреактивности, развитием частичной толерантности, повышенной аллергенной нагрузкой и маскировкой симптомов ухудшения заболевания. Развитие толерантности к β2-агонистам и повышение чувствительности бронхов к бронхоконстрикторным стимулам имеют в своей основе специфические механизмы, включая десенситизациию β2-адренорецептора, увеличение экспрессии фосфолипазы-Cβ и до конца не изученные механизмы, связанные с вариантами гена β2-АР.

Despite exclusively high clinical efficacy of 2-agonists in bronchospasm, their regular using is associated with increased level of bronchial asthma control and the development of severe and life-threatening states which in turn is associated with increasing bronchial hyper-reactivity, development of partial tolerance, increased allergic load and masking of the disease aggravation. Deve- lopment of tolerance to 2-agonists and increasing sensibility of bronchi to bronchoconstrictive stimuli are based on specific mecha-nisms including desensitization of 2-adrenoreceptor, increasing expression of C phospholipase and mechanisms associated with gene AP variants which are not studied enough.

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