ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2025-2-124-140ssmu-6061Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEW AND LECTURESАтеросклероз и воспаление – путь от патогенеза к терапии: обзор современного состояния проблемы (часть 2)Atherosclerosis and inflammation – the path from pathogenesis to treatment: review of the current state of the issue (part 2)https://orcid.org/0000-0002-5383-8355АвагимянА. А.AvagimyanA. A.

Авагимян Ашот Арманович – канд. мед. наук, преподаватель кафедры пропедевтики внутренних болезней 

Республика Армения, 0025, г. Ереван, ул. Корюна, 2а 

2a Koryuna St., 0025 Yerevan, Armenia 

avagimyan.cardiology@mail.ruhttps://orcid.org/0000-0001-7896-2080КактурскийЛ. В.KakturskyL. V.

Кактурский Лев Владимирович – д-р мед. наук, профессор, чл.-корр. РАН, науч. руководитель НИИ морфологии человека им. акад. А.П. Авцына 

Россия, 117418, г. Москва, ул. Цюрупы, 3

3 Tsyurupy St., 117418 Moscow, Russian Federation

levkaktur@mail.ruhttps://orcid.org/0000-0002-9457-8879УразоваО. И.UrazovaO. I.

Уразова Ольга Ивановна – д-р мед. наук, профессор, чл.-корр. РАН, зав. кафедрой патофизиологии

Россия, 634050, г. Томск, Московский тракт, 2

2 Moskovsky trakt, 634050 Tomsk, Russian Federation 

urazova.oi@ssmu.ruТрофименкоА. И.TrofimenkoA. I.

Трофименко Артем Иванович – канд. мед. наук, доцент кафедры патологической физиологии

Россия, 350063, г. Краснодар, ул. Митрофана Седина, 4

4 Mitrofan Sedin St., 350063 Krasnodar, Russian Federation 

artemtrofimenko@mail.ruhttps://orcid.org/0000-0001-7696-0639СукиасянЛ. М.SukiasyanL. M.

Сукиасян Лилит Магаковна – канд. мед. наук, науч. сотрудник, Центральная научная исследовательская лаборатория 

Республика Армения, 0025, г. Ереван, ул. Корюна, 2а 

2a Koryuna St., 0025 Yerevan, Armenia 

lilit.sukiasyan@inbox.ruhttps://orcid.org/0000-0002-1107-3753КоганЕ. А.KoganE. A.

Коган Евгения Алтаровна – д-р мед. наук, профессор, зав. кафедрой патологической анатомии им. акад. А.И. Струкова, зав. референс-центром патоморфологических и иммуногистохимических методов исследований

Россия, 119048, г. Москва, ул. Трубецкая, 8, стр. 2 

2 Building, 8 Trubetskaya St., 119048 Moscow, Russian Federation 

kogan_e_a@staff.sechenov.ruhttps://orcid.org/0000-0002-6946-6146ДемураТ. А.DemuraT. A.

Демура Татьяна Александровна – д-р мед. наук, профессор, директор Института клинической морфологии и цифровой патологии, проректор по научной деятельности

Россия, 119048, г. Москва, ул. Трубецкая, 8, стр. 2

 2 Building, 8 Trubetskaya St., 119048 Moscow, Russian Federation 

demura_t_a@staff.sechenov.ruhttps://orcid.org/0000-0002-4165-804XПогосоваН. В.PogosovaN. V.

Погосова Нана Вачиковна – д-р мед. наук, профессор, чл.-корр. РАН, зам. генерального директора по науке и профилактической кардиологии; зав. кафедрой доказательной медицины 

Россия, 121552, г. Москва, ул. Академика Чазова, 15а, стр. 6Россия, 117198, г. Москва, ул. Миклухо-Маклая, 6

6 Building, 15A Academician Chazov St., 121552 Moscow, Russian Federation6 Miklouho-Maclay St., 117198 Moscow, Russian Federation 

nanapogosova@gmail.comЕреванский государственный медицинский университет (ЕГМУ) им. МхитараАрменияYerevan State Medical University named after Mkhitar Heratsi (YSMU after M. Heratsi)ArmeniaНаучно-исследовательский институт морфологии человека (НИИМЧ) им. академика А.П. Авцына Российского научного центра хирургии (РНЦХ) им. академика Б.В. ПетровскогоРоссияA.P. Avtsyn Research Institute of Human Morphology, Federal State Budgetary Scientific Institution “Russian Scientific Center for Surgery named after Academician B.V. Petrovsky” (Petrovskiy NRCS)Russian FederationСибирский государственный медицинский университет (СибГМУ)РоссияSiberian State Medical UniversityRussian FederationКубанский государственный медицинский университет (КубГМУ)РоссияKuban State Medical University (KubSMU)Russian FederationПервый Московский государственный медицинский университет (Первый МГМУ) им. И.М. Сеченова (Сеченовский Университет)РоссияI. M. Sechenov First Moscow State Medical University (Sechenov University)Russian FederationНациональный медицинский исследовательский центр кардиологии (НМИЦК) им. академика Е.И. Чазова; Российский университет дружбы народов (РУДН) им. Патриса ЛумумбыРоссияNational Medical Research Center of Cardiology named after Academician E.I. Chazov (NMRCC after acad. E.I. Chazov); Peoples’ Friendship University of Russia named after Patrice Lumumba (RUDN University)Russian Federation202514072025242124140Copyright © Авагимян А.А., Кактурский Л.В., Уразова О.И., Трофименко А.И., Сукиасян Л.М., Коган Е.А., Демура Т.А., Погосова Н.В., 20252025Авагимян А.А., Кактурский Л.В., Уразова О.И., Трофименко А.И., Сукиасян Л.М., Коган Е.А., Демура Т.А., Погосова Н.В.Avagimyan A.A., Kaktursky L.V., Urazova O.I., Trofimenko A.I., Sukiasyan L.M., Kogan E.A., Demura T.A., Pogosova N.V.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/6061

Достижения многочисленных исследований в изучении фундаментальных аспектов атеросклероза диктуют необходимость систематизации накопленных данных. Во второй части лекции представлен анализ роли ключевых механизмов реализации воспалительного процесса в развитии атеросклероза. Рассмотрена роль инфламмасомы, нарушений гемодинамики в сосудистой стенке, патологии vasa vasorum, дисфункции эндотелиоцитов, матриксных металлопротеиназ, сигнальных путей Notch и Wnt в атерогенезе, а также ассоциированные с атеросклерозом особенности патогенеза кальцификации сосудов.Отдельным разделом представлен обзор современных фармакотерапевтических подходов к лечению атерогенной дислипидемии. Комплексный анализ современных представлений о патогенезе атеросклероза и перспективных методов лекарственной терапии позволит обозначить дальнейшие направления исследований в липидологии и вывести возможности профилактической кардиологии на потенциально новый уровень.

Numerous studies addressing the fundamental aspects of atherosclerosis emphasize the importance of systematically organizing the accumulated data. The second part of this lecture provides an analysis of the critical mechanisms involved in the development of atherosclerosis. This analysis includes a discussion on the roles of inflammasomes, hemodynamic disorders within the vascular wall, vasa vasorum pathology, endothelial cell dysfunction, matrix metalloproteinases, and the Notch and Wnt signaling pathways in the process of atherogenesis. Additionally, it explores the specific characteristics of the pathogenesis of vascular calcification associated with atherosclerosis. A dedicated section thoroughly reviews contemporary pharmacotherapeutic strategies for managing atherogenic dyslipidemia. A comprehensive analysis of current concepts regarding the pathogenesis of atherosclerosis, along with promising approaches to drug therapy, will facilitate the identification of future research directions within the field of lipidology. This endeavor has the potential to elevate preventive cardiology to a new standard.

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