Современные стратегии таргетной терапии фиброза печени

Учитывая, что фиброз печени (ФП) является неблагоприятным событием естественного течения хронических заболеваний печени (ХЗП), скорейшее внедрение и широкое применение методов антифибротической терапии являются актуальной проблемой гепатологии. Цель обзора – описать современные подходы к таргетной терапии ФП.

Для поиска научных статей применялись база данных PubMed, поисковая система Google Scholar, Кокрановские систематические обзоры, научная электронная библиотека eLIBRARY.RU, а также пристатейные списки литературы. Соответствующие цели обзора публикации отбирались за период с 1998 по 2021 г. по терминам «фиброз печени», «патогенез», «лечение». Критерии включения ограничивались таргетной терапией ФП.

Несмотря на растущее число доказательств обратимости ФП, в настоящее время пока не существует каких-либо эффективных или одобренных для клинического применения схем его специфической терапии. Однако, принимая во внимание актуальность вопроса, научные поиски в этом направлении необходимы. Были изучены многочисленные лекарственные средства с хорошим профилем безопасности, которые хотя и предлагались для других целей, способны оказывать позитивное влияние на ФП. Кроме того, ряд отличных от фармакотерапии новаторских подходов вселяют оптимизм относительно успешности решения данной проблемы. Очевидно, что необходимы исследования, сосредоточенные на хорошо охарактеризованных группах пациентов с подтвержденными гистологическими, эластографическими, клиническими и радиологическими показателями. Это достаточно сложная задача, поскольку ключевым моментом будет стратификация риска на основе этнической принадлежности, этиологии и клинического статуса и для достоверной оценки потребуются очень большие размеры выборок. Тем не менее ее решение позволит повысить эффективность лечения пациентов с ХЗП, улучшит прогноз и качество их жизни, а также существенно уменьшит необходимость в трансплантации печени, потребность в которой во всем мире остается чрезвычайно высокой.

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