Д.С. Бадмажапова, И.В. Гальцева, Е.Е. Звонков
ФГБУ «НМИЦ гематологии» Минздрава России, Новый Зыковский пр-д, д. 4, Москва, Российская Федерация, 125167
Для переписки: Дарима Сэмункоевна Бадмажапова, Новый Зыковский пр-д, д. 4, Москва, Российская Федерация, 125167; тел.: +7(929)562-93-41; e-mail: badmazhapova-darima@mail.ru
Для цитирования: Бадмажапова Д.С., Гальцева И.В., Звонков Е.Е. Роль иммунологического синапса в биологии хронического лимфолейкоза. Клиническая онкогематология. 2018;11(4):313–8.
DOI: 10.21320/2500-2139-2018-11-4-313-318
РЕФЕРАТ
Хронический лимфолейкоз (ХЛЛ) — злокачественное лимфопролиферативное заболевание, которое проявляется накоплением опухолевых В-лимфоцитов с характерным иммунофенотипом (CD19+CD5+CD23+) в костном мозге, периферической крови и вторичных лимфоидных органах. По клиническому течению ХЛЛ является гетерогенным заболеванием. Это самый частый вид лейкоза у лиц старшей возрастной группы. Несмотря на применение новых лекарственных средств, остаются рефрактерные формы заболевания. Последние открытия в иммунологии позволили понять некоторые механизмы уклонения опухолевых клеток от иммунного надзора. Взаимодействие клеток иммунной системы друг с другом осуществляется за счет формирования иммунологического синапса, в котором основная роль отводится семейству молекул CD28/В7, так называемым иммунным контрольным точкам, регулирующим активационные и ингибирующие механизмы регуляции клеток. Приобретение клетками опухолевого фенотипа — многоступенчатый процесс, в котором клетка приобретает уникальные биологические свойства, в т. ч. и возможность быть невидимой для иммунитета. В отличие от солидных опухолей при лимфопролиферативных заболеваниях опухолевые В-лимфоциты способны экспрессировать главный комплекс гистосовместимости II класса и костимулирующие молекулы CD80 и CD86. Это свидетельствует о том, что они могут быть антигенпрезентирующими клетками для Т-клеток. Наличие коингибирующих молекул на поверхности опухолевых клеток может служить одним из факторов ингибирования иммунного ответа. В настоящем обзоре рассматриваются современные представления о биологических особенностях и иммунологических взаимодействиях клеток ХЛЛ с клетками микроокружения.
Ключевые слова: хронический лимфолейкоз, иммунологический синапс, иммунитет.
Получено: 15 марта 2018 г.
Принято в печать: 29 июня 2018 г.
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