cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2025-40-1-11-18cardiotomsk-2628Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESПептиды – кардиопротекторные препараты будущего. АдреномедуллинPeptides are cardioprotective drugs of the future. Adrenomedullinhttps://orcid.org/0000-0002-1607-1482ПоповС. В.PopovS. V.

Попов Сергей Валентинович, д-р мед. наук, профессор, академик РАН, директор

634012, Томск, ул. Киевская, 111а

Sergey V. Popov, Dr. Sci. (Med.), Academician of the Russian Academy of Sciences, Director

111a, Kievskaya str., Tomsk, 634012

press@cardio-tomsk.ruhttps://orcid.org/0000-0002-6020-1598МасловЛ. Н.MaslovL. N.

Маслов Леонид Николаевич, д-р мед. наук, профессор, заведующий лабораторией экспериментальной кардиологии

634012, Томск, ул. Киевская, 111а

Leonid N. Maslov, Dr. Sci. (Med.), Professor, Head of the Laboratory of Experimental Cardiology

111a, Kievskaya str., Tomsk, 634012

maslov@cardio-tomsk.ruhttps://orcid.org/0000-0003-1808-556XМухомедзяновА. В.MukhomedzyanovA. V.

Мухомедзянов Александр Валерьевич, канд. мед. наук, научный сотрудник, лаборатория экспериментальной кардиологии

634012, Томск, ул. Киевская, 111а

Alexander V. Mukhomedzyanov, Cand. Sci. (Med.), Research Scientist, Laboratory of Experimental Cardiology

111a, Kievskaya str., Tomsk, 634012

 

sasha_m91@mail.ruhttps://orcid.org/0009-0004-2215-5414СлидневскаяА. С.SlidnevskayaA. S.

Слидневская Алиса Сергеевна, старший лаборант, лаборатория экспериментальной кардиологии

634012, Томск, ул. Киевская, 111а

Alisa S. Slidnevskaya, Senior Laboratory Assistant, Laboratory of Experimental Cardiology

111a, Kievskaya str., Tomsk, 634012

alisaslidnevskaa@gmail.comhttps://orcid.org/0000-0002-6418-1643КанА.KanA.

Кан Артур, старший лаборант, лаборатория экспериментальной кардиологии

634012, Томск, ул. Киевская, 111а

Arthur Kan, Senior Laboratory Assistant, Laboratory of Experimental Cardiology

111a, Kievskaya str., Tomsk, 634012

kan989817@gmail.comhttps://orcid.org/0000-0003-2264-1928НарыжнаяН. В.NaryzhnayaN. V.

Нарыжная Наталья Владимировна, д-р мед. наук, ведущий научный сотрудник, лаборатория экспериментальной кардиологии

634012, Томск, ул. Киевская, 111а

Natalia V. Naryzhnaya, Dr. Sci. (Med.), Leading Research Scientist, Laboratory of Experimental Cardiology

111a, Kievskaya str., Tomsk, 634012

natalynar@yandex.ruhttps://orcid.org/0000-0003-1237-9786БирулинаЮ. Г.BirulinaYu. G.

Бирулина Юлия Георгиевна, канд. биол. наук, доцент кафедры биофизики и функциональной диагностики

634050, Томск, Московский тракт, 2

Yulia G. Birulina, Cand. Sci. (Biol.), Associate Professor, Department of Biophysics and Functional Diagnostics

2, Moskovsky tract, Tomsk, 634050

birulina20@yandex.ruhttps://orcid.org/0000-0003-3274-6010ЛасуковаТ. В.LasukovaT. V.

Ласукова Татьяна Викторовна, д-р биол. наук, профессор, кафедра нормальной физиологии

634050, Томск, Московский тракт, 2

Tatyana V. Lasukova, Dr. Sci. (Biol.), Professor, Department of Physiology

2, Moskovsky tract, Tomsk, 634050

tlasukova@mail.ruhttps://orcid.org/0000-0002-8939-2340ПодоксеновЮ. К.PodoxenovYu. K.

Подоксенов Юрий Кириллович, д-р мед. наук, ведущий научный сотрудник, отделение сердечно-сосудистой хирургии

634012, Томск, ул. Киевская, 111а

Yuri K. Podoksenov, Dr. Sci. (Med.)., Leading Research Scientist, Department of Cardiovascular Surgery

111a, Kievskaya str., Tomsk, 634012

uk@cardio-tomsk.ruНаучно-исследовательский институт кардиологии, Томский национальный исследовательский медицинский центр Российской академии наук (НИИ кардиологии Томского НИМЦ)РоссияCardiology Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences (Cardiology Research Institute, Tomsk NRMC)Russian FederationСибирский государственный медицинский университет Министерства здравоохранения Российской Федерации (СибГМУ Минздрава России)РоссияSiberian State Medical University of the Ministry of Health of the Russian Federation (Siberian State Medical University)Russian Federation2025120420254011118Copyright © Попов С.В., Маслов Л.Н., Мухомедзянов А.В., Слидневская А.С., Кан А., Нарыжная Н.В., Бирулина Ю.Г., Ласукова Т.В., Подоксенов Ю.К., 20252025Попов С.В., Маслов Л.Н., Мухомедзянов А.В., Слидневская А.С., Кан А., Нарыжная Н.В., Бирулина Ю.Г., Ласукова Т.В., Подоксенов Ю.К.Popov S.V., Maslov L.N., Mukhomedzyanov A.V., Slidnevskaya A.S., Kan A., Naryzhnaya N.V., Birulina Y.G., Lasukova T.V., Podoxenov Y.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/2628

Повсеместное внедрение чрескожного коронарного вмешательства (ЧКВ) в качестве метода терапии острого инфаркта миокарда (ОИМ) позволило радикально снизить летальность при этом заболевании. Однако смертность все же остается высокой: по некоторым оценкам, при инфаркте миокарда (ИМ) с подъемом сегмента ST (STEMI) она может достигать 7–9%. Сегодня при применении ЧКВ на первый план выступает реперфузионное повреждение сердца. К сожалению, лекарственные препараты, применяемые в клинической практике для лечения ОИМ, малоэффективны в отношении реперфузионного повреждения сердца. Существует настоятельная необходимость в разработке лекарственных препаратов с молекулярным механизмом действия, отличным от механизма действия тех препаратов, которые уже применяются для лечения ОИМ. Прототипом для создания подобных препаратов мог бы стать полипептид адреномедуллин.

Цель обзора: анализ публикаций, посвященных кардиопротекторному эффекту адреномедуллина при ишемии и реперфузии (И/Р) сердца. Показано, что адреномедуллин уменьшает размер ИМ, ингибирует апоптоз кардиомиоцитов, препятствует возникновению постинфарктного ремоделирования сердца. Адреномедуллин способен избирательно усиливать толерантность сердца к реперфузионному повреждению. Продемонстрировано, что кардиопротекторный эффект адреномедуллина связан с активацией киназы Akt, NO-синтазы, протеинкиназы А, увеличением уровня цГМФ в ткани миокарда и усилением синтеза NO в сердце.

The widespread use of percutaneous coronary intervention (PCI) as a method of treatment for acute myocardial infarction (AMI) has radically reduced mortality in this disease. However, the mortality rate still remains high and, according to some reports, for myocardial infarction with ST segment elevation can reach 7–9%. Today, when using PCI, cardiac reperfusion injury comes to the fore. Unfortunately, drugs used in clinical practice for treatment of AMI are low effective against reperfusion injury of the heart. There is an urgent need to develop drugs with a molecular mechanism of action that is different from those of drugs already used to treat AMI. The prototype for creating such drugs could be polypeptide adrenomedullin. The purpose of this review is to analyze articles devoted to the cardioprotective effect of adrenomedullin in cardiac ischemia and reperfusion. Adrenomedullin has been shown to reduce myocardial infarct size, inhibit cardiomyocyte apoptosis, and prevent the occurrence of post-infarction cardiac remodeling. Adrenomedullin is able to selectively enhance cardiac tolerance to reperfusion injury. It has been shown that the cardioprotective effect of adrenomedullin is associated with activation of Akt kinase, NO-synthase, protein kinase A, an increase in the cGMP level in myocardial tissue and increased NO synthesis in the heart.

кардиопротекторные препаратыпептидыишемия / реперфузияпостинфарктное ремоделирование сердцаадреномедуллинcardioprotective drugspeptidesischemia/reperfusionpost-infarction cardiac remodelingadrenomedullinРабота выполнена при финансовой поддержке гранта Российского научного фонда №2365-10017. Раздел, посвященный постинфарктному ремоделированию сердца, подготовлен в рамках государственного задания 122020300042-4The study was supported by the Russian Science Foundation grant No. 23-65-10017. The section on post-infarction cardiac remodeling was prepared in the framework of the state assignment 122020300042-4ReferencesCurrey E.M., Falconer N., Isoardi K.Z., Barras M. Impact of pharmacists during in-hospital resuscitation or medical emergency response events: A systematic review. Am. J. Emerg. Med. 2024;75:98–110. https://doi.org/10.1016/j.ajem.2023.10.020Currey E.M., Falconer N., Isoardi K.Z., Barras M. 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The authors declare that there are no conflicts of interest present.