Scientific journal
Научное обозрение. Медицинские науки
ISSN 2500-0780
ПИ №ФС77-57452

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PATHOPHYSIOLOGICAL ASPECTS OF INNATE IMMUNITY CHANGES AND CORRECTION IN CHRONIC RENAL FAILURE

Osikov M.V. 1 Telesheva L.F. 1 Ageev Y.I. 1 Cherepanov D.A. 1 Fedosov A.A. 1
1 South Ural State Medical University of Health Ministry of Russia
The article presents an overview of recent data on the role of innate immune dysfunction, primarily of neutrophils, monocytes / macrophages, natural cell killers, dendritic cells in case of chronic renal failure progression, the development of infectious and inflammatory pathology, cardiovascular and other complications of chronic renal failure due to inhibition of apoptosis and hyperergy of innate immunity effectors: activation of adhesion, chemotaxis, as well as the absorptive and killing capacity. Critical analysis of domestic and foreign databases over the past 5 years revealed the changes in the quantitative composition, functional activity, intercellular cooperation of innate immunity cells due to the shifts in the epigenetic, transcriptomic, proteomic levels in patients with chronic renal failure. The azotemia, vitamin D metabolic disorder, hyperparathyroidism and concomitant calcium-phosphorus metabolism disturbance, the iron metabolism disturbance, anemia, the activation of the renin-angiotensin-aldosterone system, the hemodialysis procedure and etc. are the pathogenetic factors of innate immunity effectors dysfunction in patients with chronic renal failure. A wide range of approaches such as anti-inflammatory agents of gamma-tocopherol, docosahexaenoic acid, isoflavones, catechins, preparations on the basis of cholecalciferol, anti-cytokine agents, antioxidants, cell therapy and nutritional status modulation can be used to correct the immunity in case of chronic renal failure. Recently discovered numerous pleiotropic effects of erythropoietin as well as the detection of receptors for erythropoietin on immune competent cells are a prerequisite for the study of immunotropic erythropoietin effects in patients with chronic renal failure, when the production of endogenous EPO is critically reduced.