KARDIORENAL SINDROMDA GENETIK VA EPIGENETIK DETERMINANTLAR HAMDA OQSIL BIOMARKERLAR PANELI: INTEGRATSION DIAGNOSTIK YONDASHUV
DOI:
https://doi.org/10.5281/zenodo.23178965Keywords:
kardiorenal sindrom, genlar polimorfizmi, mikroRNK, KIM-1, NGAL, sistatin C, biomarkerlar, shaxsiylashtirilgan tibbiyotAbstract
Kardiorenal sindrom (KRS) — yurak va buyraklar o‘rtasidagi murakkab ikki tomonlama o‘zaro bog‘liqlik va bir-birini og‘irlashtiruvchi shikastlanish bilan kechadigan holat bo‘lib, unda bir a’zoning disfunksiyasi va zararlanishi boshqasining shikastlanishiga olib keladi. Kardio-renal-metabolik kontinuum konsepsiyasi joriy etilganiga qaramay, klinik amaliyot asosan kreatinin va uning asosida CKD-EPI formulasi bo‘yicha hisoblangan koptokchalar filtratsiyasi tezligiga (KFT) tayanadi. KFT buyraklar funksiyasining allaqachon yo‘qotilganini aks ettiruvchi ko‘rsatkichdir. O‘xshash kliniklaborator va funksional profilga ega bemorlarda kasallikning kechishi va zo‘rayib borish sur’atlari keskin farq qiladi, bu esa genetik moyillik va epigenetik regulyatsiya bilan bog‘liqligidan dalolat beradi. Sharhda KRSning to‘rtta patogenetik bosqichi (gemodinamik, neyrogumoral, yallig‘lanish-fibrotik va mitoxondrial-metabolik); renin-angiotenzin-aldosteron tizimining (ACE, AGTR1, CYP11B2, NR3C2), endotelial funksiyaning (NOS3), profibrotik signalizatsiyaning (TGFB1, IL6, TNF), tubular gomeostazning (UMOD) nomzod genlari va shikastlanish biomarkerlarining genlari (HAVCR1, LCN2); aylanib yuruvchi mikroRNK profili; shuningdek, buyraklar zararlanishini eng erta bosqichlarda aniqlash imkonini beruvchi KIM-1 va NGALdan iborat oqsil biomarkerlari paneli ko‘rib chiqilgan. «Genotip — mikroRNK — oqsil biomarkeri» integratsiyasining uchta sxema bilan tasvirlangan uch bosqichli modeli taklif etilgan.References
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