Нейровоспаление как фактор патогенеза глаукомной оптической нейропатии

Современное представление о патогенезе нейродегенеративного процесса при глаукоме выделяет несколько ключевых факторов риска его развития: ишемию/гипоксию, митохондриальную дисфункцию, окислительный стресс и нейровоспаление. Анализ исследований последних лет показывает, что при глаукомной оптической нейропатии, как и при других нейродегенеративных заболеваниях, в патологический процесс вовлекается иммунная система, при этом иммунорегуляция осуществляется преимущественно глиальными клетками сетчатки, микроглией, астроцитами, клетками Мюллера и системой комплемента. Хроническая активация глиальных клеток при глаукоме, вызванная повышенным внутриглазным давлением, может провоцировать провоспалительное состояние на уровне сетчатки, вызывая нарушение гематоретинального барьера и гибель ганглиозных клеток сетчатки. В обзоре представлены провоспалительные маркеры глаукомы, иммуномодулирующие и провоспалительные медиаторы, показана роль ряда металлопротеиназ и их тканевых ингибиторов, а также провоспалительных цитокинов в развитии глаукомы.

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