Острые лейкозы Причины

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Острые лейкозы остаются распространенными заболеваниями среди всех опухолевых заболеваний крови. В последние годы наблюдается тенденция к увеличению случаев заболеваний ОЛ В мире, в общем, И В России И по Красноярскому краю в частности, а также наблюдается рост числа госпитализаций по данному поводу.

В большинстве случаев конкретная причина возникновения острых лейкозов остается неизвестной. Однако существуют предрасполагающие факторы, которые значительно увеличивают риск развития этих заболеваний. На первом месте, можно выделить врожденные И приобретенные хромосомные аномалии. Роль вирусов в развитии лейкозов доказана в отношении РНК- ретровирусов.

Четко доказана взаимосвязь между ионизирующей радиацией при взрыве атомной бомбы, а также химио- И радиотерапией по поводу других опухолей с повышенным риском возникновения острых лейкозов. Доказано, что между курением И риском развития острого лейкоза существует дозовая зависимость, которая особенно наблюдается у лиц старше 60 лет. Длительное воздействие ряда химических средств также повышает риск возникновения острого лейкоза.

Таким образом, хромосомные аномалии, вирусы, ионизирующая ра- диация, химио- и радиотерапии, курение, химические вещества И наследственный фактор могут способствовать появлению того или иного гемобластоза, увеличивая риск возникновения заболевания, однако до конца неизвестна точная первопричина заболевания. В основе возникновения острого лейкоза лежит мутация клоногенной кроветворной клетки с последующими событиями, приводящими к нарушениям пролиферации, дифференцировки И апоптоза клеток с накоплением патологического продукта.

В настоящее время полностью не изучены патогенетические механизмы, вызывающие нарушение нормальной функции клетки и запускающие патологические процессы, в конечном итоге, приводящие к возникновению лейкозов. Еще одним фактором, обусловливающим развитие онкологического заболевания, является снижение реактивности иммунной системы.

С одной стороны доказано, что именно иммунодефицитное состояние определяет развитие злокачественной опухоли. С другой стороны, накапливается все больше сведений, что и сама опухоль индуцирует развитие иммунной супрессии, которая может проявляться в широком диапазоне (от незначительной степени до полной анергии). Механизмы, ответственные за нарушения функции иммунной системы, в настоящее время полностью не определены.

В целом, установлено, что у больных онкологическими заболеваниями дисфункция иммунной системы проявляется в нарушении функции антигенпрезентирующих клеток, эффекторной функции Т-лимфоцитов, уменьшении пролиферативного индекса. И экспрессии отдельных субъединиц рецептора интерлейкина-2, а также в нарушении баланса синтеза цитокинов. Несмотря на ряд проведенных исследований, многое в патогенезе острого лейкоза остается неизученным.

Недостаточно полно исследованы механизмы иммунной реактивности при остром лейкозе. Полностью отсутствуют исследования метаболического статуса клеток иммунной системы при данных заболеваниях. В то же время известно, что интенсивность метаболических процессов в значительной степени определяет функцию клеток иммунной системы.

При этом наибольшей информативностью при исследовании метаболизма лимфоцитов обладают окислительно-восстановительные ферменты, так как они осуществляют ключевые реакции клеточного метаболизма И координируют сопряженные метаболические пути. Не Исследованными остаются особенности иммунного статуса, состояние метаболизма лимфоцитов. В зависимости от вида лейкоза И стадии заболевания.

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