cfpdБюллетень физиологии и патологии дыханияBulletin Physiology and Pathology of Respiration1998-5029Дальневосточный научный центр физиологии и патологии дыхания10.36604/1998-5029-2020-76-97-106cfpd-806Research ArticleОБЗОРЫREVIEWSГамк и ее роль в регуляции тонуса дыхательных путейGABA and its role in the regulation of the airway toneШелудькоЕ. Г.SheludkoE. G.

Елизавета Григорьевна Шелудько - кандидат медицинских наук, младший научный сотрудник, лаборатория молекулярных и трансляционных исследований.

675000, Благовещенск, ул. Калинина, 22

Elizaveta G. Sheludko - MD, PhD, Junior Staff Scientist, Laboratory of molecular and translational research.

22 Kalinina Str, Blagoveshchensk, 675000

liza.sheludko@mail.ruНаумовД. Е.NaumovD. E.

Денис Евгеньевич Наумов - кандидат медицинских наук, зав. лабораторий молекулярных и трансляционных исследований.

675000, Благовещенск, ул. Калинина, 22

Denis E. Naumov - MD, PhD, Head of Laboratory of molecular and translational research.

22 Kalinina Str, Blagoveshchensk, 675000

denn1985@bk.ruФедеральное государственное бюджетное научное учреждение Дальневосточный научный центр физиологии и патологии дыханияРоссияFar Eastern Scientific Center of Physiology and Pathology ofRespirationRussian Federation20202606202007697106Copyright © Шелудько Е.Г., Наумов Д.Е., 20202020Шелудько Е.Г., Наумов Д.Е.Sheludko E.G., Naumov D.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cfpd.elpub.ru/jour/article/view/806

В литературе описана высокая распространенность сочетания обструктивной патологии верхних и нижних дыхательных путей, основными из которой является бронхиальная астма (БА), синдром обструктивного апноэ сна (СОАС), хроническая обструктивная болезнь лёгких (ХОБЛ). Так, по результатам мета-анализа средняя распространённость СОАС среди больных БА приближается к 50%. Шанс наличия СОАС у больных БА в 2,64 95%ДИ (1,76; 3,52) раза выше, по сравнению с лицами, у которых БА отсутствует (p<0,001). Распространенность ХОБЛ с СОАС трудно оценить. Исследование, проведенное в Европе, показало, что около 1% от общей численности населения и 9,2% пациентов с СОАС имели ХОБЛ по результатам спирометрии. Такая высокая распространенность сочетанного течения говорит о наличии патофизиологического сопряжения данных патологий, которое еще только предстоит раскрыть. Наиболее очевидным общим патогенетическим звеном указанных расстройств могут быть генетически обусловленные нарушения, возникающие на рецепторном уровне. Известно несколько нейропептидных систем, контролирующих тонус мышц дыхательных путей, одна из которых ГАМКергическая. В данном обзоре мы описали распространенность ГАМКергической передачи, её роль в регуляции тонуса дыхательной мускулатуры, локализацию и функциональное значение ГАМК рецепторов, не только в центральной нервной системе, но и в респираторном эпителии и гладкой мускулатуре респираторного тракта. Таким образом, дисбаланс в нейромедиаторной системе может приводить к развитию обструктивных заболеваний как верхних, так и нижних дыхательных путей. Кроме того, ГАМКергические рецепторы могут быть очевидной мишенью при лечении обструктивных заболеваний дыхательных путей.

The literature describes the high prevalence of a combination of the upper and lower obstructive pathology of respiratory tract, the main of which are asthma, obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD). Thus, according to the results of a meta-analysis, the average prevalence of OSAS among AD patients is approaching 50%. The chance of the OSAS presence in patients with asthma is 2.64 95%CI (1.76; 3.52) times higher than in individuals who do not have asthma (p<0.001). A study in Europe showed that about 1% of the total population and 9.2% of patients with OSAS had COPD according to spirometry. Such a high prevalence of the combined course indicates the presence of a pathophysiological pairing of these pathologies, which has yet to be revealed. The most obvious common pathogenetic link of these disorders can be genetically caused disorders that occur at the receptor level. Several neuropeptide systems are known to control muscle tone of the respiratory tract, one of which is GABAergic. In this review, we described the prevalence of GABAergic transmission, its role in regulating the tone of the respiratory muscles, the localization and functional significance of GABA receptors, not only in the central nervous system, but also in the respiratory epithelium and smooth muscles of the respiratory tract. Thus, an imbalance in the neurotransmitter system can lead to the development of obstructive diseases of both the upper and lower respiratory tract. In addition, GABAergic receptors may be an obvious target for the treatment of obstructive airways diseases.

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The authors declare that there are no conflicts of interest present.