Стимуляторы гемопоэза в лечении и профилактике реакции «трансплантат против хозяина»

   Режимы кондиционирования, предшествующие трансплантации гемопоэтических стволовых клеток (ТГСК), часто сопровождаются периодом аплазии, характеризующимся тяжелой нейтропенией, анемией и тромбоцитопенией. Длительная антибактериальная и иммуносупрессивная терапия больных с реакцией «трансплантат против хозяина» (РТПХ) усугубляет депрессию гемопоэза. Для коррекции гематологической дисфункции у данных пациентов используют колониестимулирующие факторы, эритропоэтины и агонисты рецепторов тромбопоэтина. Однако эти препараты обладают побочными эффектами, а их стимулирующее действие, как правило, ограничивается одним из ростков кроветворения. Вместе с тем у больных после ТГСК для профилактики и лечения нарушения гемопоэза на фоне РТПХ необходимо применение препаратов, способствующих восстановлению всех ростков гемопоэза. В качестве перспективных препаратов для этой категории больных могут рассматриваться индукторы Toll- и NOD-подобных рецепторов – стимуляторы экстренного гемопоэза. К таким соединениям относятся бактериальные дериваты и сульфатированные поли(олиго)сахариды, способные стимулировать кроветворение, что позволяет рассматривать их как перспективные стимуляторы гемопоэза для лечения и профилактики нарушений иммунного статуса и кроветворения при РТПХ.

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