BOLALARDA KAWASAKI KASALLIGIDA KORONAR ARTERIYA ZARARLANISHINING IMMUNOLOGIK MEXANIZMLARI: YALLIG‘LANISH MEDIATORLARI VA VASKULYAR REMODELLASIYANING PATOGENETIK ROLI
Abstract
Kawasaki kasalligi bolalarda uchraydigan, asosan o‘rta va kichik qon tomirlarni zararlovchi o‘tkir tizimli vaskulit bo‘lib, rivojlangan mamlakatlarda bolalar orttirilgan yurak kasalliklarining asosiy sabablaridan biri hisoblanadi. Kasallikning eng xavfli asorati koronar arteriyalarning zararlanishi bo‘lib, bu jarayon koronar anevrizmalar, miokard ishemiyasi va uzoq muddatli yurak-qon tomir asoratlariga olib kelishi mumkin. Kawasaki kasalligining aniq etiologiyasi to‘liq aniqlanmagan bo‘lsa-da, zamonaviy tadqiqotlar uning rivojlanishida genetik moyillik, infeksion triggerlar va immun tizimining nazoratsiz faollashuvi muhim rol o‘ynashini ko‘rsatmoqda.
Kasallik patogenezida tug‘ma va orttirilgan immunitet komponentlarining o‘zaro ta’siri, yallig‘lanish sitokinlarining ko‘payishi, endotelial disfunksiya va qon tomir devorining strukturaviy buzilishi asosiy ahamiyatga ega. Ayniqsa interleykin-1β (IL-1β), interleykin-6 (IL-6), o‘sma nekroz omili-α (TNF-α) kabi mediatorlar koronar arteriyalarda yallig‘lanish jarayonini kuchaytirib, anevrizma shakllanishiga sabab bo‘lishi mumkin.
Ushbu maqolada Kawasaki kasalligida koronar arteriya zararlanishining immunologik mexanizmlari, yallig‘lanish jarayonlarining molekulyar asoslari, zamonaviy diagnostika usullari va davolash strategiyalari tahlil qilinadi.
References
1. Баранов А.А., Намазова-Баранова Л.С. Педиатрия: национальное руководство. Москва: ГЭОТАР-Медиа; 2020.
2. Шабалов Н.П. Детские болезни: учебник для медицинских вузов. Санкт-Петербург: СпецЛит; 2021.
3. Белоусов Ю.В., Гуревич К.Г. Клиническая фармакология в педиатрии. Москва: ГЭОТАР-Медиа; 2019.
4. Abdullayev A.M., Karimov Sh.I. Ichki kasalliklar va pediatriya asoslari. Toshkent: Tibbiyot nashriyoti; 2020.
5. Mamatqulov B.M., Jo‘rayev A.R. Pediatriya: bolalar kasalliklari diagnostikasi va davolash tamoyillari. Toshkent: O‘zbekiston tibbiyot nashriyoti; 2019.
6. Sog‘liqni saqlash vazirligi. Bolalarda yurak-qon tomir kasalliklarini tashxislash va davolash bo‘yicha klinik tavsiyalar. Toshkent; 2022.
7. Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Japanese Journal of Allergy. 1967;16:178–222.
8. McCrindle B.W., Rowley A.H., Newburger J.W., et al. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. Circulation. 2017;135(17):e927–e999.
9. Newburger J.W., Takahashi M., Burns J.C. Kawasaki Disease. Journal of the American College of Cardiology. 2016;67(14):1738–1749.
10. Tremoulet A.H., Jain S., Kim K.K., et al. Rationale and design of a randomized clinical trial for primary prevention of coronary artery aneurysms in Kawasaki disease. Contemporary Clinical Trials. 2019;83:1–8.
11. Dionne A., Dahdah N. Coronary artery abnormalities in Kawasaki disease: what is the role of imaging? Current Opinion in Cardiology. 2018;33(5):526–531.
12. Burns J.C., Glodé M.P. Kawasaki syndrome. The Lancet. 2004;364(9433):533–544.
13. Weng K.P., Hsieh K.S., Huang S.H., et al. Cytokine profiles in children with Kawasaki disease and coronary artery lesions. Pediatric Cardiology. 2010;31:635–641.
14. Lee Y.C., Kuo H.C., Chang J.S., et al. Two new susceptibility loci for Kawasaki disease identified through genome-wide association analysis. Nature Genetics. 2012;44:522–525.
15. Noval Rivas M., Arditi M. Kawasaki disease: pathophysiology and insights from mouse models. Nature Reviews Rheumatology. 2020;16:391–403.
16. Onouchi Y. The genetics of Kawasaki disease. International Journal of Rheumatic Diseases. 2018;21(1):26–30.
17. Brogan P., Burns J.C., Cornish J., et al. Lifetime cardiovascular management of patients with previous Kawasaki disease. Heart. 2020;106:411–418.
18. McCrindle B.W., Manlhiot C. Kawasaki disease: a comprehensive review. European Journal of Pediatrics. 2014;173:1–10.
19. Furusho K., Kamiya T., Nakano H., et al. High-dose intravenous gammaglobulin for Kawasaki disease. The Lancet. 1984;2(8411):1055–1058.
20. Eleftheriou D., Levin M., Shingadia D., et al. Management of Kawasaki disease. Archives of Disease in Childhood. 2014;99:74–83.
