Протеомные аспекты резистентности к антитромбоцитарной терапии: механизмы, биомаркеры и перспективы персонализированного лечения

Обзор посвящен проблеме резистентности к антитромбоцитарной терапии (Ацетилсалициловая кислота (АСК), клопидогрел, празугрел, тикагрелор), которая повышает риск тромбозов, инфаркта и инсульта у кардиологических пациентов. Причины явления сложны и включают генетические, метаболические и воспалительные факторы. Ключевой фокус обзора — это применение современных протеомных технологий для углубленного изучения молекулярных основ резистентности. Высокоразрешающая масс-спектрометрия и методы изотопного мечения позволяют идентифицировать и количественно оценить тысячи белков в тромбоцитах, выявляя специфические протеомные сигнатуры, ассоциированные с нарушением ответа на терапию. Обзор суммирует результаты исследований, демонстрирующих изменения в протеоме тромбоцитов как в ответ на прием антиагрегантов, так и при развитии резистентности. Протеомный подход позволил идентифицировать специфические белки-биомаркеры резистентности, такие как THBS2, DECR1 для АСК и SPON2, галектин-9 для клопидогрела, вовлеченные в активацию тромбоцитов, воспаление и метаболизм. Протеомный анализ открывает путь к персонализированной медицине, предлагая основы для новых диагностических тестов и стратегий преодоления резистентности.

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