kurskvestЧеловек и его здоровьеHumans and their health1998-57461998-5754Kursk State Medical University10.21626/vestnik/2025-4/05ONBMSXkurskvest-1466Research ArticleПРОФИЛАКТИЧЕСКАЯ МЕДИЦИНАPREVENTATIVE MEDICINEВысокодозная иммуносупрессивная терапия с аутологичной трансплантацией гемопоэтических стволовых клеток как эффективный метод лечения аутоиммунных заболеванийHigh-Dose Immunosuppressive Therapy with Autologous Hematopoietic Stem Cell Transplantation as an effective method for treating autoimmune diseaseshttps://orcid.org/0000-0001-8699-2482ПолушинАлексей ЮрьевичPolushinAlexey Yu.

канд. мед. наук, доцент, руководитель научно-клинического центра трансплантации и клеточной терапии при аутоиммунных и нейродегенеративных заболеваниях, доцент кафедры неврологии, ПСПбГМУ им. ак. И.П. Павлова, г. Санкт-Петербург

Cand. Sci. (Med.), Associate Professor, Head of the Scientific and Clinical Center for Transplantation and Cell Therapy in Autoimmune and Neurodegenerative Diseases, Associate Professor of the Department of Neurology, ac. I.P. Pavlov FSPbSMU, St. Petersburg, Russian Federation

alexpolushin@yandex.ruhttps://orcid.org/0000-0002-9850-1107СагановаЕлена СергеевнаSaganovaElena S.

канд. мед. наук, зав. нефрологическим отделением № 1 клиники «НИИ Нефрологии» НКИЦ, врач-нефролог, врач-ревматолог научно-клинического центра трансплантации и клеточной терапии при аутоиммунных и нейродегенеративных заболеваниях, доцент кафедры неврологии, доцент кафедры внутренних болезней с клиникой, ПСПбГМУ им. ак. И.П. Павлова, г. Санкт-Петербург

Cand. Sci. (Med.), Head of the Nephrological Department No. 1 of the Clinic "Research Institute of Nephrology" of the NCIC, nephrologist, rheumatologist at the Scientific and Clinical Center for Transplantation and Cell Therapy in Autoimmune and Neurodegenerative Diseases, Associate Professor of the Department of Neurology, Associate Professor of the Department of Internal Medicine with the clinic, ac. I.P. Pavlov FSPbSMU, St. Petersburg, Russian Federation

nephrolog1985@gmail.comhttps://orcid.org/0000-0001-6567-6990ЧернаяМария ЕвгеньевнаChernayaMaria E.

ассистент кафедры терапии факультетской с курсом энокринологии, кардиологии с клиникой им. Акад. Г.Ф. Ланга, ПСПбГМУ им. ак. И.П. Павлова, Санкт-Петербург

Assistant at the Department of Faculty Therapy with a course in Enocrinology and Cardiology at the Academician G.F. Lang Clinic, ac. I.P. Pavlov FSPbSMU, St. Petersburg, Russian Federation

mashaeatworld@gmail.comhttps://orcid.org/0000-0003-1376-4651ГаничЕкатерина ГеоргиевнаGanichEkaterina G.

врач-гастроэнтеролог кабинета ВЗК поликлиники с КДЦ, ПСПбГМУ им. акад. И.П. Павлова, г. Санкт-Петербург

Gastroenterologist at the IBD office of the polyclinic with KDC, ac. I.P. Pavlov FSPbSMU, St. Petersburg, Russian Federation

dr.ganich@yandex.ruhttps://orcid.org/0000-0002-3881-4486ЗаляловЮрий РинатовичZalyalovYuri R.

канд. мед. наук, врач-гематолог, зав. отделением химиотерапии и трансплантации костного мозга при онкологических и аутоиммунных заболеваниях НКЦ, ПСПбГМУ им. ак. И.П. Павлова, г. Санкт-Петербург

Cand. Sci. (Med.), Hematologist, Head of the Department of Chemotherapy and Bone Marrow Transplantation in Oncological and Autoimmune Diseases of the NCC, ac. I.P. Pavlov FSPbSMU, St. Petersburg, Russian Federation

yz21@mail.ruhttps://orcid.org/0000-0001-8402-0743ЩукинаОксана БорисовнаShchukinaOksana B.

д-р мед. наук, профессор кафедры общей врачебной практики (семейной медицины), зав. кабинетом ВЗК поликлиники с КДЦ, ПСПбГМУ им. акад. И.П. Павлова, г. Санкт-Петербург

Dr. Sci. (Med.), Professor of the Department of General Medical Practice (Family Medicine), Head of the Office of the IBD Polyclinic with KDC, ac. I.P. Pavlov FSPbSMU, St. Petersburg, Russian Federation

burmao@gmail.comhttps://orcid.org/0000-0002-4544-2967КуликовАлександр НиколаевичKulikovAlexander N.

д-р мед. наук, профессор, зав. кафедрой пропедевтики внутренних болезней с клиникой, зав. кафедрой функциональной диагностики, директор НКИЦ, ПСПбГМУ им. акад. И.П. Павлова, г. Санкт-Петербург

Dr. Sci. (Med.), Professor, Head of the Department of Propaedeutics of Internal Diseases with Clinic, Head of the Department of Functional Diagnostics, Director of the NCIC, ac. I.P. Pavlov FSPbSMU, St. Petersburg, Russian Federation

ankulikov2005@yandex.ruhttps://orcid.org/0000-0002-7755-7275ХалимовЮрий ШавкатовичKhalimovYuri Sh.

д-р мед. наук, профессор, зав. кафедрой факультетской терапии с курсом эндокринологии, кардиологии с клиникой им. акад. Г.Ф. Ланга, проректор по лечебной работе, ПСПбГМУ им. акад. И.П. Павлова, г. Санкт-Петербург, главный эндокринолог КЗ г. Санкт-Петербурга

Dr. Sci. (Med.), Professor, Head of Department Department of Faculty Therapy with a course in endocrinology, cardiology with the clinic named after Academician G.F. Lang, Vice-rector for Medical Work, ac. I.P. Pavlov FSPbSMU, St. Petersburg, Russian Federation, Chief Endocrinologist of the St. Petersburg Medical Center

yushkha@gmail.comhttps://orcid.org/0000-0002-9589-4136КулагинАлександр ДмитриевичKulaginAlexander D.

д-р мед. наук, директор НИИ детской онкологии, гематологии и трансплантологии имени Р.М. Горбачевой, зав. кафедрой гематологии, трансфузиологии и трансплантологии с курсом детской онкологии ФПО им. профессора Б.В. Афанасьева, ПСПбГМУ им. акад. И.П. Павлова, г. Санкт-Петербург

Dr. Sci. (Med.), Director of the Research Institute of Pediatric Oncology, Hematology and Transplantology named after R.M. Gorbacheva, Head of the Department of Hematology, Transfusiology and Transplantology with a course in Pediatric Oncology of Professor B.V. Afanasyev, ac. I.P. Pavlov FSPbSMU, St. Petersburg, Russian Federation

kulagingem@rambler.ruhttps://orcid.org/0000-0002-6380-137XБагненкоСергей ФедоровичBagnenkoSergey F.

д-р мед. наук, профессор, академик РАН, ректор, ПСПбГМУ им. акад. И.П. Павлова, г. Санкт-Петербург

Dr. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Rector, ac. I.P. Pavlov FSPbSMU, St. Petersburg, Russian Federation

rector@1spbgmu.ruПервый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова (ПСПбГМУ им. ак. И.П. Павлова)РоссияFirst Saint-Petersburg State Medical University named after ac. I.P. Pavlov (ac. I.P. Pavlov FSPbSMU)Russian FederationПервый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова (ПСПбГМУ им. ак. И.П. Павлова)Russian Federation2025011220252833849Copyright © Полушин А.Ю., Саганова Е.С., Черная М.Е., Ганич Е.Г., Залялов Ю.Р., Щукина О.Б., Куликов А.Н., Халимов Ю.Ш., Кулагин А.Д., Багненко С.Ф., 20252025Полушин А.Ю., Саганова Е.С., Черная М.Е., Ганич Е.Г., Залялов Ю.Р., Щукина О.Б., Куликов А.Н., Халимов Ю.Ш., Кулагин А.Д., Багненко С.Ф.Polushin A.Y., Saganova E.S., Chernaya M.E., Ganich E.G., Zalyalov Y.R., Shchukina O.B., Kulikov A.N., Khalimov Y.S., Kulagin A.D., Bagnenko S.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.kursk-vestnik.ru/jour/article/view/1466

К настоящему времени накоплены данные, указывающие на высокую эффективность метода высокодозной иммуносупрессивной терапии с аутологичной трансплантацией гемопоэтических стволовых клеток (ВИСТ-АТГСК) и возможность сохранения и улучшения качества жизни пациентов с аутоиммунными заболеваниями (АИЗ) после него. Опыт применения ВИСТ-АТГСК в мире к 2025 году составляет 30 лет, в нашей стране - 27 лет. Однако, несмотря на это, метод до сих пор считается экспериментальным и не входит в Клинические рекомендации соответствующих нозологий.

Цель - представить эффективный, потенциально однократно применяемый метод лечения АИЗ; описать мировой опыт применения ВИСТ-АТГСК при лечении некоторых АИЗ.

В статье описаны точки приложения и возможности метода иммунной реконституции для стабилизации и лечения тяжелых аутоиммунных заболеваний, таких как системная склеродермия, системная красная волчанка, ревматоидный артрит, болезнь Крона, сахарный диабет 1 типа, рассеянный склероз. ВИСТ-АТГСК является высокоэффективным методом лечения агрессивных и рефрактерных форм АИЗ при условии своевременного его применения на этапе преобладания активного аутоиммунного воспаления над процессами поражения органов и систем-мишеней.

To date, data have been accumulated indicating the high efficiency of high-dose immunosuppressive therapy with autologous hematopoietic stem cell transplantation (HDIT-AHSCT) and the possibility of maintaining and improving the quality of life of patients with autoimmune diseases (AIDs) after it. The experience of using HDIT-AHSCT in the world by 2025 is 30 years, in our country - 27 years. However, despite this, the method is still considered experimental and is not included in the Clinical Guidelines for the relevant nosologies.

Objective - to present an effective potentially single-use method for the treatment of AIDs; to describe the world experience of using HDIT-AHSCT in the treatment of some AIDs.

The article describes the application points and capabilities of the immune reconstitution method for stabilizing and treating severe autoimmune diseases such as systemic scleroderma, systemic lupus erythematosus, rheumatoid arthritis, Crohn's disease, type 1 diabetes mellitus, multiple sclerosis. Thus, HDIT-AHSCT is a highly effective method for treating aggressive and refractory forms of AIDs, provided that it is used in a timely manner - at the stage of predominance of active autoimmune inflammation over the processes of damage to target organs and systems.

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