Атеросклероз и остеопороз. Общие мишени для влияния сердечно-сосудистых и антиостеопорозных препаратов (Часть II). Влияние антиостеопорозных препаратов на состояние сосудистой стенки

Во второй части обзора литературы приводятся данные о возможном влиянии антиостеопорозной терапии на сосудистую стенку и развитие кальцификации. Открытие общих биологических веществ, участвующих в развитии атеросклероза, кальцификации сосудистой стенки и остеопороза привлекает внимание ученых с точки зрения мишеней для оценки эффектов уже известных препаратов или разработки новых лекарственных средств, способных одновременно предотвратить развитие или замедлить прогрессирование как атеросклероза, так и остеопороза. В настоящее время различные группы препаратов для лечения остеопороза исследованы с целью предотвращения или снижения прогрессирования субклинического атеросклероза и сосудистой кальцификации. Изучались как антирезорбтивные препараты (бисфосфонаты, моноклональные антитела к RANKL, селективные модуляторы эстрогенных рецепторов), так и костно-анаболическая терапия, к которой относится терипаратид. Однако таких исследований немного, и наиболее перспективными препаратами, оказывающими профилактический эффект на ранних стадиях атеросклеротического повреждения, являются бисфосфонаты. У других классов антиостеопорозных препаратов не было выявлено позитивного влияния на сосудистую стенку, а некоторые из них повышали сердечно-сосудистый риск. Обращают на себя внимание расхождения в результатах экспериментальных и клинических исследований. Если в эксперименте практически все препараты для лечения остеопороза оказывали атеропротективный эффект и подавляли сосудистую кальцификацию, то в клинических условиях только бисфосфонаты подтвердили позитивное влияние на сосудистую стенку.

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