ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2012-4-22-26ophthalmology-169Research ArticleОБЗОРЫREVIEWSРоль окислительного стресса и его коррекции в развитии возрастной макулярной дегенерации. ОбзорThe role of free-radical processes in the pathogenesis of age-related macular degeneration. ReviewКолесниковА. В.KolesnikovA. V.

к.м.н., доцент кафедры глазных и ЛОР-болезнейРязанского государственного медицинского университета им. акад. И.П. Павлова, Рязань, Россия

ЩулькинА. В.ShchulkinA. V.БаренинаО. И.BareninaO. I.ГБОУ ВПО «Рязанский государственный медицинский университет им. акад. И.П. Павлова», РязаньRussian Federation201216072014942226Copyright © Колесников А.В., Щулькин А.В., Баренина О.И., 20142014Колесников А.В., Щулькин А.В., Баренина О.И.Kolesnikov A.V., Shchulkin A.V., Barenina O.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/169

Рассмотрены современные представления о роли свободно-радикальных процессов в патогенезе возрастной макулярной дегенерации (ВМД). Приведены данные крупных клинических рандомизированных исследований по применению антиоксидантов для профилактики и терапии ВМД. Обсуждается возможность дифференцированного применения антиоксидантов в зависимости от генетического статуса пациентов.

the modern ideas of the role of free radical processes in the pathogenesis of age-related macular degeneration (AMD) are consid- ered. Data of large randomized clinical trials on application of antioxidants for prevention and therapy AMD are provided. Possibility of the differential application of antioxidants depending on the genetic status of patients is discussed.

возрастная макулярная дегенерацияперекисное окисление липидовантиоксидантыage-related macular degenerationlipid peroxidationantioxidantsReferencesGass J. D. Stereoscopic atlas of macular diseases, St. Louis ets, CV Mosby Co, 1977. — 411 p.Gass J. D. Stereoscopic atlas of macular diseases, St. Louis ets, CV Mosby Co, 1977. — 411 p.Jager R. D., Mieler W. F., Miller J. W. Age‐related macular degeneration // N Engl J Med. — 2008. — Vol. 358. — P. 2606‐2617.Jager R. D., Mieler W. F., Miller J. W. Age‐related macular degeneration // N Engl J Med. — 2008. — Vol. 358. — P. 2606‐2617.Rein D. B., Wittenborn J. S., Zhang X., et al. Forecasting Age‐Related Macular De- generation Through the Year 2050 // Arch Ophthalmol. — 2009. — Vol. 127. — P. 533‐540.Rein D. B., Wittenborn J. S., Zhang X., et al. Forecasting Age‐Related Macular De- generation Through the Year 2050 // Arch Ophthalmol. — 2009. — Vol. 127. — P. 533‐540.Chakravarthy U., Wong T. Y., Fletcher A. Clinical risk factors for age‐related mac- ular degeneration: a systematic review and meta‐analysis // BMC Ophthalmolo- gy. — 2010. — Vol. 13. — P. 10‐31.Chakravarthy U., Wong T. Y., Fletcher A. Clinical risk factors for age‐related mac- ular degeneration: a systematic review and meta‐analysis // BMC Ophthalmolo- gy. — 2010. — Vol. 13. — P. 10‐31.Киселёва Т. Н. Возрастная макулярная дегенерация: современные подходы к лечению и профилактике. Клинические рекомендации и лекции для прак- тикующих врачей Вестник «МЕДСИ». — 2009. — No 4. — С. 33‐39.Киселёва Т. Н. Возрастная макулярная дегенерация: современные подходы к лечению и профилактике. Клинические рекомендации и лекции для прак- тикующих врачей Вестник «МЕДСИ». — 2009. — No 4. — С. 33‐39.Beatty S., Koh H., Henson D., et al. The Role of Oxidative Stress in the Pathogen- esis of Age‐Related Macular Degeneration // Int. Review J. — 2000. — Vol. 45. — P. 115‐134.Beatty S., Koh H., Henson D., et al. The Role of Oxidative Stress in the Pathogen- esis of Age‐Related Macular Degeneration // Int. Review J. — 2000. — Vol. 45. — P. 115‐134.Christen W. G., Glynn R. J., Hennekens C. H. Antioxidants and age‐related eye dis- ease. Current and future perspectives // Ann Epidemiol. — 1996. — Vol. 6. — P. 60‐66.Christen W. G., Glynn R. J., Hennekens C. H. Antioxidants and age‐related eye dis- ease. Current and future perspectives // Ann Epidemiol. — 1996. — Vol. 6. — P. 60‐66.Ланкин В. З., Тихазе А. К., Беленков Ю. Н. Свободнорадикальные процессы в норме и при патологических состояниях. 2001. — 78 с.Ланкин В. З., Тихазе А. К., Беленков Ю. Н. Свободнорадикальные процессы в норме и при патологических состояниях. 2001. — 78 с.Киселева Т. Н., Будзинская М. В., Кравчук Е. А. Вазоактивные препараты в комплексной терапии неэксудативных форм возрастной макулярной деге- нерации // Русский мед. журнал. — 2007. No 3. — C. 119‐123.Киселева Т. Н., Будзинская М. В., Кравчук Е. А. Вазоактивные препараты в комплексной терапии неэксудативных форм возрастной макулярной деге- нерации // Русский мед. журнал. — 2007. No 3. — C. 119‐123.Зарубина И. В. Молекулярная фармакология антигипоксантов. СПб.: ООО «Издательство Н‐Л», 2004. — 368 с.Зарубина И. В. Молекулярная фармакология антигипоксантов. СПб.: ООО «Издательство Н‐Л», 2004. — 368 с.Seddon J. M., Francis P. J., George S., et al. Association of CFH Y402H and LOC387715 A69S with progression of age‐related macular degeneration // JAMA. — 2007. — Vol. 297. — P. 1793‐1800.Seddon J. M., Francis P. J., George S., et al. Association of CFH Y402H and LOC387715 A69S with progression of age‐related macular degeneration // JAMA. — 2007. — Vol. 297. — P. 1793‐1800.Ding X., Patel M., Chan C. C. Molecular pathology of age‐related macular degen- eration // Progress in Retinal and Eye Research. — 2009. Vol. 28. — P. 1‐18.Ding X., Patel M., Chan C. C. Molecular pathology of age‐related macular degen- eration // Progress in Retinal and Eye Research. — 2009. Vol. 28. — P. 1‐18.Fritsche L. G., Loenhardt T., Janssen A. et al. Age‐related macular degenera-Fritsche L. G., Loenhardt T., Janssen A. et al. Age‐related macular degenera-tion is associated with an unstable ARMS2 (LOC387715) mRNA // Nat Genet. — 2008. — Vol. 40. — P. 892‐896.tion is associated with an unstable ARMS2 (LOC387715) mRNA // Nat Genet. — 2008. — Vol. 40. — P. 892‐896.Handa T. J. How does the macula protect itself from oxidative stress? Mo- lecular Aspects of Medicine. — 2012. — No 5. — электр. реж. доступ: http://www.ncbi.nlm.nih.gov / pubmed / 22503691.Handa T. J. How does the macula protect itself from oxidative stress? Mo- lecular Aspects of Medicine. — 2012. — No 5. — электр. реж. доступ: http://www.ncbi.nlm.nih.gov / pubmed / 22503691.Laud K., Visaetsilpanonta S., Yannuzzi L. A., et al. Autofluorescence imaging of optic pit maculopathy // Retina. — 2007. — Vol. 27. — P. 116‐119.Laud K., Visaetsilpanonta S., Yannuzzi L. A., et al. Autofluorescence imaging of optic pit maculopathy // Retina. — 2007. — Vol. 27. — P. 116‐119.Milam A. H., Curcio C. A., Cidaciyan A. V. et al. Dominant late‐ouset retinal degen- eration with regional variation of sub‐retinal pigment epithelium deposits, reti- nal function and photoreceptor degeneration // Ophthalmology. — 2002. — Vol. 107. — P. 2256‐2266.Milam A. H., Curcio C. A., Cidaciyan A. V. et al. Dominant late‐ouset retinal degen- eration with regional variation of sub‐retinal pigment epithelium deposits, reti- nal function and photoreceptor degeneration // Ophthalmology. — 2002. — Vol. 107. — P. 2256‐2266.Teikari J. M., Laatikainen L., Virtamo J., et al. Six‐year supplementation with al- pha‐tocopherol and beta‐carotene and age‐related maculopathy // Acta Oph- thalmol Scand. — 1998. — Vol. 76. — P. 224‐229.Teikari J. M., Laatikainen L., Virtamo J., et al. Six‐year supplementation with al- pha‐tocopherol and beta‐carotene and age‐related maculopathy // Acta Oph- thalmol Scand. — 1998. — Vol. 76. — P. 224‐229.Hennekens C. H., Eberlein K. A randomized trial of aspirin and beta‐carotene among US physicians // Prev Med. — 1985. — Vol. 14. — P. 165‐168.Hennekens C. H., Eberlein K. A randomized trial of aspirin and beta‐carotene among US physicians // Prev Med. — 1985. — Vol. 14. — P. 165‐168.Taylor H., Tikellis G., Robman L., et al. Vitamin E supplementation and macu- lar degeneration: randomised controlled trial // JJ.BMJ. — 2002. — Vol. 325. — P. 325‐311.Taylor H., Tikellis G., Robman L., et al. Vitamin E supplementation and macu- lar degeneration: randomised controlled trial // JJ.BMJ. — 2002. — Vol. 325. — P. 325‐311.Evans J. Antioxidant supplements to prevent or slow down the progression of AMD: a systematic review and meta‐analysis // Eye. — 2008. — 22. — P. 751‐760. 21. Christen W. G., Glynn R. J., Chew E. Y., et al. Vitamin E and Age‐Related MacularEvans J. Antioxidant supplements to prevent or slow down the progression of AMD: a systematic review and meta‐analysis // Eye. — 2008. — 22. — P. 751‐760. 21. Christen W. G., Glynn R. J., Chew E. Y., et al. Vitamin E and Age‐Related MacularDegeneration in a Randomized Trial of Women // Ophthalmology. — 2010. —Degeneration in a Randomized Trial of Women // Ophthalmology. — 2010. —Vol. 117. — P. 1163‐1168.Vol. 117. — P. 1163‐1168.Christen W. G., Glynn R. J., Sesso H. D. et al. Vitamins E and C and Medical Re-Christen W. G., Glynn R. J., Sesso H. D. et al. Vitamins E and C and Medical Re-cord‐Confirmed Age‐Related Macular Degeneration in a Randomized Tri- al of Male Physicians Ophthalmology. — 2012. — 13. — электр. реж. доступ. http://www.sciencedirect.com / science / article / pii / S016164201200114.cord‐Confirmed Age‐Related Macular Degeneration in a Randomized Tri- al of Male Physicians Ophthalmology. — 2012. — 13. — электр. реж. доступ. http://www.sciencedirect.com / science / article / pii / S016164201200114.Age Related Eye Disease Study Research Group. A randomized, placebo‐con- trolled, clinical trial of high‐dose supplementation with vitamins C and E, beta‐ carotene, and zinc for age‐related macular degeneration and vision loss: AREDS report no. 8 // Arch Ophthalmology. — 2001. — Vol. 119. — P. 1417‐1436.Age Related Eye Disease Study Research Group. A randomized, placebo‐con- trolled, clinical trial of high‐dose supplementation with vitamins C and E, beta‐ carotene, and zinc for age‐related macular degeneration and vision loss: AREDS report no. 8 // Arch Ophthalmology. — 2001. — Vol. 119. — P. 1417‐1436.Bjelakovic G., Nikolova D., Gluud L. L., et al. Mortality in Randomized Trials of Antioxidant Supplements for Primary and Secondary Prevention // JAMA. — 2007. — Vol. 297. — P. 842‐857.Bjelakovic G., Nikolova D., Gluud L. L., et al. Mortality in Randomized Trials of Antioxidant Supplements for Primary and Secondary Prevention // JAMA. — 2007. — Vol. 297. — P. 842‐857.The Alpha Tocopherol and Beta‐Carotene Cancer Prevention Study Group. The effect of vitamin E and beta‐carotene on the incidence of lung cancer and oth- er cancers in male smokers // N Engl J Med. — 1994. — Vol. 330. — P. 1029‐1035.The Alpha Tocopherol and Beta‐Carotene Cancer Prevention Study Group. The effect of vitamin E and beta‐carotene on the incidence of lung cancer and oth- er cancers in male smokers // N Engl J Med. — 1994. — Vol. 330. — P. 1029‐1035.The HOPE and HOPE‐TOO trial investigators. Effects of long‐term vitamin E sup- plementation on cardiovascular events and cancer: a randomized controlled tri- al // JAMA. — 2005. — Vol. 293. — P. 1338‐1347.The HOPE and HOPE‐TOO trial investigators. Effects of long‐term vitamin E sup- plementation on cardiovascular events and cancer: a randomized controlled tri- al // JAMA. — 2005. — Vol. 293. — P. 1338‐1347.Bhatt D. L., Pashkow F. Y. Oxidative stress and heart disease // Am J Cardiol. 2008. — Vol. 101. — 1D — 86D.Bhatt D. L., Pashkow F. Y. Oxidative stress and heart disease // Am J Cardiol. 2008. — Vol. 101. — 1D — 86D.Меньщикова Е. Б., Ланкин В. З., Зенков Н. К. и др. Окислительный стресс. Про- оксиданты и антиоксиданты. М.: Фирма «Слово», 2006. — 556 с.Меньщикова Е. Б., Ланкин В. З., Зенков Н. К. и др. Окислительный стресс. Про- оксиданты и антиоксиданты. М.: Фирма «Слово», 2006. — 556 с.Klein M. L., Francis P. J, Rosner B., et al. CFH and LOC387715 / ARMS2 Genotypes and Treatment with Antioxidants and Zinc for Age‐Related Macular Degenera- tion // Ophthalmology. — 2008. — Vol. 115. — P. 1019‐1025.Klein M. L., Francis P. J, Rosner B., et al. CFH and LOC387715 / ARMS2 Genotypes and Treatment with Antioxidants and Zinc for Age‐Related Macular Degenera- tion // Ophthalmology. — 2008. — Vol. 115. — P. 1019‐1025.Ho L., van Leeuwen R., Witteman J. C., et al. Reducing the Genetic Risk of Age‐ Related Macular Degeneration With Dietary Antioxidants, Zinc, and ω‐3 Fat- ty Acids The Rotterdam Study // Arch. Ophthalmol. — 2011. — Vol. 129. — P. 758‐766.Ho L., van Leeuwen R., Witteman J. C., et al. Reducing the Genetic Risk of Age‐ Related Macular Degeneration With Dietary Antioxidants, Zinc, and ω‐3 Fat- ty Acids The Rotterdam Study // Arch. Ophthalmol. — 2011. — Vol. 129. — P. 758‐766.Baker K., Marcus C. B., Huffman K. et al. Synthetic combined superoxide dis- mutase / catalase mimetics are protective as a delayed treatment in a rat stroke model: a key role for reactive oxygen species in ischemic brain injury // J Phar- macol Exp Ther. — 1998. — Vol. 284. — P. 215‐221.Baker K., Marcus C. B., Huffman K. et al. Synthetic combined superoxide dis- mutase / catalase mimetics are protective as a delayed treatment in a rat stroke model: a key role for reactive oxygen species in ischemic brain injury // J Phar- macol Exp Ther. — 1998. — Vol. 284. — P. 215‐221.Pasternack R. F., Skowronek W. R. Jr. Catalysis of the disproportionation of super- oxide by metalloporphyrins // Inorg Biochem. — 1979. — Vol. 11. — P. 261‐267.Pasternack R. F., Skowronek W. R. Jr. Catalysis of the disproportionation of super- oxide by metalloporphyrins // Inorg Biochem. — 1979. — Vol. 11. — P. 261‐267.Müller A., Cadenas E., Graf P. et al. A novel biologically active seleno‐organ- ic compound‐‐I. Glutathione peroxidase‐like activity in vitro and antioxidant capacity of PZ 51 (Ebselen) // Biochem Pharmacol. — 1984. — Vol. 15. — P. 3235‐3239.Müller A., Cadenas E., Graf P. et al. A novel biologically active seleno‐organ- ic compound‐‐I. Glutathione peroxidase‐like activity in vitro and antioxidant capacity of PZ 51 (Ebselen) // Biochem Pharmacol. — 1984. — Vol. 15. — P. 3235‐3239.Skulachev V. P., Skulachev M. V. Pharmaceutical compositions for preventing and treating eye pathologies. United States Patent Application Publication. NoUS 2010 / 0323992 A1. — Dec. 23, 2010, 11 p.Skulachev V. P., Skulachev M. V. Pharmaceutical compositions for preventing and treating eye pathologies. United States Patent Application Publication. NoUS 2010 / 0323992 A1. — Dec. 23, 2010, 11 p.Lin H., Xu H., Liang F. Q. Mitochondrial DNA damage and repair in RPE associ- ated with aging and age‐related macular degeneration // Invest Ophthalmol Vis Sci. — 2011. — Vol. 52. — P. 3521‐3529.Lin H., Xu H., Liang F. Q. Mitochondrial DNA damage and repair in RPE associ- ated with aging and age‐related macular degeneration // Invest Ophthalmol Vis Sci. — 2011. — Vol. 52. — P. 3521‐3529.Dikalova A. E., Bikineyeva A. T., Budzyn K. et al. Therapeutic Targeting of mitochon- drial superoxide in hypertension // Cir Res. — 2010. — Vol. 107. — P. 106‐116.Dikalova A. E., Bikineyeva A. T., Budzyn K. et al. Therapeutic Targeting of mitochon- drial superoxide in hypertension // Cir Res. — 2010. — Vol. 107. — P. 106‐116.

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