kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2026-15-4-98-115kpccz-1677Research ArticleАНАЛИТИЧЕСКИЙ ОБЗОР. Патологическая физиология. Клеточная биологияГЕНЕТИЧЕСКАЯ АРХИТЕКТОНИКА КОРОНАРНОЙ МИКРОСОСУДИСТОЙ ДИСФУНКЦИИ: ПОЛИМОРФИЗМЫ, СИГНАЛЬНЫЕ КАСКАДЫ И МОЛЕКУЛЯРНЫЕ МИШЕНИGENETIC ARCHITECTURE OF CORONARY MICROVASCULAR DYSFUNCTION: POLYMORPHISMS, SIGNALING PATHWAYS, AND MOLECULAR TARGETShttps://orcid.org/0009-0005-3720-3607ШейхгасановаАнжела КадиевнаSheikhgasovaAnzhela K.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Астраханский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Астрахань, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University” of the Ministry of Healthcare of the Russian Federation, Astrakhan, Russian Federation

glable@bk.ruhttps://orcid.org/0000-0002-1113-2127ЧеркашинаДиана АлександровнаCherkashinaDiana A.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Астраханский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Астрахань, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University” of the Ministry of Healthcare of the Russian Federation, Astrakhan, Russian Federation

СалаватоваФатима АбдуразаковнаSalavatovaFatima A.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Астраханский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Астрахань, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University” of the Ministry of Healthcare of the Russian Federation, Astrakhan, Russian Federation

https://orcid.org/0009-0005-2225-6060АлиеваРафида МагомедовнаAlievaRafida M.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Астраханский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Астрахань, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University” of the Ministry of Healthcare of the Russian Federation, Astrakhan, Russian Federation

https://orcid.org/0009-0000-2160-5808АлиеваФарида МагомедовнаAlievaFarida M.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Астраханский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Астрахань, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University” of the Ministry of Healthcare of the Russian Federation, Astrakhan, Russian Federation

https://orcid.org/0009-0008-6370-9718НенастьеваНаталья АлександровнаNenastyevaNatalya A.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Астраханский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Астрахань, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University” of the Ministry of Healthcare of the Russian Federation, Astrakhan, Russian Federation

https://orcid.org/0009-0002-2303-912XАдигузеловаЗиярат НизамиевнаAdiguzelovaZiyarat N.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Астраханский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Астрахань, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University” of the Ministry of Healthcare of the Russian Federation, Astrakhan, Russian Federation

https://orcid.org/0009-0004-3935-5092КеримоваГюльшан АдилевнаKerimovaGyulshan A.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Астраханский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Астрахань, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University” of the Ministry of Healthcare of the Russian Federation, Astrakhan, Russian Federation

https://orcid.org/0000-0001-5009-9772АбдурахмановаПатимат КадилавовнаAbdurakhmanovaPatimat K.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Астраханский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Астрахань, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University” of the Ministry of Healthcare of the Russian Federation, Astrakhan, Russian Federation

https://orcid.org/0009-0009-6340-0080МурадхановЭдуард РобертовичMuradkhanovEduard R.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Ставропольский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Ставрополь, Российская Федерация

student, Stavropol State Medical University, Stavropol, Russian Federation

https://orcid.org/0009-0006-3310-7252КушнаревВладислав ЕвгеньевичKushnarevVladislav E.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Ставропольский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Ставрополь, Российская Федерация

student, Stavropol State Medical University, Stavropol, Russian Federation

https://orcid.org/0009-0002-8756-9488ГоворухаАлександра АндреевнаGovorukhaAleksandra A.

студент федерального государственного автономного образовательного учреждения высшего образования «Крымский федеральный университет имени В.И. Вернадского», Симферополь, Российская Федерация

student, V.I. Vernadsky Crimean Federal University, Simferopol, Russian Federation

https://orcid.org/0009-0003-1399-2600АнфимиадиВероника АндреевнаAnfimiadiVeronika A.

студент федерального государственного бюджетного образовательного учреждения высшего образования «Ростовский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Ростов-на-Дону, Российская Федерация

student, Federal State Budgetary Educational Institution of Higher Education “Rostov State Medical University” of the Ministry of Healthcare of the Russian Federation, Rostov-on-Don, Russian Federation

Федеральное государственное бюджетное образовательное учреждение высшего образования «Астраханский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University” of the Ministry of Healthcare of the Russian FederationRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Ставропольский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияStavropol State Medical UniversityRussian FederationФедеральное государственное автономное образовательное учреждение высшего образования «Крымский федеральный университет имени В.И. Вернадского»РоссияV.I. Vernadsky Crimean Federal UniversityRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Ростовский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education “Rostov State Medical University” of the Ministry of Healthcare of the Russian FederationRussian Federation20260409202615498115Copyright © Шейхгасанова А.К., Черкашина Д.А., Салаватова Ф.А., Алиева Р.М., Алиева Ф.М., Ненастьева Н.А., Адигузелова З.Н., Керимова Г.А., Абдурахманова П.К., Мурадханов Э.Р., Кушнарев В.Е., Говоруха А.А., Анфимиади В.А., 20262026Шейхгасанова А.К., Черкашина Д.А., Салаватова Ф.А., Алиева Р.М., Алиева Ф.М., Ненастьева Н.А., Адигузелова З.Н., Керимова Г.А., Абдурахманова П.К., Мурадханов Э.Р., Кушнарев В.Е., Говоруха А.А., Анфимиади В.А.Sheikhgasova A.K., Cherkashina D.A., Salavatova F.A., Alieva R.M., Alieva F.M., Nenastyeva N.A., Adiguzelova Z.N., Kerimova G.A., Abdurakhmanova P.K., Muradkhanov E.R., Kushnarev V.E., Govorukha A.A., Anfimiadi V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/1677Основные положения

Основные положения

 

 

Резюме

Резюме

Коронарная микрососудистая дисфункция (КМД) в последние годы рассматривается как самостоятельный и клинически значимый патофизиологический механизм ишемии миокарда, наблюдающийся даже при отсутствии обструктивных поражений коронарных артерий. Она обусловлена как функциональными нарушениями – в том числе дисбалансом между вазодилатацией и вазоконстрикцией, – так и структурными изменениями микрососудистого русла. Современные исследования демонстрируют, что ключевую роль в развитии КМД играют молекулярные и генетические факторы, включая однонуклеотидные полиморфизмы в генах, кодирующих эндотелиальную NO-синтазу (NOS3), субъединицы ионных каналов (KCNJ11, CACNA1C), медиаторы воспаления и ангиогенеза (JAK2, VEGFA, HMOX1). В дополнение, в рамках патогенеза коронарной микроциркуляторной дисфункции важную роль играет антиоксидантная система, участвующая в поддержании сосудистого гомеостаза и защите от оксидативного стресса. Основные исследуемые гены антиоксидантной системы включают SOD1–3, GPX1, CAT, HMOX1 и NOX2/NOX4, которые обеспечивают баланс продукции и утилизации активных форм кислорода и играют значимую роль в патофизиологии сосудистой стенки. Особый интерес представляют микроРНК, регулирующие экспрессию генов, ответственных за сосудистую реактивность, ангиогенез, окислительный стресс и воспаление. Нарушение экспрессии таких микроРНК, как miR-126, miR-155, miR-30, ассоциировано с дисфункцией эндотелия и ремоделированием капиллярной сети. В статье рассматриваются ключевые сигнальные каскады и молекулярные механизмы, лежащие в основе КМД, с акцентом на их генетическую и эпигенетическую модуляцию. Понимание этих механизмов открывает перспективы для развития персонализированных подходов к диагностике и терапии микрососудистых форм ишемической болезни сердца.

Highlights      

Highlights      

 

 

Abstract

Abstract

Coronary microvascular dysfunction (CMD) has increasingly been recognized as an independent and clinically significant pathophysiological mechanism of myocardial ischemia, even in the absence of obstructive coronary artery disease. CMD is caused by both functional impairments, such as imbalance between vasodilation and vasoconstriction–and structural alterations of the microcirculatory network. Recent research highlights the crucial role of molecular and genetic factors in the development of CMD, including single nucleotide polymorphisms (SNPs) in genes encoding endothelial nitric oxide synthase (NOS3), ion channel subunits (KCNJ11, CACNA1C), inflammatory and angiogenic mediators (JAK2, VEGFA, HMOX1). In addition, the antioxidant system plays an important role in the pathogenesis of coronary microcirculatory dysfunction, which is involved in maintaining vascular homeostasis and protecting against oxidative stress. The main studied genes of the antioxidant system include SOD1–3, GPX1, CAT, HMOX1 and NOX2/NOX4, which provide a balance of production and utilization of reactive oxygen species and play a significant role in the pathophysiology of the vascular wall. Of particular interest are microRNAs that regulate the expression of genes involved in vascular reactivity, angiogenesis, oxidative stress, and inflammation. Dysregulation of microRNAs such as miR-126, miR-155, and miR-30 has been associated with endothelial dysfunction and capillary remodeling. This review explores key signaling pathways and molecular mechanisms underlying CMD, with a focus on their genetic and epigenetic modulation. A better understanding of these processes opens new perspectives for the development of personalized diagnostic and therapeutic approaches in microvascular forms of ischemic heart disease.

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