MODERN APPROACHES TO THE ASSESSMENT OF BIOLOGICAL MARKERS OF AUTOPHAGY AND APOPTOSIS IN ACUTE ISCHEMIC STROKE
Over the past decades, acute ischemic stroke (AIS) has been an urgent medical and social problem. The high mortality and disability accompanying AIS necessitate the creation of new algorithms for the prevention, diagnosis and prognosis of the outcome of the disease. Reliable biological markers and high-tech laboratory diagnostic methods can help. The results of recent studies indicate that apoptosis, autophagy and necrosis are the main mechanisms of neuronal death in AIS. However, it is not completely clear which of these processes prevails at a particular stage of the ischemic cascade and to a greater extent affects the outcome of the disease. Research in the field of neuroimmunology made it possible to establish signaling proteins that initiate both apoptotic and autophagic death of brain cells in AIS. These proteins act either synergistically by creating common modules, or alternatively, as switches from one cell program to another. According to scientists, the study of cross-interactions between apoptosis and autophagy and their individual mediators in the pathogenesis of AIS is of great interest. A comparative assessment of the dynamics of the concentration of autophagy and apoptosis biomarkers in the peripheral blood of patients with AIS in comparison with the dynamics of the severity of neurological deficit and the volume of brain damage will help to better understand the cross-interactions between these processes at different stages of the acute period of ischemic stroke. According to some authors, the study of proteins involved in the induction of autophagy and apoptosis in acute respiratory infections will contribute not only to a deeper understanding of the pathogenesis of the disease, but also to the creation of new diagnostic algorithms, the development of specific biomarkers, predictors of the course and outcome of the disease.