pediatricjournalАрхив педиатрии и детской хирургииArchives of Pediatrics and Pediatric Surgery2949-46643033-6783НИКИ детства Минздрава Московской области10.66825/2949-4664-apps-3-3-81-88pediatricjournal-235Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWTRAIL-рецепторы в патогенезе крапивницы: анализ современных данныхTRAIL receptors in the pathogenesis of urticaria: Analysis of current datahttps://orcid.org/0000-0003-0383-5006КрасиловаЕ. В.KrasilovaE. V.

Красилова Елена Владимировна, к. м. н., доцент кафедры клинической иммунологии с курсом последипломного образования

ул. Бакинская, д. 121, г. Астрахань, 414000

Elena V. Krasilova, Cand. Sci. (Med.), Associate Professor, Department of Clinical Immunology with a Postgraduate Course 

121 Bakinskaya St., Astrakhan, 414000

el25kv@mail.ruhttps://orcid.org/0000-0003-4168-4851БашкинаО. А.BashkinaO. A.

Башкина Ольга Александровна, д. м. н., заведующий кафедрой факультетской педиатрии

ул. Бакинская, д. 121, г. Астрахань, 414000

Olga A. Bashkina, Dr. Sci. (Med.), Head of Department of Faculty Pediatrics

121 Bakinskaya St., Astrakhan, 414000

bashkina1@mail.ruhttps://orcid.org/0000-0002-8172-2421ШелеповаТ. Н.ShelepovaT. N.

Шелепова Татьяна Николаевна, к. м. н., доцент кафедры клинической иммунологии с  курсом последипломного образования

ул. Бакинская, д. 121, г. Астрахань, 414000

Tatiana N. Shelepova, Cand. Sci. (Med.), Associate Professor, Department of Clinical Immunology with a Postgraduate Course

121 Bakinskaya St., Astrakhan, 414000

shelepovatn@yandex.ruhttps://orcid.org/0000-0001-6766-079XВоронинаЛ. П.VoroninaL. P.

Воронина Людмила Петровна, д. м. н., заведующий кафедрой клинической иммунологии с  курсом последипломного образования

ул. Бакинская, д. 121, г. Астрахань, 414000

Lyudmila P. Voronina, Dr. Sci. (Med.), Head of Department of Clinical Immunology with a  Postgraduate Course

121 Bakinskaya St., Astrakhan, 414000

voroninaluda74@mail.ruФГБОУ ВО «Астраханский государственный медицинский университет» Минздрава РоссииAstrakhan State Medical University202526122025338188Copyright © Красилова Е.В., Башкина О.А., Шелепова Т.Н., Воронина Л.П., 20252025Красилова Е.В., Башкина О.А., Шелепова Т.Н., Воронина Л.П.Krasilova E.V., Bashkina O.A., Shelepova T.N., Voronina L.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nikid.ru/jour/article/view/235Актуальность

Актуальность. Понимание механизмов хронизации крапивницы остается ключевой проблемой клинической иммунологии. Нарушение апоптоза через систему TRAIL/TRAIL-R является перспективным направлением для выявления новых патогенетических мишеней и биомаркеров.

Материалы и методы

Материалы и методы. Проведен аналитический обзор литературы. Осуществлен систематизированный поиск в базах PubMed, Scopus, Web of Science, eLibrary и КиберЛенинка за 2000–2025 гг. Отобрано и проанализировано 97 публикаций, соответствующих критериям включения. Применен метод сравнительного патогенетического анализа.

Результаты

Результаты. Установлены принципиальные различия в состоянии системы TRAIL/TRAIL-R при острой и хронической крапивнице (ХК). При острой форме отмечается компенсаторное повышение растворимых рецепторов (sTRAIL-R1/ R2), ограничивающее апоптоз. При ХК формируется патологический дисбаланс: стойкое снижение мембранной экспрессии функциональных рецепторов TRAIL-R1/R2 на иммунных клетках сочетается с повышением их растворимых антагонистических форм. Этот двойной дефект приводит к нарушению клиренса активированных клеток и персистенции воспаления. Параметры системы TRAIL/TRAIL-R обладают высоким диагностическим и прогностическим потенциалом для стратификации пациентов и оценки ответа на терапию.

Выводы

Выводы. Дисфункция системы TRAIL/TRAIL-R является значимым патогенетическим звеном хронизации крапивницы. Ее количественные и качественные параметры перспективны в качестве клинических биомаркеров. Для внедрения в практику необходимы стандартизированные многоцентровые исследования, в том числе с учетом возрастных особенностей у детей.

Introduction

Introduction. Elucidation of the mechanisms of urticaria chronification remains a key challenge in clinical immunology. Dysregulation of apoptosis via the TRAIL/TRAIL-R system is a promising direction in identifying new pathogenetic targets and biomarkers.

Materials and methods

Materials and methods. An analytical literature review was conducted. A systematic search was performed across the PubMed, Scopus, Web of Science, eLibrary, and CyberLeninka databases for the period from 2000 to 2025. A total of 97 publications meeting the inclusion criteria were selected and analyzed. The method of comparative pathogenetic analysis was applied.

Results

Results. Fundamental differences in the state of the TRAIL/ TRAIL-R system between acute and chronic urticaria (CU) were established. In its acute form, a compensatory increase in soluble receptors (sTRAIL-R1/R2) is observed, which limits apoptosis. In CU, a pathological imbalance develops; thus, a persistent decrease in the membrane expression of functional TRAIL-R1/R2 receptors on immune cells is coupled with an increase in their soluble antagonistic forms. This dual defect leads to impaired clearance of activated cells and persistence of inflammation. The parameters of the TRAIL/TRAIL-R system demonstrate a high diagnostic and prognostic potential for patient stratification and assessment of therapy response.

Conclusions

Conclusions. Dysfunction of the TRAIL/TRAIL-R system is a significant pathogenetic link in the chronification of urticaria. Its quantitative and qualitative parameters are promising as clinical biomarkers. For implementation into practice, standardized multicenter studies are required, including those considering age-related characteristics in children.

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