problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl13222problendo-13222Research ArticleКлиническая эндокринологияClinical endocrinologyСовременные представления о генетических и иммуногистохимических особенностях пролактин-секретирующих аденом гипофизаModern concepts of genetic and immunohistochemical features of prolactin-secreting pituitary adenomashttps://orcid.org/0000-0003-0047-7223ШутоваА. С.ShutovaA. S.

Шутова Александра Сергеевна.

Москва, ул. Дмитрия Ульянова, д. 11, 117036

Aleksandra S. Shutova.

Dmitry Ulyanov street, 11, Moscow 117036

shutova.aleksandra@gmail.comhttps://orcid.org/0000-0002-0327-4619ДзерановаЛ. К.DzeranovaL. K.

Дзеранова Лариса Константиновна – доктор медицинских наук.

Москва

Larisa K. Dzeranova - MD, PhD.

Moscow

dzeranovalk@yandex.ruВоротниковаС. Ю.VorotnikovaS. Yu.

Воротникова Светлана Юрьевна – кандидат медицинских наук.

Москва

Svetlana Yu. Vorotnikovа.

Moscow

vorotnikova.s.y@gmail.comhttps://orcid.org/0000-0002-6520-4296КутинМ. A.KutinM. A.

Кутин Максим Александрович - кандидат медицинских наук.

Москва

Maxim A. Kutin – PhD.

Moscow

dr.m.kutin@yandex.ruhttps://orcid.org/0000-0001-6539-466XПигароваЕ. А.PigarovaE. A.

Пигарова Екатерина Александровна - доктор медицинских наук.

Москва

Ekaterina A. Pigarova - MD, Phd.

Moscow

kpigarova@gmail.comНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian FederationНациональный медицинский исследовательский центр нейрохирургии имени академика Н.Н. БурденкоРоссияN.N. Burdenko National Medical Research Center of NeurosurgeryRussian Federation2023300620236934450Copyright © Шутова А.С., Дзеранова Л.К., Воротникова С.Ю., Кутин М.A., Пигарова Е.А., 20232023Шутова А.С., Дзеранова Л.К., Воротникова С.Ю., Кутин М.A., Пигарова Е.А.Shutova A.S., Dzeranova L.K., Vorotnikova S.Y., Kutin M.A., Pigarova E.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.probl-endojournals.ru/jour/article/view/13222

Пролактиномы — наиболее распространенные гормонально-активные аденомы гипофиза. В 20% случаев наблюдается резистентность к методу выбора их лечения — медикаментозной терапии агонистами дофамина. Наличие резистентности обусловливает прогрессию патологических проявлений гиперпролактинемии и негативные топографо-анатомические изменения пролактиномы. Причины нечувствительности к терапии агонистами дофамина не вполне изучены, а подходы к ведению пациентов требуют уточнения. Существующие в настоящее время концепции резистентности базируются на данных, получаемых в результате оперативного вмешательства или после периода длительной неэффективной терапии. В связи с этим весьма актуален поиск методов оценки чувствительности пролактин-секретирующих аденом к медикаментозной терапии на раннем диагностическом этапе. Особое место среди этих методов занимают молекулярно-генетические исследования, позволяющие прогнозировать ответ аденомы на медикаментозную терапию до проведения хирургического лечения. На основании полученных данных возможно формирование персонализированного алгоритма ведения пациентов.

Prolactinomas are the most common secreting adenomas of the pituitary. In 20% of cases resistance to dopamine-agonists treatment is observed. Medical therapy resistance causes progression of pathological symptoms of hyperprolactinemia and negative topographic and anatomical changes of prolactinoma. The causes of ineffectiveness of dopamine agonists therapy are not fully understood as well as approaches to managing patients require clarification. Current concepts of resistance are based on the data obtained as a result of surgery or after a period of long-term ineffective therapy. Thus, it is very important to find methods of assessing the sensitivity of prolactin-secreting adenomas to drug therapy before surgical treatment. Genetic and immunohistochemical studies find special place among these methods, making it possible to predict adenoma’s response to drug therapy at early diagnostic stage. Obtained results will allow us to form personalized algorithm for managing patients.

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