Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children44010.24287/1726-1708-2020-19-4-243-250LITERATURE REVIEWОБЗОР ЛИТЕРАТУРЫNew approaches to the diagnosis and treatment of coagulation disordersНовые направления в терапии и диагностике нарушений свертыванияhttps://orcid.org/0000-0003-1494-3125ShibekoA. M.ШибекоА. М.
Russian Federation

Alexey М. Shibeko, PhD, leading researcher, laboratory of biophysics

1 Samory Mashela St., Moscow 117997

Шибеко Алексей Михайлович, канд. биол. наук, ведущий научный сотрудник лаборатории биофизики

117997, Москва, ул. Саморы Машела, 1

alshibeko@gmail.comBalandinaA. N.БаландинаА. Н.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0002-8128-7757PanteleevM. A.ПантелеевМ. А.
Russian Federation

Moscow

Москва

Center for Theoretical Problems of Physical and Chemical Pharmacology, Russian Academy of SciencesФГБУН «Центр теоретических проблем физико-химической фармакологии» РАНDmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian FederationФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава России081220201942432502212202022122020Copyright ©; 2025, «D. Rogachev NMRCPHOI»Copyright ©; 2025, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2025«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/440

With the advent of new approaches in coagulation studies capable of identifying regulatory mechanisms involved in transport processes, the spatial localization of processes and interaction between the coagulation system and the immune system, the complement system, and fibrinolysis, the existing diagnostic and treatment approaches used in clinical and laboratory practice are changing as well. This review describes modern diagnostic methods for hemostasis disorders that are based on an integrative approach and are used to assess many aspects of the coagulation system at once. The reviewed methods are sensitive not only to bleeding but also to prothrombotic states, and enable monitoring of treatment with various medications including both oral anticoagulants and antihemophilic agents. We will also cover new approaches to the treatment of hemostasis disorders made possible by the understanding of the involved control mechanisms, such as the use of bispecific antibodies as an alternative to coagulation cofactors, the inhibition of inhibitors and the development of new drug delivery techniques.

Вслед за появлением новых подходов в исследовании свертывания крови, позволяющих выявлять механизмы регуляции, связанные с транспортными процессами, пространственной локализацией процессов, взаимодействием с системами иммунитета, комплемента, фибринолизом, меняются и диагностические и терапевтические подходы, используемые в клинико-лабораторной практике. В данном обзоре будут описаны современные методы диагностики нарушений гемостаза, основанные на интегральном подходе и оценивающие сразу множество аспектов состояния системы свертывания, чувствительные не только к проявлениям кровоточивости, но и к протромботическим состояниям, а также позволяющие производить мониторинг терапии различными лекарственными препаратами, как оральными антикоагулянтами, так и антигемофильными агентами. Также будет рассказано о новых подходах в терапии нарушений гемостаза, связанных с пониманием управляющих механизмов, таких как использование биспецифичных антител как альтернативы кофакторам свертывания, ингибирование ингибиторов и разработка новых методов доставки препаратов.

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