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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">docru</journal-id><journal-title-group><journal-title xml:lang="ru">Доктор.Ру</journal-title><trans-title-group xml:lang="en"><trans-title>Title</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1727-2378</issn><issn pub-type="epub">2713-2994</issn><publisher><publisher-name>ООО "ГК "РУСМЕДИКАЛ"</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.31550/1727-2378-2022-21-5-47-52</article-id><article-id custom-type="elpub" pub-id-type="custom">docru-280</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>АКУШЕРСТВО И ПЕРИНАТОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>OBSTETRICS AND PERINATOLOGY</subject></subj-group></article-categories><title-group><article-title>Роль тромбоцитов в формировании иммунологической толерантности при привычном выкидыше</article-title><trans-title-group xml:lang="en"><trans-title>The Role of Platelets in the Formation of Immunological Tolerance in Recurrent Miscarriage</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1155-014X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Жукова</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhukova</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Жукова Анастасия Сергеевна — к. б. н., старший научный сотрудник лаборатории клинической иммунологии</p><p>117997, г. Москва, ул. Академика Опарина, д. 4</p></bio><bio xml:lang="en"><p>4 Academician Oparin Str., Moscow, 117997</p></bio><email xlink:type="simple">anastasia.s.belyaeva@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1139-3797</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ванько</surname><given-names>Л. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Vanko</surname><given-names>L. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ванько Людмила Викторовна — д. м. н., профессор, ведущий научный сотрудник лаборатории клинической иммунологии</p><p>117997, г. Москва, ул. Академика Опарина, д. 4</p></bio><bio xml:lang="en"><p>4 Academician Oparin Str., Moscow, 117997</p></bio><email xlink:type="simple">l_vanko@oparina4.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5023-3476</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кречетова</surname><given-names>Л. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Krechetova</surname><given-names>L. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кречетова Любовь Валентиновна — д. м. н., заведующая лабораторией клинической иммунологии</p><p>117997, г. Москва, ул. Академика Опарина, д. 4</p></bio><bio xml:lang="en"><p>4 Academician Oparin Str., Moscow, 117997</p></bio><email xlink:type="simple">k_l_v@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5153-5422</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хорошкеева</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Khoroshkeeva</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хорошкеева Ольга Владимировна — врач 2-го акушерского отделения патологии беременности</p><p>117997, г. Москва, ул. Академика Опарина, д. 4</p></bio><bio xml:lang="en"><p>4 Academician Oparin Str., Moscow, 117997</p></bio><email xlink:type="simple">o_khoroshkeeva@oparina4.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9201-2281</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тетруашвили</surname><given-names>Н. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Tetruashvili</surname><given-names>N. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Тетруашвили Нана Картлосовна — д. м. н., доцент, заместитель директора Института акушерства по научной работе, заведующая отделом медицины плода и 2-м акушерским отделением патологии беременности</p><p>117997, г. Москва, ул. Академика Опарина, д. 4</p></bio><bio xml:lang="en"><p>4 Academician Oparin Str., Moscow, 117997</p></bio><email xlink:type="simple">tetrauly@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>FSBI “National Medical Research Center for Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov” Ministry of Healthcare of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>19</day><month>02</month><year>2025</year></pub-date><volume>21</volume><issue>5</issue><issue-title>ГИНЕКОЛОГИЯ</issue-title><fpage>47</fpage><lpage>52</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Жукова А.С., Ванько Л.В., Кречетова Л.В., Хорошкеева О.В., Тетруашвили Н.К., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Жукова А.С., Ванько Л.В., Кречетова Л.В., Хорошкеева О.В., Тетруашвили Н.К.</copyright-holder><copyright-holder xml:lang="en">Zhukova A.S., Vanko L.V., Krechetova L.V., Khoroshkeeva O.V., Tetruashvili N.K.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://docru.elpub.ru/jour/article/view/280">https://docru.elpub.ru/jour/article/view/280</self-uri><abstract><p>Цель обзора: анализ и обобщение данных об участии тромбоцитов в формировании иммунологической толерантности при физиологическом течении беременности и при привычном выкидыше. Основные положения. Растворимые факторы тромбоцитарного происхождения определяют вовлеченность данных клеток в эндокринную регуляцию плаценты, инициируют и поддерживают инвазию трофобласта. Показана способность тромбоцитов оказывать влияние на баланс М1- и М2-макрофагов, ингибировать цитотоксический потенциал NK-клеток и антиген-презентирующую способность дендритных клеток. Взаимодействие тромбоцитов с регуляторными Т-клетками инициирует привлечение лимфоцитарных клеток в место воспаления и их активацию. Дифференцировка иммунных клеток и изменение их функциональной активности, направленное на создание условий, благоприятных для пролонгирования беременности, во многом определяются как растворимыми факторами тромбоцитарного происхождения, так и непосредственным взаимодействием мембранных рецепторов, сопровождающимся образованием тромбоцитарно-лейкоцитарных комплексов. Заключение. Тромбоциты и продукты их активации играют важную роль в создании условий, необходимых для наступления беременности и успешного ее пролонгирования до доношенного срока. Функциональное состояние тромбоцитов определяет успех плацентации как непосредственно (через контроль гемодинамических показателей в сосудах плаценты, усиление инвазивности вневорсинчатого трофобласта, влияние на эндокринный фон), так и опосредованно (путем модулирования функций иммунокомпетентных клеток децидуальной оболочки), что подчеркивает их значимость в реализации идиопатического привычного выкидыша.</p></abstract><trans-abstract xml:lang="en"><p>Objective of the Review: Аnalysis of literature and summarizing of data on the participation of platelets in the formation of immunological tolerance during the physiological pregnancy and recurrent miscarriage.Key points. Platelet-derived soluble factors determine their involvement in the endocrine regulation of the placenta, initiate and maintain trophoblast invasion. Platelets are able to influence the balance of M1 and M2 macrophages, inhibit the cytotoxic potential of NK cells and the antigen-presenting ability of dendritic cells. The interaction of platelets with regulatory T cells initiates the recruitment of lymphocyte cells to the site of inflammation and their activation. It has been shown that the differentiation of immune cells and changes in their functional activity, aimed at creating conditions favorable for prolonging pregnancy, are largely determined by both platelet-derived soluble factors and the formation of platelet-leukocyte complexes.Conclusion. Platelets and products of their activation play an important role in creating the conditions necessary for the onset of pregnancy and its prolongation to full term. The functional state of platelets determines the success of placentation both directly (through the control of hemodynamic parameters in the placental vessels, increased invasiveness of the extracellular trophoblast, the effect on the endocrine background) and indirectly by modulating the functions of decidual immune cells, which determines their contribution in the implementation of idiopathic pregnancy loss.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>тромбоциты</kwd><kwd>тромбоцитарно-лейкоцитарные взаимодействия</kwd><kwd>иммунорегуляция</kwd><kwd>привычный выкидыш</kwd><kwd>невынашивание беременности</kwd></kwd-group><kwd-group xml:lang="en"><kwd>platelets</kwd><kwd>platelet-leukocyte interaction</kwd><kwd>immunoregulation</kwd><kwd>recurrent abortion</kwd><kwd>pregnancy loss</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Работа поддержана финансированием государственного задания «Разработка системы прогнозирования осложнений и исходов беременностей у женщин с привычным выкидышем» № 16-А21.</funding-statement><funding-statement xml:lang="en">This work was supported by the funding of the State Assignment No. 16-А21: “Development of a system for predicting complications and outcomes of pregnancy in women with recurrent miscarriage”.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Малышкина А.И., Таланова И.Е., Сотникова Н.Ю., Крошкина Н.В. 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