N.P. Shimanovskya, M.M. Rasulov, S.N. Bobkova, O.A. Belikova, M.K. Nurbekov, M.V. Zvereva

In a review modern data about a role of kathepsines in pathogenesis an atherosclerosis are cited, a heart attack of a myocardium and ability of kathepsines to adjust a number of factors of curtailing system of blood. The functioning optimum of kathepsines at pH 4-5, that corresponds pH in лизосомах, but kathepsines are capable to function also at neutral pH, out of lysosoms, but with low efficiency. Except functioning in the general circulation of the cellular fibers, separate kathepsines have also specific functions progressions of a cellular cycle, for example, participate in presentation of antigenes, a homeostasis of epidermis, to destroy extracellular matrix if secreting in extracellular space, or to cause programmed cellular destruction (apoptosis) if are liberated in cytozol. Apoptosis has drawn to itself attention of cardiologists as the potential pathogenetic factor at various cardiovascular diseases. Morphological signs of apoptosis are found out both in vessels, and in the myocardium in reply to influence hypoxia, oxidizing stress, reperfusion at a myocardium ischemia, postinfarctic changes and at development of warm insufficiency. Now processes апоптоза in патогенезе дилатационной and ischemic cardiamyopathy, arythmogenic dysplasya of right ventriculi, transplant tearing away are intensively investigated at aorto-coronaric shunting. The most studied are processes of apoptosis at formation of a coronary atherosclerosis. The massive cellular destruction along with accumulation lipid and collagenic weight, a congestion of foamy cages, and macrophages is one of the basic morphological characteristics of an atherosclerotic plaque. Considering, that at stimulation macrophages the person secreting cystatin extracellular, and the atherosclerosis is considered as inflammatory disease in which mechanism of development take part macrofags, research of local changes cystatin (in a zone of an arrangement of an atherosclerotic plaque) is perspective. Plaques are characterized by activity increase cysteines proteases and decrease in level of their core endogenic inhibitors - cystatin C (infringement of this balance leads to degradation matrix walls of arteries). According to last experimental data, an atherosclerosis consider as consequence of expression decrease of cystatin C, and deficiency lysosomes cysteines proteasae of cysteins proteasae of kathepsine S promotes the prevention of development of an experimental atherosclerosis. Considerable reduction of concentration cystatin C in whey of blood at patients with abdominal dilatation aortas so, possibly, cystatin C operates not only in a place of formation of atherosclerotic defeat of arteries is besides, shown, but also is system, at level of the whole organism (change of an indicator in blood whey). These data allow to assume, that an expression cystatin C and its parity and cysteines protheases are key in regulation remodeling arterial wall at an atherosclerosis and progressing aorta aneurysms. At persons of 50-65 years, in comparison with practically healthy faces, increase of concentration СРБ and cystatin C in blood whey is revealed. Cited data allow to consider all these facts not only in the isolated kind, but also in a complex, and to emphasize the important role which play of kathepsines in a complex circuit in pathogenesis an atherosclerosis. Interest to this problem, and also necessity of accumulation of new data and their new judgement is emphasized.