Физиологические механизмы действия салицилатов на сердечно-сосудистую систему

Abstract

In modern literature, there is an increased interest in studying the biological and therapeutic effects of salicylates. Extensive clinical trials have demonstrated the effectiveness of acetylsalicylic acid (ASA) and its complex compounds in the treatment and prevention of ischemic heart disease, chronic heart failure, hypertension, and others, which makes it possible to assess the breadth of beneficial effects of ASA on the functioning of the cardiovascular system (CVS) and to state lack of other equivalent medicines in the coming years. The essential direction remains the expansion and enhancement of the known therapeutic activity (antipyretic, analgesic, anti-inflammatory, antioxidant, antidepressant, anti-migraine, anxiolytic, etc.) against the background of reducing and/or eliminating side effects since ASA occupies a leading position among all non-steroidal anti-inflammatory drugs in terms of volumes and one of the first places for the number of side effects. A promising solution to this problem is the creation of complex compounds of salicylates, since the formation of new coordination compounds based on them may lead to the emergence of new useful biological properties, as well as the strengthening of physiological effects characteristic of ASA, which will help to solve the problem of reducing side effects, resistance to aspirin therapy and increasing the therapeutic potential of the initial compound to obtain effective new-generation drugs. The article summarizes extensive information about the physiological and molecular mechanisms of action of ASA and its derivatives on CVS in health and disease, including on various physiological and biochemical links of the body's homeostasis: vasoregulatory function of the vascular endothelium, vascular-platelet hemostasis; fibrinolysis; processes of free radical oxidation and antioxidant protection; cyclooxygenase and lipoxygenase pathways of arachidonic acid oxidation; molecular markers of inflammation processes (prostaglandins; pro- and anti-inflammatory cytokines; anti-inflammatory lipid mediators). We analyzed and described the literature data and our own experimental studies of salicylates' effects on central hemodynamics and tissue microcirculation. We concluded that it is promising to study quantitative and qualitative changes in microcirculatory processes under the influence of ASA and its derivatives, which will clarify the mechanisms of these compounds' biological action on the CVS.