ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet2017473-76ometendo-9528Research ArticleЛекцияLectureМетаболические механизмы развития и компенсации осмотического стресса в головном мозгеMetabolic mechanisms of development and compensation of osmotic stress in the brainПигароваЕкатерина АлександровнаPigarovaEkaterina A.

к.м.н.

PhD

kpigarova@gmail.comДзерановаЛариса КонстантиновнаDzeranovaLarisa K.

д.м.н.

ScD

dzeranovalk@yandex.ru<p>ФГБУ &laquo;Национальный медицинский исследовательский центр эндокринологии&raquo; Минздрава России</p>Россия<p>Endocrinology Research Centre</p>Russian Federation2017271220171447376Copyright &#x00A9; Пигарова Е.А., Дзеранова Л.К., 20172017Пигарова Е.А., Дзеранова Л.К.Pigarova E.A., Dzeranova L.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/9528

Внеклеточная жидкость головного мозга, состоящая из цереброспинальной и интерстициальной жидкости, в норме изотонична плазме крови. Проблемы возникают при быстром изменении осмоляльности или циркулирующей крови или жидкостей головного мозга. Проницаемость гематоэнцефалического барьера ниже, чем периферических капиллярах, но эта проницаемость все равно в несколько раз больше, чем пассивная проницаемость для электролитов или глюкозы. Вследствие этой разницы считается, что мозг подобен осмометру: отекает при снижении осмоляльности плазмы и сжимается (дегидратируется), когда плазма становится гипертоничной. Осмотический стресс оказывает непосредственное влияние на функционирование головного мозга и запускает физиологические компенсаторные механизмы, при недостаточности которых вследствие интенсивности или продолжительности стресса, могут развиться необратимые тяжелые осложнения. Знание и понимание этих процессов являются основой для предупреждения их развития и лечения.

Extracellular fluid of the brain, consisting of cerebrospinal fluid and interstitial fluid, is normally isotonic to blood plasma. Problems arise with a rapid change in osmolality of circulating blood or interstitial brain fluid. The permeability of the blood-brain barrier is lower than in the peripheral capillaries, but this permeability is still several times greater than the passive permeability for electrolytes or glucose. Because of this difference, it is believed that the brain is like an osmometer: it swells with reduced plasma osmolality and contracts (dehydrated) when the plasma becomes hypertonic. Osmotic stress has a direct effect on the functioning of the brain and triggers physiological compensatory mechanisms, in the absence of which due to the intensity or duration of stress, irreversible serious complications may develop. Knowledge and understanding of these processes are the basis for preventing their development and treatment.

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