vfumedВестник Северо-Восточного федерального университета имени М.К. Аммосова. Vestnik of North-Eastern Federal University. Серия «Медицинские науки. Medical Sciences»Vestnik of North-Eastern Federal University. Medical Sciences2587-5590Северо-Восточный федеральный университет имени М.К. Аммосова10.25587/2587-5590-2026-2-15-29vfumed-448Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEРоль микроРНК в поддержании низко – интенсивного воспаления у пациентов с дискогенной болью в спине и комморбидными расстройствами снаThe role of microRNAs in maintaining low-grade inflammation in patients with discogenic back pain and comorbid sleep disordershttps://orcid.org/0000-0003-3565-8657АшхотовА. В.AshkhotovA. V.

АШХОТОВ Азамат Вячеславович, аспирант

г. Санкт-Петербург

ASHKHOTOV, Azamat Vyacheslavovich, postgraduate student

St. Petersburg

ashkhotov.v@mail.ruhttps://orcid.org/0000-0002-2840-837XШнайдерН. А.ShnayderN. A.

ШНАЙДЕР Наталья Алексеевна, доктор медицинских наук, профессор, главный научный сотрудник 

г. Санкт-Петербург, г. Красноярск

SHNAYDER, Natalia Alekseevna, Dr. Sci. (Medicine), Professor, Chief Researcher

St. Petersburg; Krasnoyarsk

naschnaider@yandex.ruhttps://orcid.org/0000-0002-4378-1308ТрефиловВ. В.TrefilovaV. V.

ТРЕФИЛОВА Вера Васильевна, аспирант 

г. Санкт-Петербург

TREFILOVA, Vera Vasilyevna, postgraduate student

St. Petersburg

vera.v.trefilova@yandex.ruhttps://orcid.org/0000-0003-1874-9434НасыроваР. Ф.NasyrovaR. F.

НАСЫРОВА Регина Фаритовна, доктор медицинских наук, главный научный сотрудник

г. Санкт-Петербург

NASYROVA, Regina Faritovna, Dr. Sci. (Medicine), Chief Researcher

St. Petersburg

regina_nmrcpn@mail.ruИнститут персонализированной психиатрии и неврологии НМИЦ ПН им. В.М. Бехтерева; Отделение неврологии ООО «Единые Медицинские Системы»РоссияInstitute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology; Department of Neurology, Unified Medical SystemsRussian FederationИнститут персонализированной психиатрии и неврологии НМИЦ ПН им. В.М. Бехтерева; Центр коллективного пользования «Молекулярные и клеточные технологии» КрасГМУ им. проф. В.Ф. Войно-ЯсенецкогоРоссияInstitute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology; Center for Collective Use Molecular and Cellular Technologies, after Professor V.F. Voyno-Yasenetsky State Medical UniversityRussian FederationИнститут персонализированной психиатрии и неврологии НМИЦ ПН им. В.М. Бехтерева; Отделение неврологии ООО «МЕДИЦЕНТР ЮЗ»РоссияInstitute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology; Department of Neurology, MEDICAL CENTER YUZRussian FederationИнститут персонализированной психиатрии и неврологии НМИЦ ПН им. В.М. БехтереваРоссияInstitute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Research Medical Center for Psychiatry and NeurologyRussian Federation202612072026021529Copyright © Ашхотов А.В., Шнайдер Н.А., Трефилов В.В., Насырова Р.Ф., 20262026Ашхотов А.В., Шнайдер Н.А., Трефилов В.В., Насырова Р.Ф.Ashkhotov A.V., Shnayder N.A., Trefilova V.V., Nasyrova R.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.smnsvfu.ru/jour/article/view/448

Хроническая дискогенная боль в спине и коморбидные расстройства сна (инсомния) представляют собой труднокурабельную патологию в практике невролога. В развитии коморбидности предполагается наличие общих патогенетических путей, но однозначных связующих «мостиков» до конца не определено. В современных исследованиях раскрывается феномен низкоинтенсивного воспаления НИВ, который имеет место в основе прогрессирования дегенерации межпозвонковых дисков и инсомнии. В клинической практике невролога нет валидизированных специфических и чувствительных методов определения течения НИВ, потому необходима разработка перспективных диагностических панелей, одним из которых выступают сигнатуры малых некодирующих рибонуклеиновых кислот (микроРНК), так как в доклинических исследованиях показано их участие в эпигенетическом контроле НИВ. Установлено влияние микроРНК в поддержании LGI, нейропластичности и дисфункции циркадных. Цель данного обзора – обновление знаний неврологов о роли микроРНК (через связующий «мостик» – НИВ) в патогенезе хронического болевого синдрома, ассоциированного с инсомнией у пациентов с дегенерацией межпозвонковых дисков (ДМПД), и оценить их в диагностическом потенциале. Проведен поиск публикаций в базах данных PubMed, Springer, Reseаrch Gate, Google Scholar, Cochrane и e-Library за 2016–2026 гг. В анализ включены оригинальные доклинические и клинические исследования, систематические обзоры. Обобщены данные о более чем 40 микроРНК, вовлеченных в регуляцию ключевых воспалительных путей (NF-κB, NLRP3-инфламмасома и др.), циркадных генов (PER, BMAL1, CLOCK и др.) в клетках межпозвонковых дисков (МПД) и центральной нервной системе. Выделена сигнатура из наиболее перспективных кандидатов (miR-29a, miR-132, miR-155, miR-34a-5p, семейство let-7), одновременно участвующих в регуляции НИВ, болевой сигнализации и циркадных ритмов. Показано, что уровень экспрессии некоторых микроРНК (miR-340-5p, miR-494) коррелирует с тяжестью ДМПД по данным МРТ и может быть использован в качестве чувствительного эпигенетического биомаркера. МикроРНК являются перспективными эпигенетическими биомаркерами и терапевтическими мишенями для персонализированной терапии дискогенной боли в спине и инсомнии при ДМПД. Необходимы дальнейшие «мостовые» и валидационные клинические исследования для внедрения сигнатуры микроРНК в практику невролога.

Chronic discogenic back pain and comorbid sleep disorders (insomnia) are a pressing and difficult-to-treat condition in the practice of neurologist. The development of this comorbidity is thought to involve common pathogenetic pathways, but the definitive connecting “bridges” have not been fully established. A growing number of recent studies focus on the phenomenon of low-grade inflammation (LGI), which underlies both the progression of intervertebral disc degeneration and insomnia. Since there are no validated, specific, and sensitive methods for assessing LGI in clinical neurology, the development of promising diagnostic panels is necessary. Signatures of small non-coding ribonucleic acids (microRNAs) represent one such promising panel, as preclinical studies have demonstrated their involvement in the epigenetic control of LGI. The influence of microRNAs on sustaining LGI, neuroplasticity, and circadian dysfunction has been established. The aim of this review is to update neurologists’ knowledge on the role of microRNAs (via the connecting “bridge” of LGI) in the pathogenesis of chronic pain syndrome associated with insomnia in patients with intervertebral disc degeneration (IVDD), and to assess their diagnostic potential. A search for publications was conducted in the PubMed, Springer, Research Gate, Google Scholar, Cochrane, and e-Library databases for the period 2016–2026 using the keywords: inflammation, lowgrade inflammation, intervertebral disc degeneration, discogenic pain syndrome, neuropathic pain syndrome, comorbidity, insomnia, diagnosis, epigenetics, microRNAs. The analysis includes original preclinical and clinical studies, as well as systematic reviews. The review summarizes data on more than 40 microRNAs involved in the regulation of key inflammatory pathways (NF-κB, NLRP3 inflammasome, etc.) and circadian genes (PER, BMAL1, CLOCK, etc.) in intervertebral disc (IVD) cells and the central nervous system. A signature of the most promising candidates (miR-29a, miR-132, miR-155, miR-34a-5p, and the let-7 family), which are simultaneously involved in the regulation of LGI, pain signaling, and circadian rhythms, has been identified. The expression levels of certain microRNAs (miR-340-5p, miR-494) have been shown to correlate with the severity of IVDD on MRI and may serve as sensitive epigenetic biomarkers. MicroRNAs are promising epigenetic biomarkers and therapeutic targets for personalized therapy of discogenic back pain and insomnia in IVDD. Further translational and validation clinical studies are required to introduce the microRNA signature into neurological practice.

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