{"id":10308,"date":"2020-04-23T04:02:35","date_gmt":"2020-04-23T01:02:35","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/anticorpi-anti-canale-de-potasiu-voltaj-dependente\/"},"modified":"2025-02-06T11:34:28","modified_gmt":"2025-02-06T09:34:28","slug":"anticorpi-anti-canale-de-potasiu-voltaj-dependente","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/anticorpi-anti-canale-de-potasiu-voltaj-dependente\/","title":{"rendered":"\u0410\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u043a \u043f\u043e\u0442\u0435\u043d\u0446\u0438\u0430\u043b \u0437\u0430\u0432\u0438\u0441\u0438\u043c\u044b\u043c \u043a\u0430\u043b\u0438\u0435\u0432\u044b\u0445 \u043a\u0430\u043d\u0430\u043b\u043e\u0432"},"content":{"rendered":"

Informa<\/em><\/strong>\u0163<\/em><\/strong>ii generale <\/em><\/strong><\/p>\n

Canalele de potasiu voltaj-dependente (engl. voltage-gated potassium channels, VGKCs) constituie grupul cel mai r\u0103sp\u00e2ndit \u015fi mai divers de canale ionice controlate de valoarea poten\u0163ialului de membran\u01031<\/sup>.<\/p>\n

VGKCs sunt alc\u0103tuite din 4 subunit\u0103\u0163i \u03b1 transmembranare \u015fi 4 subunit\u0103\u0163i \u03b2 intracelulare. Subunit\u0103\u0163ile \u03b1 se pot combina homotipic sau heterotipic pentru a genera o mare varietate de VGKCs ce sunt larg distribuite \u00een sistemul nervos central \u015fi periferic, av\u00e2nd un rol esen\u0163ial \u00een controlul excitabilit\u0103\u0163ii membranei celulare1;2<\/sup>.<\/p>\n

Anticorpii \u00eendrepta\u0163i \u00eempotriva canalelor de potasiu perturb\u0103 func\u0163ia acestora cu apari\u0163ia unor sindroame de hiperexcitabilitate a sistemului nervos central \u015fi periferic2<\/sup>.<\/p>\n

Spectrul afec\u0163iunilor asociate cu hiperexcitabilitate nervoas\u0103 periferic\u0103 include neuromiotonia<\/em> \u0438 sindromul crampe-fascicula\u0163ii<\/em>. Tulbur\u0103rile pot fi mo\u015ftenite sau dob\u00e2ndite, acestea din urm\u0103 av\u00e2nd o baz\u0103 autoimun\u0103.<\/p>\n

Neuromiotonia dob\u00e2ndit\u0103 (sindromul Isaacs) se caracterizeaz\u0103 clinic prin fascicula\u0163ii \u015fi crampe musculare dureroase, redoare, relaxare muscular\u0103 \u00eent\u00e2rziat\u0103 (pseudomiotonie), miochimie \u015fihiperhidroz\u0103. Este afectat\u0103 \u00een principal musculatura trunchiului \u015fi membrelor. P\u00e2n\u0103 la 20% dintre pacien\u0163i prezint\u0103 tulbur\u0103ri senzitive (parestezii) ceea ce sugereaz\u0103 \u015fi o hiperexcitabilitate a neuronilor senzitivi, al\u0103turi de cea a neuronilor motori. Traseul electromiografic (EMG) indic\u0103 desc\u0103rc\u0103ri sponatane \u015fi repetitive ale unit\u0103\u0163ilor motorii sub form\u0103 de dublete, triplete sau multiplete de o frecven\u0163\u0103 sporit\u0103. Sindromul crample-fascicula\u0163ii reperezint\u0103 o form\u0103 mai u\u015foar\u0103 a aceleia\u015fi condi\u0163ii clinice, f\u0103r\u0103 desc\u0103rc\u0103ri neuromiotonice pe EMG1<\/sup>.<\/p>\n

Neuromiotonia se poate asocia cu alte afec\u0163iuni autoimune (miastenie, lupus eritematos sistemic, diabet zaharat, etc) sau poate fi uneori o condi\u0163ie paraneoplazic\u0103 (asociere cu timom \u00een 10-20% din cazuri \u015fi mult mai rar cu cancerul pulmonar altul dec\u00e2t cel cu celule mici \u2013 SCLC \u2013 sau cu boala Hodgkin). Imunoprecipitarea VGKCs extrase din creier de iepure \u015fi marcate radioactiv cu alfa-dendrotoxin\u0103 a pus \u00een eviden\u0163\u0103 pentru prima dat\u0103 prezen\u0163a \u00een ser a anticorpilor anti-canale de potasiu la aproximativ 40% din pacien\u0163ii cu neuromiotonie, sus\u0163in\u00e2nd patogenia imun\u0103 \u015fi explic\u00e2nd \u00eembun\u0103ta\u0163irea st\u0103rii clinice dup\u0103 plasmaferez\u0103 \u015fi tratament imunosupresor1<\/sup>.<\/p>\n

Anticorpi anti-VGKCs au fost detecta\u0163i \u015fi \u00een sindromul Morvan<\/em>, \u00een care neuromiotonia se combin\u0103 cu manifest\u0103ri disautonome (hiperhidroz\u0103, constipa\u0163ie sever\u0103, incontinen\u0163\u0103 urinar\u0103, tulbur\u0103ri de ritm cardiac) \u015fi simptome de sistem nervos central (insomnii, halucina\u0163ii, tulbur\u0103ri ale memoriei de scurt\u0103 durat\u0103, crize epileptice). \u00cen aproximativ 40% din cazuri este depistat\u0103 o tumor\u0103 subiacent\u0103 (timom sau SCLC)3;4<\/sup>.<\/p>\n

Encefalita limbic\u0103<\/em> cu anti-VGKCs a fost primul sindrom SNC descris ca fiind asociat cu anticorpi \u00eendrepta\u0163i \u00eempotriva antigenelor neuronale de suprafa\u0163\u0103 \u015fi care r\u0103spunde la imunoterapie. Sindromul se caracterizeaz\u0103 clinic prin debut subacut cu agita\u0163ie, confuzie, pierderi ale memoriei de scurt\u0103 durat\u0103, tulbur\u0103ri de somn, accese epileptice (de lob temporal sau par\u0163iale complexe), halucina\u0163ii, idea\u0163ie paranoid\u0103. Hiponatremia este descris\u0103 la majoritatea pacien\u0163ilor \u015fi se datoreaz\u0103 secre\u0163iei inadecvate de hormon antidiuretic (SIADH). Spre deosebire de sindromul Morvan, \u00een encefalita limbic\u0103 lipsesc semnele clinice \u015fi electrofiziologice de hiperexcitabilitate nervoas\u0103 periferic\u0103. Rezonan\u0163a magnetic\u0103 cerebral\u0103 (IRM) este anormal\u0103 \u00een 75% din cazuri, cu un semnal crescut adesea restric\u0163ionat la hipocamp. Pe electroencefalogram\u0103 (EEG) se constat\u0103 \u00eencetinirea ritmurilor de fond \u015fi, adesea, prezen\u0163a unui focar epileptogen. Cazurile paraneoplazice sunt rare, encefalita limbic\u0103 cu anti-VGKCs fiind considerat\u0103 astfel o encefalit\u0103 autoimun\u0103, non-paraneoplazic\u0103, poten\u0163ial tratabil\u0103. De obicei, \u00een decurs de c\u00e2teva s\u0103pt\u0103m\u00e2ni de la ini\u0163ierea terapiei pacien\u0163ii \u00eenregistreaz\u0103 un r\u0103spuns clinic bun sau chiar foarte bun1;2;4;5<\/sup>.<\/p>\n

Pe l\u00e2ng\u0103 afec\u0163iunile men\u0163ionate mai sus, anticorpi anti-VGKCs au fost detecta\u0163i recent la pacien\u0163i cu epilepsie, durere cronic\u0103 idiopatic\u0103, afec\u0163iuni psihiatrice precum \u015fi \u00een unele cazuri de boli neurodegenerative (de exemplu, scleroza lateral\u0103 amiotrofic\u0103 \u015fi boala Creutzfeldt-Jacob)6;7<\/sup>.<\/p>\n

\u00cen ultimii s-au \u00eenregistrat progrese remarcabile \u00een ceea ce prive\u015fte \u00een\u0163elegerea mecanismelor autoimunit\u0103\u0163ii mediate prin anticorpi anti-VGKCs, studiile indic\u00e2nd faptul c\u0103 anticorpii sunt \u00eendrepta\u0163i \u00een principal \u00eempotriva proteinelor asociate canalelor de potasiu (ce formeaz\u0103 complexe cu VGKCs). Din acest motiv, anticorpii sunt denumi\u0163i \u00een prezent anticorpi anti-complex VGKC. Dintre proteinele \u0163int\u0103 ale complexului VGKC men\u0163ion\u0103m LGI1 (leucine-rich glioma inactivated 1) \u015fi CASPR2 (contactin associated protein 2). Anticorpii anti-LGI1 sunt asocia\u0163i \u00een special cu encefalita limbic\u0103 \u015fi cu atacurile distonice facio-brahiale, \u00een timp ce anticorpii anti-CASPR2 predomin\u0103 la pacien\u0163ii cu neuromiotonie \u015fi sindrom Morvan. Exist\u0103 \u00een continuare un procent de pacien\u0163i cu anticorpi anti-complex VGKC la \u0163inta antigenic\u0103 nu este cunoscut\u01033;4;6<\/sup>.<\/p>\n

Din punct de vedere patogenic, exist\u0103 dovezi privind activarea sistemului complementului \u00een cazurile de encefalit\u0103 cu anticorpi anti-complex VGKC ceea ce ar putea explica pierderile neuronale \u00eenregistrate la nivelul hipocampului3<\/sup>.<\/p>\n

Deoarece at\u00e2t pacien\u0163ii cu encefalit\u0103 limbic\u0103 av\u00e2nd anticorpi anti-complex VGKC c\u00e2t \u015fi cei cu sindrom Morvan f\u0103r\u0103 tumori asociate pot beneficia de imunoterapie este important s\u0103 se identifice prezen\u0163a acestor anticorpi \u00een ser4<\/sup>. Mai mult, extinderea spectrului de fenotipuri clinice asociate cu anticorpi anti-complex VGKC \u015fi includerea de pacien\u0163i cu manifest\u0103ri clinice mai restric\u0163ionate (cum ar fi cazuri de pierdere de memorie izolat\u0103 sau forme refractare de epilepsie de lob temporal) care de asemenea par s\u0103 r\u0103spund\u0103 favorabil la tratamentul imunomodulator accentueaz\u0103 importan\u0163a determin\u0103rii \u00een laborator a anticorpilor anti-canale de potasiu2<\/sup>.<\/p>\n

Recomand\u0103ri pentru determinarea anticorpilor anti-canale de potasiu voltaj-dependente<\/em><\/strong><\/p>\n

\u2013\u00a0evaluarea pacien\u0163ilor care prezint\u0103 tulbur\u0103ri neurologice de tip subacut de cauz\u0103 neprecizat\u0103;<\/div>\n
\u2013\u00a0examen LCR \u015fi investiga\u0163ii imagistice sugestive pentru un proces inflamator al sistemului nervos central (\u00een special la nivelul lobului temporal medial)<\/div>\n
\u2013\u00a0suspiciune de encefalopatie autoimun\u0103 la pacien\u0163i cu antecedente personale sau familiale de boli autoimune (diabet zaharat tip 1, tiroidit\u0103 autoimun\u0103, vitiligo, miastenie gravis, artrit\u0103 reumatoid\u0103, lupus eritematos sistemic);<\/div>\n
\u2013\u00a0evaluarea encefalitei limbice;<\/div>\n
\u2013\u00a0\u00een prezen\u0163a unor atacuri distonice facio-brahiale;<\/div>\n
\u2013\u00a0evaluarea pacien\u0163ilor cu hiperexcitabilitate nervoas\u0103 periferic\u0103;<\/div>\n
\u2013\u00a0evaluarea dup\u0103 imunoterapie a pacien\u0163ilor care au fost depista\u0163i anterior cu anti-VGKCs5;8;9<\/sup>.<\/div>\n

Preg\u0103tire pacient <\/em><\/strong>-<\/em>nu este necesar\u0103 o preg\u0103tire special\u010310<\/sup>.<\/p>\n

Specimen recoltat <\/em><\/strong>- <\/em>\u0432\u0435\u043d\u043e\u0437\u043d\u0430\u044f \u043a\u0440\u043e\u0432\u044c10<\/sup>.<\/p>\n

Recipient de recoltare <\/em><\/strong>-<\/em> vacutainer f\u0103r\u0103 anticoagulant, cu\/f\u0103r\u0103 gel separator10<\/sup> .<\/p>\n

Prelucrare necesar\u0103 dup\u0103 recoltare<\/em><\/strong> \u2013 se separ\u0103 serul prin centrifugare10<\/sup>.<\/p>\n

Volum prob\u0103<\/em><\/strong> \u2013 minim 1 mL ser10<\/sup>.<\/p>\n

Cauze de respingere<\/em><\/strong> a probei<\/em><\/strong><\/p>\n

\u2022 ser intens hemolizat;<\/div>\n
\u2022 ser intens lipemic;<\/div>\n
\u2022 ser icteric8;10<\/sup>.<\/div>\n

Stabilitate prob\u0103 <\/em><\/strong>\u2013serulseparat este stabil 14 zile<\/em> la 2-80<\/sup>\u041210<\/sup>.<\/p>\n

Metod\u0103 <\/em><\/strong>\u2013 radioimunologic\u0103 (RIA)10<\/sup>.<\/p>\n

Valori de referin\u0163\u0103 \u015fi interpretarea rezultatelor<\/em><\/strong><\/p>\n

Anticorpi anti-canale de potasiu voltaj-dependente: Negativ10<\/sup>.<\/div>\n
Un rezultat pozitiv trebuie interpretat \u00een contextul clinic al pacientului9;10<\/sup>.<\/div>\n
Anticorpii anti-canale de potasiu voltaj-dependente nu sunt \u00eent\u00e2lni\u0163i la persoanele s\u0103n\u0103toase8<\/sup>.<\/div>\n

Limite \u015fi interferen\u0163e<\/em><\/strong><\/p>\n

Un rezultat negativ nu exclude prezen\u0163a encefalopatiei autoimune sau a unei tumori8<\/sup>.<\/p>\n

\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/span><\/strong><\/p>\n

\u00a01. Kleopa KA. Autoimmune channelopathies of the nervous system. Curr Neuropharmacol<\/em>.<\/em> 2011 Sep;9(3):458-67.<\/span><\/div>\n
2. Buckley C. Diseases Associated with Antibodies to Voltage-GatedPotassium Channels. ACNR<\/em> (Advances in Clinical Neuroscience & Rehabilitation), vol.5, no.4, September\/October 2005.<\/span><\/div>\n
3. Bera KD, Vincent A, Irani SR. Autoimmune Encephalitis\u2014Antibody Targets and Their Potential Pathogenicity in Immunotherapy \u2013 responsive Syndromes. US Neurology, <\/em>2013;9(1):55\u201360.<\/span><\/div>\n
4. Misawa T, Mizusawa H. Anti-VGKC antibody-associated limbic encephalitis\/Morvan syndrome. Brain Nerve<\/em>. 2010 Apr;62(4):339-45.<\/span><\/div>\n
5. Zuliani L, Graus F, Giometto B, Bien C, Vincent A. Central nervous system neuronal\u00a0\u00a0 surface antibody associated syndromes: review and guidelines for recognition. J Neurol Neurosurg Psychiatry<\/em>. 2012 Jun;83(6):638-45.<\/span><\/div>\n
6. Park SB. The clinical relevance of voltage gated potassium channel (VGKC)-complex antibodies: the story is still unfolding.\u00a0 Neurol Neurosurg Psychiatry <\/em>doi:10.1136\/jnnp-2013-305811.<\/span><\/div>\n
7. Watanabe O. VGKC-complex antibodies. Brain Nerve<\/em>. 2013 Apr;65(4):401-11.<\/span><\/div>\n
8. Mayo Medical Laboratories. Test Catalog:Paraneoplastic Autoantibody Evaluation, Serum. www.mayomedicallaboratories.com. Ref Type: Internet Communication, 2014.<\/span><\/div>\n
9. ARUP Laboratories. Voltage-gated Potassium Channel Antibody Disorders. www.aruplab.com. Ref Type: Internet Communication, 2014.<\/span><\/div>\n
10. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate 2014. Ref Type: Catalog.<\/span><\/div>","protected":false},"excerpt":{"rendered":"

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\u0412\u044b\u044f\u0432\u043b\u0435\u043d\u0438\u0435 \u0430\u043d\u0442\u0438\u0442\u0435\u043b (\u0410\u0422) \u043a \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u0443 \u043a\u0430\u043b\u0438\u0435\u0432\u044b\u0445 \u043a\u0430\u043d\u0430\u043b\u043e\u0432 (VGKC) \u043f\u043e\u0437\u0432\u043e\u043b\u044f\u0435\u0442 \u043e\u0431\u044a\u0435\u043a\u0442\u0438\u0432\u0438\u0437\u0438\u0440\u043e\u0432\u0430\u0442\u044c \u0434\u0438\u0430\u0433\u043d\u043e\u0437.<\/p>\n

LGI1 \u0438 \u0421ASPR2 \u2013 \u0431\u0435\u043b\u043a\u0438, \u0430\u0441\u0441\u043e\u0446\u0438\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0435 \u0441 \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u043e\u043c \u043f\u043e\u0442\u0435\u043d\u0446\u0438\u0430\u043b-\u0437\u0430\u0432\u0438\u0441\u0438\u043c\u044b\u0445 \u043a\u0430\u043b\u0438\u0435\u0432\u044b\u0445 \u043a\u0430\u043d\u0430\u043b\u043e\u0432 (VGKC). \u0412\u044b\u044f\u0432\u043b\u0435\u043d\u0438\u0435 \u0430\u0443\u0442\u043e\u0430\u043d\u0442\u0438\u0442\u0435\u043b \u043a \u044d\u0442\u0438\u043c \u0431\u0435\u043b\u043a\u0430\u043c-\u043c\u0438\u0448\u0435\u043d\u044f\u043c \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u0443\u044e\u0442 \u0432 \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0435 \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0433\u043e \u044d\u043d\u0446\u0435\u0444\u0430\u043b\u0438\u0442\u0430 \u0438 \u0434\u0440\u0443\u0433\u0438\u0445 \u0432\u0438\u0434\u043e\u0432 \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0439 \u043f\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u0438 \u0446\u0435\u043d\u0442\u0440\u0430\u043b\u044c\u043d\u043e\u0439 \u043d\u0435\u0440\u0432\u043d\u043e\u0439 \u0441\u0438\u0441\u0442\u0435\u043c\u044b.<\/p>\n

\u0411\u0435\u043b\u043a\u0438 LGI1 (leucine-rich glioma-inactivated protein 1 – \u0431\u043e\u0433\u0430\u0442\u044b\u0439 \u043b\u0435\u0439\u0446\u0438\u043d\u043e\u043c \u0438\u043d\u0430\u043a\u0442\u0438\u0432\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0439 \u0433\u043b\u0438\u043e\u043c\u043e\u0439 \u043f\u0440\u043e\u0442\u0435\u0438\u043d 1) \u0438 \u0421ASPR2 (contactin-associated protein 2 – \u0441\u0432\u044f\u0437\u0430\u043d\u043d\u044b\u0439 \u0441 \u043a\u043e\u043d\u0442\u0430\u043a\u0442\u0438\u043d\u043e\u043c \u043f\u0440\u043e\u0442\u0435\u0438\u043d 2) – \u043a\u043e\u043c\u043f\u043e\u043d\u0435\u043d\u0442\u044b \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u0430 \u043f\u043e\u0442\u0435\u043d\u0446\u0438\u0430\u043b-\u0437\u0430\u0432\u0438\u0441\u0438\u043c\u044b\u0445 \u043a\u0430\u043b\u0438\u0435\u0432\u044b\u0445 \u043a\u0430\u043d\u0430\u043b\u043e\u0432 (VGKC – voltage gated complex). \u0412\u044b\u044f\u0432\u043b\u0435\u043d\u0438\u0435 \u0430\u043d\u0442\u0438\u0442\u0435\u043b \u043a \u044d\u0442\u0438\u043c \u0430\u043d\u0442\u0438\u0433\u0435\u043d\u043d\u044b\u043c \u043c\u0438\u0448\u0435\u043d\u044f\u043c \u0434\u0430\u0435\u0442 \u0432\u043e\u0437\u043c\u043e\u0436\u043d\u043e\u0441\u0442\u044c \u0431\u043e\u043b\u0435\u0435 \u043f\u043e\u0434\u0440\u043e\u0431\u043d\u043e \u043e\u043f\u0438\u0441\u0430\u0442\u044c \u043a\u043b\u0438\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u0435 \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u044b, \u043e\u0442\u043b\u0438\u0447\u0430\u044e\u0449\u0438\u0435\u0441\u044f \u043c\u043e\u043b\u0435\u043a\u0443\u043b\u044f\u0440\u043d\u043e\u0439 \u043e\u0441\u043d\u043e\u0432\u043e\u0439.<\/p>\n

LGI1 \u2013 \u043d\u0435\u0439\u0440\u043e\u043d\u0430\u043b\u044c\u043d\u044b\u0439 \u0431\u0435\u043b\u043e\u043a, \u0443\u0447\u0430\u0441\u0442\u0432\u0443\u044e\u0449\u0438\u0439 \u0432 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u0430\u0446\u0438\u0438 \u0442\u0440\u0430\u043d\u0441-\u0441\u0438\u043d\u0430\u043f\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u0431\u0435\u043b\u043a\u043e\u0432\u044b\u0445 \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u043e\u0432.<\/p>\n

\u0410\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u044b\u0439 \u044d\u043d\u0446\u0435\u0444\u0430\u043b\u0438\u0442, \u0430\u0441\u0441\u043e\u0446\u0438\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0439 \u0441 \u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430\u043c\u0438 \u043a LGI1, \u043f\u0440\u0435\u0434\u0441\u0442\u0430\u0432\u043b\u0435\u043d \u043b\u0438\u043c\u0431\u0438\u0447\u0435\u0441\u043a\u0438\u043c \u044d\u043d\u0446\u0435\u0444\u0430\u043b\u0438\u0442\u043e\u043c \u0441 \u043f\u0430\u0440\u0446\u0438\u0430\u043b\u044c\u043d\u044b\u043c\u0438 \u044d\u043f\u0438\u043b\u0435\u043f\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u043c\u0438 \u043f\u0440\u0438\u0441\u0442\u0443\u043f\u0430\u043c\u0438, \u043f\u0441\u0438\u0445\u043e\u043f\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0438\u043c \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u043e\u043c, \u0433\u0438\u043f\u043e\u043d\u0430\u0442\u0440\u0438\u0435\u043c\u0438\u0435\u0439. \u0412\u043e\u0437\u043c\u043e\u0436\u043d\u0430 \u0430\u0441\u0441\u043e\u0446\u0438\u0430\u0446\u0438\u044f \u0441 \u0440\u0430\u0437\u043b\u0438\u0447\u043d\u044b\u043c\u0438 \u043e\u043f\u0443\u0445\u043e\u043b\u044f\u043c\u0438 (\u0447\u0430\u0449\u0435 \u0440\u0430\u043a\u043e\u043c \u043b\u0435\u0433\u043a\u0438\u0445 \u0438 \u0442\u0438\u043c\u043e\u043c\u043e\u0439).<\/p>\n

CASPR2 \u2013 \u0430\u043a\u0441\u043e\u043d\u0430\u043b\u044c\u043d\u044b\u0439 \u0442\u0440\u0430\u043d\u0441\u043c\u0435\u043c\u0431\u0440\u0430\u043d\u043d\u044b\u0439 \u0431\u0435\u043b\u043e\u043a, \u0447\u043b\u0435\u043d \u0441\u0443\u043f\u0435\u0440\u0441\u0435\u043c\u0435\u0439\u0441\u0442\u0432\u0430 \u043d\u0435\u0439\u0440\u0435\u043a\u0441\u0438\u043d\u0430 (\u0438\u0437\u0432\u0435\u0441\u0442\u043d\u043e\u0433\u043e \u0443\u0447\u0430\u0441\u0442\u0438\u0435\u043c \u0432 \u0444\u043e\u0440\u043c\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u0438 \u0438 \u0440\u0435\u0433\u0443\u043b\u044f\u0446\u0438\u0438 \u0441\u0432\u043e\u0439\u0441\u0442\u0432 \u0441\u0438\u043d\u0430\u043f\u0441\u043e\u0432), \u0441\u0432\u044f\u0437\u0430\u043d\u043d\u044b\u0439 \u0441 \u043a\u043e\u043d\u0442\u0430\u043a\u0442\u0438\u043d\u043e\u043c 2). \u041b\u043e\u043a\u0430\u043b\u0438\u0437\u0443\u0435\u0442\u0441\u044f \u0432 \u043f\u0435\u0440\u0435\u0445\u0432\u0430\u0442\u0430\u0445 \u0420\u0430\u043d\u0432\u044c\u0435 (\u0432 \u0438\u0445 \u044e\u043a\u0441\u0442\u0430\u043f\u0430\u0440\u0430\u043d\u043e\u0434\u0430\u043b\u044c\u043d\u043e\u043c \u0440\u0435\u0433\u0438\u043e\u043d\u0435, \u0433\u0434\u0435 \u0438\u0433\u0440\u0430\u0435\u0442 \u0440\u043e\u043b\u044c \u0432 \u043a\u043b\u0430\u0441\u0442\u0435\u0440\u0438\u0437\u0430\u0446\u0438\u0438 \u0438 \u043b\u043e\u043a\u0430\u043b\u0438\u0437\u0430\u0446\u0438\u0438). \u0441\u0435\u0433\u043c\u0435\u043d\u0442\u0435 \u0430\u043a\u0441\u043e\u043d\u043e\u0432 \u0438 \u0441\u0438\u043d\u0430\u043f\u0441\u0430\u0445. \u041f\u0440\u0438\u0441\u0443\u0442\u0441\u0442\u0432\u0443\u0435\u0442 \u0442\u0430\u043a\u0436\u0435 \u0432 \u0433\u0438\u043f\u043f\u043e\u043a\u0430\u043c\u043f\u0435 \u0438 \u043c\u043e\u0437\u0436\u0435\u0447\u043a\u0435. \u041d\u0435\u0439\u0440\u043e\u043c\u0438\u043e\u0442\u043e\u043d\u0438\u044f (\u0441\u0438\u043d\u0434\u0440\u043e\u043c \u0418\u0441\u0430\u0430\u043a\u0441\u0430), \u0441\u0438\u043d\u0434\u0440\u043e\u043c \u041c\u043e\u0440\u0432\u0430\u043d\u0430 \u0438 \u043b\u0438\u043c\u0431\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u044d\u043d\u0446\u0435\u0444\u0430\u043b\u0438\u0442 \u044f\u0432\u043b\u044f\u044e\u0442\u0441\u044f \u043e\u0441\u043d\u043e\u0432\u043d\u044b\u043c\u0438 \u043a\u043b\u0438\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u043c\u0438 \u043d\u043e\u0437\u043e\u043b\u043e\u0433\u0438\u044f\u043c\u0438, \u043f\u0440\u0438 \u043a\u043e\u0442\u043e\u0440\u044b\u0445 \u0421ASPR2 \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u043c\u0438\u0448\u0435\u043d\u044c\u044e \u0434\u043b\u044f \u0430\u0443\u0442\u043e\u0430\u043d\u0442\u0438\u0442\u0435\u043b.<\/p>\n

\u042d\u043d\u0446\u0435\u0444\u0430\u043b\u0438\u0442, \u0430\u0441\u0441\u043e\u0446\u0438\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0439 \u0441 \u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430\u043c\u0438 \u043a \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u0430\u043c \u043a\u0430\u043b\u0438\u0435\u0432\u044b\u0445 \u043a\u0430\u043d\u0430\u043b\u043e\u0432, \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0432\u0442\u043e\u0440\u043e\u0439 \u043f\u043e \u0440\u0430\u0441\u043f\u0440\u043e\u0441\u0442\u0440\u0430\u043d\u0435\u043d\u043d\u043e\u0441\u0442\u0438 \u0444\u043e\u0440\u043c\u043e\u0439 \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0433\u043e \u044d\u043d\u0446\u0435\u0444\u0430\u043b\u0438\u0442\u0430 \u043f\u043e\u0441\u043b\u0435 \u0430\u043d\u0442\u0438-NMDA-\u0430\u0441\u0441\u043e\u0446\u0438\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0445 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u0439. \u0414\u043b\u044f \u0443\u0441\u0442\u0430\u043d\u043e\u0432\u043b\u0435\u043d\u0438\u044f \u0434\u0438\u0430\u0433\u043d\u043e\u0437\u0430 \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0433\u043e \u044d\u043d\u0446\u0435\u0444\u0430\u043b\u0438\u0442\u0430 \u043d\u0435\u043e\u0431\u0445\u043e\u0434\u0438\u043c\u043e \u0438\u043c\u043c\u0443\u043d\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u043e\u0435 \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0435 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0438 \u043a\u0440\u043e\u0432\u0438 \u043d\u0430 \u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430 \u043a \u0430\u043d\u0442\u0438\u0433\u0435\u043d\u0430\u043c \u0421ASPR2 \u0438 LGI1.<\/p>\n

\u041f\u043e\u043a\u0430\u0437\u0430\u043d\u0438\u044f \u043a \u043d\u0430\u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044e:<\/p>\n

    \n
  • \u0434\u0438\u0444\u0444\u0435\u0440\u0435\u043d\u0446\u0438\u0430\u043b\u044c\u043d\u0430\u044f \u0434\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0430 \u043d\u0435\u0439\u0440\u043e\u043c\u0438\u043e\u0442\u043e\u043d\u0438\u0438;<\/li>\n
  • \u0414\u0438\u0430\u0433\u043d\u043e\u0441\u0442\u0438\u043a\u0430 \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0433\u043e \u044d\u043d\u0446\u0435\u0444\u0430\u043b\u0438\u0442\u0430; \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u0430 \u043b\u0438\u043c\u0431\u0438\u0447\u0435\u0441\u043a\u043e\u0433\u043e \u044d\u043d\u0446\u0435\u0444\u0430\u043b\u0438\u0442\u0430;<\/li>\n
  • \u0414\u0438\u0444\u0444\u0435\u0440\u0435\u043d\u0446\u0438\u0430\u0446\u0438\u044f \u0441\u0443\u0434\u043e\u0440\u043e\u0436\u043d\u043e\u0433\u043e \u0438 \u043c\u0438\u043e\u043a\u043b\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u043e\u0433\u043e \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u0430, \u044d\u043a\u0441\u0442\u0440\u0430\u043f\u0438\u0440\u0430\u043c\u0438\u0434\u043d\u044b\u0445 \u0440\u0430\u0441\u0441\u0442\u0440\u043e\u0439\u0441\u0442\u0432;<\/li>\n
  • \u041f\u043e\u0434\u043e\u0437\u0440\u0435\u043d\u0438\u0435 \u043d\u0430 \u043f\u0430\u0440\u0430\u043d\u0435\u043e\u043f\u043b\u0430\u0441\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0435 \u043f\u0440\u043e\u0446\u0435\u0441\u0441\u044b.<\/li>\n
  • \u043e\u0446\u0435\u043d\u043a\u0430 \u043f\u0440\u043e\u0433\u0440\u0435\u0441\u0441\u0438\u0440\u043e\u0432\u0430\u043d\u0438\u044f \u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0433\u043e \u044d\u043d\u0446\u0435\u0444\u0430\u043b\u0438\u0442\u0430;<\/li>\n<\/ul>\n

    \u0417\u043d\u0430\u0447\u0435\u043d\u0438\u0435 \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u043e\u0432<\/p>\n

    \u041f\u0440\u0438\u0447\u0438\u043d\u044b \u043f\u043e\u0432\u044b\u0448\u0435\u043d\u0438\u044f \u0443\u0440\u043e\u0432\u043d\u044f:
    \n\u0430\u0443\u0442\u043e\u0438\u043c\u043c\u0443\u043d\u043d\u044b\u0439 \u044d\u043d\u0446\u0435\u0444\u0430\u043b\u0438\u0442, \u0430\u0441\u0441\u043e\u0446\u0438\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0439 \u0441 \u0430\u043d\u0442\u0438\u0442\u0435\u043b\u0430\u043c\u0438 \u043a \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u0430\u043c \u043a\u0430\u043b\u0438\u0435\u0432\u044b\u0445 \u043a\u0430\u043d\u0430\u043b\u043e\u0432.<\/p>\n

    \u041f\u0440\u0438\u0447\u0438\u043d\u044b \u0441\u043d\u0438\u0436\u0435\u043d\u0438\u044f \u0443\u0440\u043e\u0432\u043d\u044f:
    \n\u043e\u0442\u0441\u0443\u0442\u0441\u0442\u0432\u0438\u0435 \u0430\u043d\u0442\u0438\u0442\u0435\u043b;
    \n\u043d\u0438\u0437\u043a\u0438\u0439 \u0443\u0440\u043e\u0432\u0435\u043d\u044c \u0410\u0414.<\/p>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[934],"product_tag":[],"class_list":{"0":"post-10308","1":"product","2":"type-product","3":"status-publish","5":"product_cat-autoanticorpi-in-afectiuni-neurologice","7":"first","8":"instock","9":"sold-individually","10":"shipping-taxable","11":"purchasable","12":"product-type-simple"},"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product\/10308","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/comments?post=10308"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10308"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=10308"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=10308"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=10308"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}