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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medecol</journal-id><journal-title-group><journal-title xml:lang="ru">Медицина и экология</journal-title><trans-title-group xml:lang="en"><trans-title>Medicine and ecology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2305-6045</issn><issn pub-type="epub">2305-6053</issn><publisher><publisher-name>Карагандинский медицинский университет</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.59598/ME-2305-6053-2025-117-4-8-17</article-id><article-id custom-type="elpub" pub-id-type="custom">medecol-1144</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LITERATURE REVIEWS</subject></subj-group></article-categories><title-group><article-title>Гиперсенситивный пневмонит: этиопатогенетические механизмы прогрессирования</article-title><trans-title-group xml:lang="en"><trans-title>Hypersensitive pneumonitis: etiopathogenetic mechanisms of disease progression</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Есенгельдинова</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Yessengeldinova</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мадина Айтпековна Есенгельдинова</p><p>010000, г. Астана, ул. Бейбитшилик, 49А;</p><p>010000, г. Астана, пр. Мәңгілік Ел, 80</p></bio><bio xml:lang="en"><p>Madina Aitpekovna Yessengeldinova</p><p>010000, Astana c., Beibitshilik str. 49A;</p><p>010000, Astana c., Mangilik El ave., 80</p></bio><email xlink:type="simple">madina_eseng@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бакенова</surname><given-names>Р. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Bakenova</surname><given-names>R. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>010000, г. Астана, пр. Мәңгілік Ел, 80</p></bio><bio xml:lang="en"><p>010000, Astana c., Mangilik El ave., 80</p></bio><email xlink:type="simple">kense@bmc.mcudp.kz</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сейсембеков</surname><given-names>Т. З.</given-names></name><name name-style="western" xml:lang="en"><surname>Seisembekov</surname><given-names>T. Z.</given-names></name></name-alternatives><bio xml:lang="ru"><p>010000, г. Астана, ул. Бейбитшилик, 49А</p></bio><bio xml:lang="en"><p>010000, Astana c., Beibitshilik str. 49A</p></bio><email xlink:type="simple">rektorat@amu.kz</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бакиева</surname><given-names>К. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Bakiyeva</surname><given-names>K. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>010000, г. Астана, ул. Бейбитшилик, 49А;</p><p>010000, г. Астана, пр. Мәңгілік Ел, 80</p></bio><bio xml:lang="en"><p>010000, Astana c., Beibitshilik str. 49A;</p><p>010000, Astana c., Mangilik El ave., 80</p></bio><email xlink:type="simple">rektorat@amu.kz</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">НАО «Медицинский университет Астана»; Больница Медицинского Центра управления делами Президента<country>Казахстан</country></aff><aff xml:lang="en">Astana Medical University NС JSC; Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan<country>Kazakhstan</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Больница Медицинского Центра управления делами Президента<country>Казахстан</country></aff><aff xml:lang="en">Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan<country>Kazakhstan</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">НАО «Медицинский университет Астана»<country>Казахстан</country></aff><aff xml:lang="en">Astana Medical University NС JSC<country>Kazakhstan</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>20</day><month>01</month><year>2026</year></pub-date><volume>0</volume><issue>4</issue><fpage>8</fpage><lpage>17</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Есенгельдинова М.А., Бакенова Р.А., Сейсембеков Т.З., Бакиева К.М., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Есенгельдинова М.А., Бакенова Р.А., Сейсембеков Т.З., Бакиева К.М.</copyright-holder><copyright-holder xml:lang="en">Yessengeldinova M.A., Bakenova R.A., Seisembekov T.Z., Bakiyeva K.M.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://medecol.qmu.kz/jour/article/view/1144">https://medecol.qmu.kz/jour/article/view/1144</self-uri><abstract><p>Гиперсенситивный пневмонит – это хроническое иммуновоспалительное заболевание легких, развивающееся в результате повторного воздействия вдыхаемых антигенов органического или неорганического происхождения. В статье представлен анализ современных данных об этиологических факторах, патогенетических механизмах и региональных особенностях распространения заболевания. Рассмотрены ключевые звенья иммунопатогенеза, включая роль Т-клеточного иммунного ответа, регуляцию цитокинов и процессы фиброгенеза. Отмечено значение генетических факторов, таких как полиморфизмы HLA и укорочение теломер, определяющих индивидуальную восприимчивость и тяжесть течения болезни. Особое внимание уделено изучению потенциальных биомаркеров, отражающих активность воспаления и фиброзного ремоделирования легочной ткани. Подчеркнуты трудности ранней диагностики и идентификации причинно-значимых антигенов. Местные факторы, включая климатические и профессиональные воздействия, влияют на риск сенсибилизации и развития заболевания. Комплексное понимание этиологии, патогенеза и молекулярных механизмов гиперсенситивного пневмонита способствует совершенствованию подходов к раннему выявлению, дифференциальной диагностике и прогнозированию.</p><p>Кроме того, приведены результаты последних исследований, демонстрирующих сходство фиброзного гиперсенситивного пневмонита с идиопатическим легочным фиброзом на молекулярном и морфологическом уровне. Эти данные подчеркивают необходимость своевременного выявления признаков фиброзной трансформации и интеграции молекулярных биомаркеров в клиническую практику. Учитывая отсутствие масштабных отечественных исследований, дальнейшее изучение влияния местных экологических и профессиональных факторов в Казахстане представляется крайне актуальным для уточнения региональных особенностей антигенного воздействия и течения болезни.</p></abstract><trans-abstract xml:lang="en"><p>Hypersensitivity pneumonitis is a chronic immune-mediated inflammatory lung disease that develops as a result of repeated exposure to inhaled organic or inorganic antigens. This article presents an analysis of current data on etiological factors, pathogenetic mechanisms, and regional features of disease distribution. The key elements of immunopathogenesis are discussed, including the role of T-cell-mediated immune responses, cytokine regulation, and fibrogenesis. The significance of genetic factors, such as HLA polymorphisms and telomere shortening, which determine individual susceptibility and disease severity, is highlighted. Particular attention is given to the study of potential biomarkers reflecting the activity of inflammation and fibrotic remodeling. The article emphasizes the challenges of late diagnosis and the difficulties in identifying causative antigens. Local factors, including climatic and occupational exposures, influence the risk of sensitization and disease development. A comprehensive understanding of the etiology, pathogenesis, and molecular mechanisms of hypersensitivity pneumonitis contributes to improving approaches for early detection, differential diagnosis, and prognostic assessment.</p><p>In addition, the review summarizes the results of recent studies demonstrating the overlap between fibrotic hypersensitivity pneumonitis and idiopathic pulmonary fibrosis, particularly in molecular and histopathological patterns. These findings underline the need for timely recognition of fibrotic transformation and the integration of molecular biomarkers into clinical practice. Given the lack of large-scale national studies, further research focusing on local environmental and occupational factors in Kazakhstan is crucial for clarifying regional patterns of antigen exposure and disease progression.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>гиперсенситивный пневмонит</kwd><kwd>патогенез</kwd><kwd>этиология</kwd><kwd>биомаркеры</kwd><kwd>генетическая предрасположенность</kwd><kwd>легочный фиброз</kwd><kwd>экологические факторы</kwd></kwd-group><kwd-group xml:lang="en"><kwd>hypersensitivity pneumonitis</kwd><kwd>pathogenesis</kwd><kwd>etiology</kwd><kwd>pulmonary fibrosis</kwd><kwd>biomarkers</kwd><kwd>genetic predisposition</kwd><kwd>immune mechanisms</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Гиперсенситивный пневмонит Клинический протокол диагностики и лечения. https://online.zakon.kz/Document/?doc_id=36576287</mixed-citation><mixed-citation xml:lang="en">Gipersensitivnyj pnevmonit Klinicheskij protokol diagnostiki i lechenija. https://online.zakon.kz/Document/?doc_id=36576287</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Alberti M.L. 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