zdmeЗдоровье мегаполисаCity Healthcare2713-2617ГБУ «НИИОЗММ ДЗМ»10.47619/2713-2617.zm.2026.v.7i3;109-124zdme-359Research ArticleОБЗОРЫREVIEWSНейротрофический фактор мозга в патогенезе посттравматического стрессового расстройства: от нейробиологии к биомаркеруBrain-Derived Neurotrophic Factor in the Pathogenesis of Posttraumatic Stress Disorder: From Neurobiology to Biomarkerhttps://orcid.org/0000-0002-9605-557XКотельниковаА. В.KotelnikovaA. V.

Котельникова Анастасия Владимировна д-р психол. наук, доцент

119048, г. Москва, ул. Трубецкая, д. 8, стр. 2

Anastasia V. Kotelnikova Dr. Sci. in Psychology, Associate Professor

8, bldg. 2, Trubetskaya ul., 119048, Moscow

pav-kotelnikov@yandex.ruhttps://orcid.org/0009-0009-6622-4975ХовалкоЕ. Н.KhovalkoE. N.

Ховалко Елизавета Николаевна студентка факультета клинической психологии

119048, г. Москва, ул. Трубецкая, д. 8, стр. 2

Elizaveta N. Khovalko Student at the Faculty of Clinical Psychology

8, bldg. 2, Trubetskaya ul., 119048, Moscow

khovalkoelizaveta@gmail.comhttps://orcid.org/0000-0002-2290-3687КукшинаА. А.KukshinaA. A.

Кукшина Анастасия Алексеевна д-р мед. наук, ученый секретарь 

115088, г. Москва, ул. Шарикоподшипниковская, д. 9

Anastasia A. Kukshina Dr Sci. in Medicine, Scientific Secretary, Researcher of the Division of Public Health Research

9, Sharikopodshipnikovskaya ul., 115088, Moscow

KukshinaAA1@zdrav.mos.ruПервый Московский государственный медицинский университет им. И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияSechenov First Moscow State Medical UniversityRussian FederationНаучно-исследовательский институт организации здравоохранения и медицинского менеджмента Департамента здравоохранения города МосквыРоссияResearch Institute for Healthcare Organization and Medical Management of Moscow Healthcare DepartmentRussian Federation20261110202673109124Copyright © Котельникова А.В., Ховалко Е.Н., Кукшина А.А., 20262026Котельникова А.В., Ховалко Е.Н., Кукшина А.А.Kotelnikova A.V., Khovalko E.N., Kukshina A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.city-healthcare.com/jour/article/view/359Актуальность

Актуальность. Посттравматическое стрессовое расстройство (ПТСР) одно из наиболее распро­страненных и социально значимых последствий воздействия экстремального стресса. В основе его патогенеза лежат нарушения нейропластичности, ключевую роль в которых играет мозговой ней­ротрофический фактор (BDNF). В последние десятилетия активно изучается возможность использо­вания показателей системы BDNF в качестве биомаркеров для объективизации диагностики, прогно­за течения и персонализации терапии ПТСР, однако данные остаются противоречивыми и требуют систематизации.

Цель

Цель. Систематизировать и обобщить сведения о роли BDNF в патогенезе ПТСР, рассмотреть молекулярные, генетические и эпигенетические аспекты его дисфункции, а также оце­нить диагностический и прогностический потенциал компонентов системы BDNF как возможных биомаркеров.

Материалы и методы

Материалы и методы. В соответствии с критериями PRISMA проведен систематический поиск в базах PubMed, Scopus, Web of Science, eLibrary и Google Scholar за 2000-2025 гг. с исполь­зованием ключевых слов, отражающих связь BDNF и ПТСР. Включены оригинальные клинические и экспериментальные исследования, метаанализы и систематические обзоры на английском и рус­ском языках.

Результаты

Результаты. Показано, что дисфункция системы BDNF при ПТСР носит многоуровневый характер: от регион-специфичных изменений экспрессии белка до генетических и эпигенетических нарушений. Выявлены противоречия в данных об уровне периферического BDNF, обусловленные ти­пом биоматериала, формой белка и гетерогенностью выборок. Установлено, что определение зрелой формы BDNF, соотношения proBDNF/mBDNF, метилирования промотора гена BDNF и регуляторных микроРНК (miR-182-5p, miR-9-5p, miR-204-5p) обладает прогностической значимостью, ассоциируясь с тяжестью течения, хронификацией и ответом на терапию.

Выводы

Выводы. Использование общего BDNF в качестве самостоятельного диагностического маркера ПТСР в настоящее время нецелесообразно. Наиболее перспективным является включение комплекса показателей системы BDNF (генотип, эпи­генетические метки, уровень зрелого белка, микроРНК) в мультифакторные модели для прогноза течения и персонализации терапии.

Background

Background. Posttraumatic stress disorder (PTSD) is one of the most prevalent and socially significant consequences of exposure to extreme stress. Its pathogenesis involves impairments in neuroplasticity, in which brain-derived neurotrophic factor (BDNF) plays a key role. In recent decades, the potential of using BDNF system components as biomarkers for objective diagnosis, disease prognosis, and personalized therapy in PTSD has been actively investigated; however, the data remain contradictory and require systematization.

The goal was to systematize and summarize current evidence on the role of BDNF in the pathogenesis of PTSD, to examine the molecular, genetic, and epigenetic aspects of its dysfunction, and to evaluate the diag­nostic and prognostic potential of BDNF system components as possible biomarkers.

Materials and methods

Materials and methods. A systematic literature search was conducted in PubMed, Scopus, Web of Science, eLibrary, and Google Schol­ar databases for the period 2000-2025 in accordance with PRISMA guidelines, using keywords reflecting the relationship between BDNF and PTSD. Original clinical and experimental studies, meta-analyses, and systematic reviews in English and Russian were included.

Results

Results. A multi-layered nature of BDNF system dysfunction in PTSD was shown, ranging from region-specific changes in protein expression to genetic and epigenetic alterations. Controversies in peripheral BDNF levels were identified, attributable to differences in biomaterial type, protein form, and sample heterogeneity. Assessment of mature BDNF, the proBDNF/mBDNF ratio, BDNF gene promoter methylation, and regulatory microRNAs (miR-182-5p, miR-9-5p, miR-204-5p) demonstrated prognostic value, being associated with symptom severity, chronicity, and treatment response. The use of total BDNF as an independent diagnostic marker for PTSD is currently not justified. The most promising approach involves integrating a panel of BDNF-related measures (genotype, epigenetic marks, mature protein level, microRNAs) into multifactorial models for disease prognosis and personalized therapy.

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