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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">pirogovestnik</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник Национального медико-хирургического центра им. Н.И. Пирогова</journal-title><trans-title-group xml:lang="en"><trans-title>Bulletin of Pirogov National Medical &amp; Surgical Center</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2072-8255</issn><issn pub-type="epub">2782-3628</issn><publisher><publisher-name>Национальный медико-хирургический Центр им. Н.И. Пирогова</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.25881/20728255_2026_21_2_4</article-id><article-id custom-type="elpub" pub-id-type="custom">pirogovestnik-579</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>РЕДАКЦИОННЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>EDITORIAL</subject></subj-group></article-categories><title-group><article-title>АМИЛОИД-АССОЦИИРОВАННЫЕ СОСТОЯНИЯ КАК ОТЯГОЩАЮЩИЙ ФАКТОР ЭНТЕЗОПАТИЙ: КОНЦЕПТУАЛЬНАЯ МОДЕЛЬ</article-title><trans-title-group xml:lang="en"><trans-title>AMYLOID-ASSOCIATED CONDITIONS AS AN AGGRAVATING FACTOR IN ENTHESOPATHIES: A CONCEPTUAL THEORY</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>Шевченко</surname><given-names>Ю. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Shevchenko</surname><given-names>Yu. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кокорин</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kokorin</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">kokorinvv@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Национальный медико-хирургический Центр  им. Н.И. Пирогова»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pirogov National medical and surgical Center</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБУ «Национальный медико-хирургический Центр  им. Н.И. Пирогова»;&#13;
ФКУ «Центральный военный клинический госпиталь  им. П.В. Мандрыка»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pirogov National medical and surgical Center;&#13;
P.V. Mandryka Central Military Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>10</day><month>06</month><year>2026</year></pub-date><volume>21</volume><issue>2</issue><fpage>4</fpage><lpage>10</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Шевченко Ю.Л., Кокорин В.В., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Шевченко Ю.Л., Кокорин В.В.</copyright-holder><copyright-holder xml:lang="en">Shevchenko Y.L., Kokorin V.V.</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://submit.pirogov-vestnik.ru/jour/article/view/579">https://submit.pirogov-vestnik.ru/jour/article/view/579</self-uri><abstract><p>Амилоидозы – группа патологических состояний, характеризующихся внеклеточным отложением амилоида (неправильно свернутых белков) в виде фибрилл, выявляемых при окраске Конго-красным. Амилоидные накопления обнаруживаются в периартикулярных тканях при различных нозологических формах. Их клиническая интерпретация принципиальна: транстиретиновый амилоид (ATTR) в карпальном канале может служить ранним маркером ATTR-кардиомиопатии; длительный очаг хронического воспаления (например, хронический остеомиелит) ассоциирован с риском AA-амилоидоза, включая кардиальное поражение; бактериальные амилоиды (curli) рассматриваются как потенциальный фактор поддержания воспаления и запуска амилоидогенеза в периартикулярных тканях. Концепция амилоидассоциированных состояний раскрывает роль амилоидной инфильтрации периартикулярных тканей в патогенезе энтезопатий и влияние диспротеиноза на свойства внеклеточного матрикса и персистирование ремоделирования энтезиса. Практическое значение имеет раннее выявление амилоида в послеоперационных биоптатах периартикулярных тканей: его наличие следует рассматривать как «настораживающий признак», требующий обязательного субтипирования с помощью современных методов протеомики, что повышает точность ранней диагностики ATTR- и AL-вариантов кардиального поражения до клинической манифестации заболевания и влияет на дальнейшую тактику лечения пациента.</p></abstract><trans-abstract xml:lang="en"><p>Amyloidoses are a group of conditions in which extracellular amyloid deposits (misfolded proteins) are present in the form of fibrils. A special Congo red stain is used for their detection. Amyloid deposits are frequently found in periarticular tissues across various disease entities, and their clinical interpretation is essential: transthyretin amyloid (ATTR) in the carpal tunnel may serve as an early marker of future ATTR cardiomyopathy; a persistent focus of chronic inflammation (e.g., chronic osteomyelitis) is associated with a risk of AA amyloidosis, including cardiac involvement; bacterial amyloids (curli) are considered potential factors that sustain inflammation and initiate amyloidogenesis in periarticular tissues. The concept of amyloid-associated conditions highlights the role of amyloid infiltration of periarticular tissues in the pathogenesis of enthesopathies and the impact of dysproteinosis on extracellular matrix properties and persistent enthesis remodeling. The early detection of amyloid in surgical biopsies of periarticular tissue has practical significance: its presence should be considered as a “warning sign” requiring mandatory subtyping of the modern proteomic techniques (including LC-MS/MS). This approach improves the accuracy of early diagnosis of ATTR and AL variants of cardiac involvement prior to clinical manifestation of the disease and influences the further treatment strategy for the patient.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>периартикулярные ткани</kwd><kwd>энтезис</kwd><kwd>энтезопатия</kwd><kwd>ангиогенез</kwd><kwd>амилоид</kwd><kwd>коллагенопатия</kwd><kwd>диспротеиноз</kwd><kwd>внеклеточный матрикс</kwd></kwd-group><kwd-group xml:lang="en"><kwd>periarticular tissues</kwd><kwd>enthesis</kwd><kwd>enthesopathy</kwd><kwd>angiogenesis</kwd><kwd>amyloid</kwd><kwd>collagenopathy</kwd><kwd>dysproteinosis</kwd><kwd>extracellular matrix</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">Scott PP, Scott WWJr, Siegelman SS. Amyloidosis: an overview. 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