healthcareЗдравоохранение. HealthcareHealthcare1027-7218Republican Scientific and Practical Center for Medical Technologies, Informatization, Management and Health Economics10.65249/1027-7218-2026-2-45-57healthcare-251Research ArticleНЕПРЕРЫВНОЕ ПРОФЕССИОНАЛЬНОЕ РАЗВИТИЕCONTINUOUS PROFESSIONAL DEVELOPMENTГеронтология: патофизиологические механизмы старения организма человекаGerontology: pathophysiological mechanisms of human developmentСущевичВ. В.SushchevichV.

Сущевич Виктор Викторович – к. м. н., доцент, врач-методист (заведующий) отделения медицинской статистики

Боровлянский с/с, 201, 223040, Минский район (вблизи аг. Лесной)

Минская ордена Трудового Красного Знамени областная клиническая больницаBelarus202616032026024557Copyright © Сущевич В.В., 20262026Сущевич В.В.Sushchevich V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://healthcare.ejournal.by/jour/article/view/251

Рассмотрены патофизиологические механизмы динамического развития организма, определяющие суть его старения, и основные механизмы, формирующие здоровое старение. Старение – это непрерывный патофизиологический процесс, характеризующийся прогрессирующими возрастными изменениями метаболизма и физико-химических свойств клеток, ведущими к нарушению саморегуляции, регенерации и функционально-структурным изменениям тканей и органов, который эволюционно заложен в нашем геноме. Старение является актуальной проблемой не только в научном, но и в социально-демографическом плане.

This article examines the pathophysiological mechanisms of the body's dynamic development, which determine the essence of aging, and the main mechanisms that shape healthy aging. Aging is a continuous pathophysiological process characterized by progressive age-related changes in metabolism and the physicochemical properties of cells, leading to impaired self-regulation, regeneration, and functional and structural changes in tissues and organs. Aging is an evolving issue, not only from a scientific perspective, but also from a socio-demographic perspective.

геронтологияпатофизиологические механизмыапоптозгенетические и эпигенетические механизмыстарение организмаздоровая старостьgerontologypathophysiological mechanismsapoptosisgenetic and epigenetic mechanismsaging of the organismhealthy agingReferencesКалабихина, И. Демографическое старение в Республике Беларусь: вызовы и новые возможности / И. Калабихина, Н. Красовская, Н. Калмыкова. – Мн. : Белсэнс, 2018. – 47 с.Kalabikhina I., Krasovskaya N., Kalmykova N. Demographic aging in the Republic of Belarus: challenges and new opportunities. Minsk: Belsance; 2018. 47. (in Russian)Пресс-релиз: к 2050 г. число людей старше 60 лет удвоится; необходимы кардинальные социальные перемены (ВОЗ) / Всемирная организация здравоохранения. – URL: https://www.who.int/ru/news/item/30-09-2015-who-number-of-people-over-60-years-set-to-double-by-2050-major-societal-changes-required (дата обращения: 22.07.2025).World Health Organization. Рress release: by 2050 the number of people over 60 will double; dramatic social change (WHO). Available at: https://www.who.int/ru/news/item/30-09-2015-who-number-of-people-over-60-years-set-to-double-by-2050-majorsocietal-changes-required (accessed: 22.07.2025). (in Russian)Old, new and emerging functions of caspases / S. Shalini, L. Dorstyn, S. Dawar, S. Kumar // Cell Death & Differentiation. – 2015. – Vol. 22, № 4. – Р. 526–539.Shalini S., Dorstyn L., Dawar S., Kumar S. Old, new and emerging functions of caspases. Cell Death Differ. 2015; 22(4): 526–539.Профилактика преждевременного старения у женщин / О. Н. Ткачева, Н. К. Рунихина, Ю. В. Котовская [и др.]. – URL: https://rgnkc.ru/images/pdf_documets/metodicheskie_rekomndacii_psj.pdf?ysclid=mlyzmfbmw3493686430 (дата обращения: 22.07.2025).Tkacheva O.N., Runikhina N.K., Kotovskaya Yu.V., et al. Prevention of premature aging in women. Available at: https://rgnkc.ru/images/pdf_documets/metodicheskie_rekomndacii_psj.pdf?ysclid=mlyzmfbmw3493686430 (accessed: 22.07.2025). (in Russian)Биологическая роль митохондрий в старении организма человека / Н. Е. Фомченко, Е. В. Воропаев, А. В. Скачков, Н. Ю. Затора // Проблемы здоровья и экологии. – 2015. – № 4. – С.8–13.Fomchenko N.E., Voropaev E.V., Skachkov A.V., Zatora N.Yu. The biological role of mitochondria in the aging of the human body. Problemy zdorov'ya i ekologii. 2015; 4: 8–13.The Hallmarks of Aging / C. Lopez-Otin, M. Blasco, L. Partridge [et al.] // Cell. – 2013. – Vol. 153, № 6. – Р. 1194–1217.Lopez-Otin C., Blasco M., Partridge L., et al. The Hallmarks of Aging. Cell. 2013; 153(6): 1194–1217.Молекулярные и клеточные механизмы старения: современные представления / Р. К. Михеев, Е. Н. Андреева, О. Р. Григорян [и др.] // Проблемы эндокринологии. – 2023. – Т. 69, № 5. – С. 45–54.Mikheev R.K., Andreeva E.N., Grigoryan O.R., et al. Molecular and cellular mechanisms of aging: modern ideas. Problemy endokrinologii. 2023; 69(5): 45–54.Conservation and divergence in eukaryotic DNA methylation / T. F. Lee, J. Zhai, B. C. Meyers // Proceedings of the National Academy of Sciences of the United States of America. – 2010. – Vol. 107, № 20. – Р. 9027–9028.Lee T.F., Zhai J., Meyers B.C. Conservation and divergence in eukaryotic DNA methylation. Proc Natl Acad Sci USA. 2010; 107(20): 9027–9028.Sarwath, H. Introduction of p16INK4a as a surrogate biomarker for HPV in women with invasive cervical cancer in Sudan / H. Sarwath, D. Bansal, N. Husain // Infectious Agents of Cancer. – 2017. – Vol. 12. – Р. 379–389.Sarwath H., Bansal D., Husain N. Introduction of p16INK4a as a surrogate biomarker for HPV in women with invasive cervical cancer in Sudan. Infect Agent Cancer. 2017; 12: 379–389.Василевич, Н. И. Молекулярные маркеры старения / Н. И. Василевич // Лаборатория и производство. – 2020. – Т. 3, № 13. – С. 118–128.Vasilevich N.I. Molecular markers of aging. Laboratoriya i proizvodstvo. 2020; 3(13): 118–128. (in Russian)Масютина, А. М. Клеточное старение: механизмы и клиническое значение / А. М. Масютина, М. В. Пащенков, Б. В. Пинегин // Иммунология. – 2024. – Т. 45, № 2. – С. 221–234.Masyutina A.M., Pashchenkov M.V., Pinegin B.V. Cellular aging: mechanisms and clinical significance. Immunologiya. 2024; 45(2): 221–234. (in Russian)Влияние эпигенетических факторов на укорочение теломер / М. Ж. Жумагул, А. К. Кыдырбаева, Г. Т. Танеева [и др.] // Вестник Казахского медицинского университета. – 2018. – № 1. – С.457–459.Zhumagul M.Zh., Kydyrbaeva A.K., Taneeva G.T., et al. Influence of epigenetic factors on telomere shortening. Vestnik Kazahskogo medicinskogo universiteta. 2018; 1:457–459. (in Russian)Теломерная теория старения и онкогенеза для медицины. – URL: https://cyberleninka.ru/article/n/telomernayakontseptsiya-stareniya-i-onkogeneza-dlya-meditsiny/viewer (дата обращения: 22.07.2025).Telomeric theory of aging and tumorigenesis for medicine. – Available at: https://cyberleninka.ru/article/n/telomernayakontseptsiya-stareniya-i-onkogeneza-dlya-meditsiny/viewer (accessed: 22.07.2025).The telomere syndromes / M. Armanios, E. Blackburn // Nature Reviews. Genetics. – 2012. – Vol. 13, № 10. – Р. 693–704.The telomere syndromes / M. Armanios, E. Blackburn // Nat Rev Genet. 2012; 13(10): 693–704.Τelomerase inhibitors and activators in aging and cancer : a systematic review / P. Fragkiadaki, E. Renieri, K. Kalliantasi [et al.] // Molecular Medicine Reports. – 2022. – Vol. 25, № 5. – Р. 158–169.Fragkiadaki P., Renieri E., Kalliantasi K., et al. Inhibitors and activators of telemerase in aging and cancer. Mol Med Rep. 2022; 25(5): 158–169.A natural astragalus-based nutritional supplement lengthens telomeres in a middle-aged population : a randomized, doubleblind, placebo-controlled study / C. Jaeger, S. Kruiskamp, E. Voronska [et al.] // Nutrients. – 2024. – Vol. 16, № 17. – Р. 2963–2970.Jaeger C., Kruiskamp S., Voronska E., et al. A natural astragalus-based nutritional supplement lengthens telomeres in a middleaged population. Nutrients. 2024; 16(17): 2963–2970.Dubrovsky, Y. V. Deficiency of circadian protein CLOCK reduces lifespan and increases age-related cataract development in mice / Y. V. Dubrovsky, W. E. Samsa, R. V. Kondratov // Aging (Albany NY). – 2010. – № 2. – Р. 936–944.Dubrovsky Y.V., Samsa W.E., Kondratov R.V. Deficiency of circadian protein CLOCK reduces lifespan and increases age-related cataract development in mice. Aging (Albany NY). 2010; 2: 936–944.Дисфункция эндотелия: экспериментальные и клинические исследования : материалы VIII Междунар. науч.-практ. конф., Витебск, 23 мая 2014 г. – Витебск : ВГУ им. П. М. Машерова, 2014. – 257 с.Endothelial dysfunction: experimental and clinical studies. Vitebsk: VGU im. P. M. Masherova; 2014. 257.Partial Least Squares (PLS) methods for neuroimaging : a tutorial and review / A. Krishnan, L. J. Williams, A. R. McIntosh, H. Abdi // Neuroimage. – 2011. – Vol. 56, № 2. – Р. 455–475.Krishnan A., Williams L.J., McIntosh A.R., Abdi H. Partial Least Squares (PLS) methods for neuroimaging. Neuroimage. 2011; 56(2): 455–475.Transgenerational epigenetic inheritance of longevity in Caenorhabditis elegans / E. Greer, T. Maures, D. Ucar, A. Hauswirth // Nature. – 2011. – Vol. 479. – Р. 365–371.Greer E., Maures T., Ucar D., Hauswirth A. Transgenerational epigenetic inheritance of longevity in Caenorhabditis elegans. Nature. 2011; 479: 365–371.Куликова, В. А. Роль NAD в регуляторных процессах в клетках человека и животных / В. А. Куликова, Д. В. Громыко, А. А. Никифоров // Биохимия. – 2018. – Т. 83, № 7. – С. 987–1001.Kulikova V.A., Gromyko D.V., Nikiforov A.A. The role of NAD in regulatory processes in human and animal cells. Biochemistry. 2018; 83(7): 987–1001. (in Russian)Antiaging properties of a grape derived antioxidant are regulated by mitochondrial balance of fusion and fission leading to mitophagy triggered by a signaling network of Sirt1-Sirt3-Foxo3-PINK1-PARKIN / S. Das, G. Mitrovsky, H. R. Vasanthi, D. K. Das // Oxidative Medicine and Cellular Longevity. – 2014. – № 214. – doi: 10.1155/2014/345105.Das S., Mitrovsky G., Vasanthi H.R., Das D.K. Antiaging properties of a grape derived antioxidant are regulated by mitochondrial balance of fusion and fission leading to mitophagy triggered by a signaling network of Sirt1-Sirt3-Foxo3-PINK1-PARKIN. Oxid Med Cell Longev. 2014; 214. – doi: 10.1155/2014/345105.Antioxidant effects of resveratrol and other stilbene derivatives on oxidative stress and NO bioavailability: potential benefits to cardiovascular diseases / M. Frombaum, S. Le Clanche, D. Bonnefont-Rousselot, D. Borderie // Biochimie. – 2012. – Vol. 94, № 2. – Р. 269–276.Frombaum M., Le Clanche S., Bonnefont-Rousselot D., Borderie D. Antioxidant effects of resveratrol and other stilbene derivatives on oxidative stress and NO bioavailability: Potential benefits to cardiovascular diseases. Biochimie. 2012; 94(2): 269–276.Pendurthi, U. R. Resveratrol, a polyphenolic compound found in wine, inhibits tissue factor expression in vascular cells: a possible mechanism for the cardiovascular benefits as-sociated with moderate consumption of wine / U. R. Pendurthi, J. T. Williams, L. V. Rao // Arteriosclerosis, Thrombosis, and Vascular Biology. – 1999. – № 19. – P. 419–426.Pendurthi U.R., Williams J.T., Rao L.V. Resveratrol, a polyphenolic compound found in wine, inhibits tissue factor expression in vascular cells: a possible mechanism for the cardiovascular benefits as-sociated with moderate consumption of wine. Arterioscler Throm Vase Biol. 1999; 19: 419–426.Resveratrol : a review of biological activities and applications / L. E. Bejenaru, A. Bita, Ai. Belu [et al.] // Applied Sciences. – 2024. – Vol. 14. – Р. 4534–4555.Bejenaru L.E., Bita A., Belu Ai., Senianu A.E., et al. Resveratrol. Appl Sci. 2024; 14: 4534–4555.Resveratrol suppresses apoptosis in intact human cardiac tissue – in vitro model simulating extracorporeal circulation / E. Usta, M. Mustafi, T. Walker, G. Ziemer // The Journal of Cardiovascular Surgery. – 2011. – Vol. 52. – № 3. – P. 399–409.Usta E., Mustafi M., Walker T., Ziemer G. Resveratrol suppresses apoptosis in intact human cardiac tissue – in vitro model simulating extracorporeal circulation. J Cardiovasc Surg. 2011; 52(3): 399–409.Vetterli, L. Resveratrol-activated SIRT1 in liver and pancreatic β-cells: a Janus head looking to the same direction of metabolic homeostasis / L. Vetterli, P. Maechler // Aging (Albany NY). – 2011. – Vol. 3, № 4. – P. 444–449.Vetterli L., Maechler P. Resveratrol-activated SIRT1 in liver and pancreatic β-cells: a Janus head looking to the same direction of metabolic homeostasis. Aging (Albany NY). 2011; 3(4): 444–449.Physical activity interventions and depression in children and adolescents : a systematic review and meta-analysis / H. E. Brown, N. N. Pearson, R. E. Braithwaite [et al.] // Sports Medicine. – 2013. – Vol. 43, № 3. – Р. 195–206.Brown H.E., Pearson N.N., Braithwaite R.E., et al. Physical activity interventions and depression in children and adolescents. Sport Med. 2013; Vol. 43(3): 195–206.Rubinsztein, D. Autophagy and aging / D. Rubinsztein, G. Marino, G. Kroemer / Cell. – 2011. – Vol. 2, № 5. – Р. 682–695.Rubinsztein D., Marino G., Kroemer G. Autophagy and aging. Cell. 2011; 2(5): 682–695.Rando, T. Aging, rejuvenation, and epigenetic reprogramming: resetting the aging clock / T. Rando, H. Chang // Cell. – 2012. – Vol. 20, № 148. – Р. 46–57.Rando T., Chang H. Aging, rejuvenation, and epigenetic reprogramming: resetting the aging clock. Cell. 2012; 20(148): 46–57.Early aging and age-related pathologies in mice deficient in BMAL1, the core componentof the circadian clock / R. V. Kondratov, A. A. Kondratova, V. Y. Gorbacheva [et al.] // Genes and Development. – 2006. – Vol. 20, № 14. – Р. 1868–1873.Kondratov R.V., Kondratova A.A., Gorbacheva V.Y., et al. Early aging and age-related pathologies in mice deficient in BMAL1, the core componentof the circadian clock. Genes Dev. 2006; 20(14): 1868–1873.Biochemical genetic pathways that modulate aging in multiple species / A. Bitto, A. M. Wang, Ch. F. Bennett, M. Kaeberlein // Cold Spring Harbor Perspectives in Medicine. – 2015. – Vol. 5, № 11. – Р. 129–133.Bitto A., Wang A.M., Bennett Ch.F., Kaeberlein M. Biochemical genetic pathways that modulate aging in multiple species. Cold Spring Harbor perspectives in medicine. 2015; 5(11): 129–133.Is red wine a SAFE sip away from cardioprotection? Mechanisms involved in resveratrol and melatonin-induced cardioprotection / А. Lamont, T. Kim, S. Somers [et al.] // Journal of Pineal Research. – 2011. – Vol. 50, № 4. – Р. 374–380.Lamont А., Kim T., Somers S., et al. Is red wine a SAFE sip away from cardioprotection? Mechanisms involved in resveratrol and melatonin-induced cardioprotection. J Pineal Res. 2011; 50(4): 374–380.Campisi, J. Cell biology: The beginning of the end / J. Campisi // Nature. – 2014. – № 505. – Р. 35–36.Campisi J. Cell biology: The beginning of the end. Nature. 2014; 505: 35–36.Myeloid sirtuin 6 deficiency causes obesity in mice by inducing norepinephrine degradation to limit thermogenic tissue function / W. Wang, J. Liang, Y. Zhang [et al.] // Science Signaling. – 2025. – № 18. – Р. 33–41.Wang W., Liang J., Zhang Y., et al. Myeloid sirtuin 6 deficiency causes obesity in mice by inducing norepinephrine degradation to limit thermogenic tissue function. Sci Signal. 2025; 18: 33–41.Влияние геропротекторов астрагалозида, циклоастрагенола и пептидного комплекса «тимовиль – эпивиаль» на длину теломер и активность теломеразы в мезенхимных стромальных клетках и стареющих фибробластах человека / Н. И. Енукашвили, М. А. Сказина, А. В. Чубарь, А. Б. Машутин // Цитология. – 2019. – Т. 61, № 11. – С. 855–863.Enukashvili N.I., Skazina M.A., Chubar' A.V., Mashutin A.B. The effect of geroprotectors astragaloside, cycloastragenol, and the timovil – epivial peptide complex on telomere length and telomerase activity in human mesenchymal stromal cells and senescent fibroblasts. Citologiya. 2019; 61(11): 855–863. (in Russian)The oral bioavailability of curcumin from micronized powder and liquid micelles is significantly increased in healthy humans and differs between sexes / C. Schiborr, A. Kocher, D. Behnam [et al.] // Molecular Nutrition and Food Research. – 2014. – Vol. 58, № 3. – Р. 516–527.Schiborr C., Kocher A., Behnam D., et al. The oral bioavailability of curcumin from micronized powder and liquid micelles is significantly increased in healthy humans and differs between sexes. Mol Nutr Food Res. 2014; 58(3): 516–527.Фомченко, Н. Е. Биологические аспекты апоптоза (обзор литературы) / Н. Е. Фомченко, Е. В. Воропаев // Проблемы здоровья и экологии. – 2013. – Т. 1, № 1. – С. 39–45.Fomchenko N.E., Voropaev E.V. Biological aspects of apoptosis. Problemy zdorov'ya i ekologii. 2013; 1(1): 39–45. (in Russian)Шишко, Е. Д. Суточный ритм, циркадианные гены и злокачественные новообразования / Е. Д. Шишко, Н. Ф. Гамалея, А. Г. Минченко // Онкология. –2010. – Т. 12. – URL: https://www.oncology.kiev.ua/article/1245/sutochnyj-ritm-cirkadiannye-genyi-zlokachestvennye-novoobrazovaniya (дата обращения: 20.08.2025).Shishko E.D., Gamaleya N.F., Minchenko A.G. Daily rhythm, circadian genes and malignant neoplasms. Onkologiya. 2010; 12. – Available at: https://www.oncology.kiev.ua/article/1245/sutochnyj-ritm-cirkadiannye-geny-i-zlokachestvennye-novoobrazovaniya (accessed 20.08.2025). (in Russian)BMAL1-dependent regulation of the mTOR signaling pathway delays aging. – URL: https://www.aging-us.com/article/100633/text (дата обращения: 22.07.2025).BMAL1-dependent regulation of the mTOR signaling pathway delays aging. – Available at: https://www.aging-us.com/article/100633/text (accessed: 22.07.2025).Fleg, J. L. Age-associated changes in cardiovascular structure and function / J. L. Fleg, J. Strait // Heart Failure Reviews. – 2012. – Vol. 17, № 4–5. – Р. 545–554.Fleg J.L., Strait J. Age-associated changes in cardiovascular structure and function. Heart Fail Rev. 2012; 17(4–5): 545–554.Руководство по геронтологии и гериатрии / под ред. В. Н. Ярыгина. – М. : ГЭОТАР-Медиа, 2010. – 896 с.V.N. Yarygin (ed.) Guide to gerontology and geriatrics. Moscow: GEOTAR-Media; 2010. 896. (in Russian)Figurk, A. Systematic review of renal functional reserve in adult kidney donors / A. Figurek, V. A. Luycks, T. F. Mueller // Kidney International Reports. – 2020. – Vol. 5, № 4. – Р. 448–458. – doi: 10.1016/j.ekir.2019.12.021.Figurek A., Luycks V.A., Mueller T.F. Systematic review of renal functional reserve in adult kidney donors. Kid Int Rep. 2020; 5(4): 448–458. doi: 10.1016/j.ekir.2019.12.021. PMID: 32274451.Трошин, В. Д. Духовная доминанта и старение организма / В. Д. Трошин // Бюллетень сибирской медицины. – 2009. – Т. 8, № 3. – С. 67–71.Troshin V.D. Spiritual dominant and aging of the body. Byulleten' sibirskoj mediciny. 2009; 8(3): 67–71. (in Russian)Данилюк, А. Я. Концепция духовно-нравственного развития и воспитания личности гражданина России. Стандарты второго поколения / А. Я. Данилюк, А. М. Кондаков, В. А. Тишков. – М. : Просвещение, 2009. – 24 с.Danilyuk A.Ya., Kondakov A.M., Tishkov V.A. The concept of spiritual and moral development and education of a Russian citizen's personality. Moscow: Prosveshchenie; 2009. 24. (in Russian)Каковы твои мысли – такова и жизнь твоя. – URL: https://alexey-osipov.ru/?ysclid=mlz1o8z0p4661063288 (дата обращения: 20.08.2025).What are your thoughts – such is your life. Available at: https: //alexey-osipov.ru/?ysclid=mlz1o8z0p4661063288 (accessed: 20.08.2025). (in Russian)Гринева, Е. А. К вопросу о сущности понятий «духовность», «нравственность», «духовно-нравственный потенциал» / Е. А. Гринева, Л. Х. Давлетшина // Современные проблемы науки и образования. – 2013. – Т. 1, № 1. – С. 1–8.Grineva E.A., Davletshina L.Kh. To the question of the essence of the concepts of “spirituality”, “morality”, “spiritual and moral potential”. Sovremennye problemy nauki i obrazovaniya. 2013; 1(1): 1–8. (in Russian)

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