Пробиотики в схемах эрадикации Helicobacter pylori: современные данные и результаты собственного исследования

Бакулина Н.В., Ильчишина Т.А., Бакулин И.Г. и др. Пробиотики в схемах эрадикации Helicobacter pylori: современные данные и результаты собственного исследования. Consilium Medicum. 2019; 21 (8): 58–64. DOI: 10.26442/20751753.2019.8.190584

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Bakulina N.V., Ilchishina T.A., Bakulin I.G. et al. Probiotics in Helicobacter pylori eradication regimens: current data and results of our own research. Consilium Medicum. 2019; 21 (8): 58–64. DOI: 10.26442/20751753.2019.8.190584

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Аннотация

В статье приведены результаты имеющихся на данный момент исследований по составу желудочного микробиома и изменениям микробной экосистемы желудка в связи с заражением бактерией Helicobacter pylori. Продемонстрировано, что существует двустороннее взаимодействие микробных сообществ как с хозяином, так и друг с другом, и некоторые виды бактерий проявляют высокие антагонистические эффекты и могут ингибировать рост H. pylori. Лечение инфекции H. pylori все еще остается проблемой для клиницистов. Уделено внимание роли пробиотиков в снижении частоты возникновения нежелательных явлений со стороны желудочно-кишечного тракта при проведении эрадикационной терапии инфекции H. pylori, а также их положительному влиянию на эрадикацию H. pylori. Отдельно рассмотрены возможности применения Lactobacillus reuteri DSMZ17648 (Pylopass™) в эрадикационной терапии инфекции H. pylori. Представлены результаты собственного исследования, проведенного в рамках образовательно-исследовательского проекта «Реальная клиническая практика лечения кислотозависимых заболеваний», по включению препарата Pylopass™ и других пробиотиков в схему эрадикации.

Ключевые слова: микробиота желудка, антихеликобактерная терапия, эрадикация, H. pylori, ¹³C-уреазный дыхательный тест, Lactobacillus reuteri, Pylopass™.

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The article presents the results of currently available studies on the composition of the gastric microbiome and changes in the microbial ecosystem of the stomach due to infection with Helicobacter pylori. It was shown that there is two-way interaction of microbial communities, both with the host and with each other, and some types of bacteria exhibit high antagonistic effects and can inhibit the growth of H. pylori. Treatment for infection is still a challenge for clinicians. Attention is paid to the role of probiotics in reducing the incidence of gastrointestinal adverse events during eradication therapy of H. pylori infection, as well as their positive effect on H. pylori eradication. The possibilities of using Lactobacillus reuteri DSMZ17648 (Pylopass™) in the eradication therapy of H. pylori infection are considered separately. The results of our own research carried out as part of the educational project "Real Clinical Practice for the Treatment of Acid-Dependent Diseases" on the inclusion of Pylopass™ and other probiotics in the eradication regimen are presented.

Key words: gastric microbiota, antihelicobacter therapy, eradication, H. pylori, ¹³C-urea breath test, Lactobacillus reuteri, Pylopass™.

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Список литературы

1. Petra CV, Rus A, Dumitraşcu DL et al. Gastric microbiota: tracing the culprit. Clujul Med 2017; 90 (4): 369–76. DOI: 10.15386/cjmed-854
2. Abelous M. Normal microbes in the human stomach. Science 1889; 13 (322): 258.
3. Bik EM, Eckburg PB, Gill SR et al. Molecular analysis of the bacterial microbiota in the human stomach. Proc Natl Acad Sci U S A 2006; 103 (3): 732–7.
4. Engstrand L, Lindberg M. Helicobacter pylori and the gastric microbiota. Best Pract Res Clin Gastroenterol 2013; 27 (1): 39–45.
5. Sahasakul Y, Takemura N, Sonoyama K. Different impacts of purified and nonpurified diets on microbiota and toll-like receptors in the mouse stomach. Biosci Biotechnol Biochem 2012; 76 (9): 1728–32.
6. Beasley DE, Koltz AM, Lambert JE et al. The evolution of stomach acidity and its relevance to the human microbiome. PLoS One 2015; 10 (7): e0134116. DOI: 10.1371/journal.pone.0134116
7. Lange K, Buerger M, Stallmach A et al. Effects of antibiotics on gut microbiota. Dig Dis 2016; 34 (3): 260–8.
8. Fisher L, Fisher A. Acid-Suppressive Therapy and Risk of Infections: Pros and Cons. Clin Drug Investig 2017; 37 (7): 587–624.
9. Minalyan A, Gabrielyan L, Scott D et al. The Gastric and Intestinal Microbiome: Role of Proton Pump Inhibitors. Curr Gastroenterol Rep 2017; 19 (8): 42. DOI: 10.1007/s11894-017-0577-6
10. Sanduleanu S, Jonkers D, De Bruine A et al. Non-Helicobacter pyloribacterial flora during acid-suppressive therapy: differential findings in gastric juice and gastric mucosa. Aliment Pharmacol Ther 2001; 15 (3): 379–88.
11. Paroni Sterbini F, Palladini A, Masucci L et al. Effects of proton pump inhibitors on the gastric mucosa-associated microbiota in dyspeptic patients. Appl Environm Microbiol 2016; 82 (22): 6633–44.
12. Li X-X, Wong GL-H, To K-F et al. Bacterial microbiota profiling in gastritis without Helicobacter pylori infection or non-steroidal anti-inflammatory drug use. PLoS One 2009; 4 (11): e7985.
13. Mason KL, Erb Downward JR, Falkowski NR et al. Interplay between the gastric bacterial microbiota and Candida albicans during postantibiotic recolonization and gastritis. Infect Immun 2012; 80 (1): 150–8.
14. Von Rosenvinge EC, Song Y, White JR et al. Immune status, antibiotic medication and pH are associated with changes in the stomach fluid microbiota. ISME J 2013; 7 (7): 1354–66.
15. Hooi J, Lai WY, Ng WK et al. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology 2017; 53 (2): 420–9. DOI: 10.1053/j.gastro.2017.04.022
16. Maldonado-Contreras A, Goldfarb KC, Godoy-Vitorino F et al. Structure of the human gastric bacterial community in relation to Helicobacter pylori status. ISME J 2011; 5 (4): 574–9.
17. Nardone G, Compare D. The human gastric microbiota: is it time to rethink the pathogenesis of stomach diseases? United Eur Gastroenterol J 2015; 3 (3): 255–60.
18. Aviles-Jimenez F, Vazquez-Jimenez F, Medrano-Guzman R et al. Stomach microbiota composition varies between patients with non-atrophic gastritis and patients with intestinal type of gastric cancer. Sci Rep 2014; 4: 4202.
19. Khosravi Y, Dieye Y, Loke MF et al. Streptococcus mitis induces conversion of Helicobacter pylori to coccoid cells during co-culture in vitro. PLoS One 2014; 9 (11): e112214.
20. Delgado S, Leite AM, Ruas-Madiedo P, Mayo B. Probiotic and technological properties of Lactobacillus spp. strains from the human stomach in the search for potential candidates against gastric microbial dysbiosis. Front Microbiol 2015; 5: 766.
21. Rolig AS, Cech C, Ahler E et al. The degree of Helicobacter pylori-triggered inflammation is manipulated by preinfection host microbiota. Infect Immun 2013; 81 (5): 1382–9.
22. Pereira V, Abraham P, Nallapeta S, Shetty A. Gastric bacterial flora in patients harbouring Helicobacter pylori with or without chronic dyspepsia: analysis with matrix-assisted laser desorption ionization time-of-flight mass spectroscopy. BMC Gastroenterology 2018; 18 (1): 20. DOI: 10.1186/s12876-018-0744-8
23. Sugano K, Tack J, Kuipers EJ. Kyoto global consensus report on Helicobacter pylori gastritis. Gut 2015; 64: 1353–67.
24. Ивашкин В.Т., Маев И.В., Лапина Т.Л. и др. Клинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению инфекции Helicobacter pylori у взрослых. Рос. журн. гастроэнтерологии, гепатологии, колопроктологии. 2018; 28 (1): 55–70. https://doi.org/10.22416/1382-4376-2018-28-1-55-70.
[Ivashkin V.T., Maev I.V., Lapina T.L. et al. Klinicheskie rekomendatsii Rossiiskoi gastroenterologicheskoi assotsiatsii po diagnostike i lecheniiu infektsii Helicobacter pylori u vzroslykh. Ros. zhurn. gastroenterologii, gepatologii, koloproktologii. 2018; 28 (1): 55–70. https://doi.org/10.22416/1382-4376-2018-28-1-55-70 (in Russian).]
25. Chen L, Xu W, Lee A et al. The impact of Helicobacter pylori infection, eradication therapy and probiotic supplementation on gut microenvironment homeostasis: An open-label, randomized clinical trial. EBioMedicine 2018; 35: 87–96. DOI: 10.1016/j.ebiom.2018.08.028
26. Jakobsson HE, Jernberg C, Andersson AF et al. Short-term antibiotic treatment has differing long-term impacts on the human throat and gut microbiome. PLoS One 2010; 5 (3): e9836. DOI: 10.1371/journal.pone.0009836
27. Adamsson I, Edlund C, Nord CE. Impact of treatment of Helicobacter pylori on the normal gastrointestinal microflora. Clin Microbiol Infect 2000; 6 (4): 175–7. DOI: 10.1111/j.1469-0691.2000.00028.x
28. Abadi ATB. Vaccine against Helicobacter pylori: inevitable approach. World J Gastroenterol 2016; 22 (11): 3150–7. DOI: 10.3748/wjg.v22.i11.3150
29. Ma F, Chen Y, Li J et al. Screening test for anti-Helicobacter pylori activity of traditional Chinese herbal medicines. World J Gastroenterol 2010; 16 (44): 5629–34. DOI: 10.3748/wjg.v16.i44.5629
30. Yee JK. C. Are the view of Helicobacter pylori colonized in the oral cavity an illusion? Exper Mol Med 2017; 49 (11, article e397). DOI: 10.1038/emm.2017.225
31. Wang Y, Wang B, Lv ZF et al. Efficacy and safety of ecabet sodium as an adjuvant therapy for Helicobacter pylori eradication: a systematic review and meta-analysis. Helicobacter 2014; 19 (5): 372–81. DOI: 10.1111/hel.12136
32. Eslami M, Yousefi B, Kokhaei P et al. Are probiotics useful for therapy of Helicobacter pylori diseases? Comp Immunol Microbiol Infect Dis 2019; 64: 99–108. DOI: 10.1016/j.cimid.2019.02.010
33. Song HY, Zhou L, Liu DY et al. What Roles Do Probiotics Play in the Eradication of Helicobacter pylori? Current Knowledge and Ongoing Research. Gastroenterol Res Pract 2018; 2018: 9379480. DOI: 10.1155/2018/9379480. eCollection 2018.
34. Dore MP, Bibbò S, Pes GM et al. Role of Probiotics in Helicobacter pylori Eradication: Lessons from a Study of Lactobacillus reuteri Strains DSM 17938 and ATCC PTA 6475 (Gastrus®) and a Proton-Pump Inhibitor. Can J Infect Dis Med Microbiol 2019; 2019: 3409820. DOI: 10.1155/2019/3409820. eCollection 2019.
35. Бордин Д.С., Войнован И.Н., Хомерики С.Г., Янова О.Б. и др. Эффективность и безопасность L. reuteri DSMZ17648 у инфицированных Helicobacter pylori, не имеющих абсолютных показаний для эрадикационной терапии. Лечащий врач. 2016; 5: 1–6.
[Bordin D.S., Voinovan I.N., Khomeriki S.G., Ianova O.B. et al. Effektivnost' i bezopasnost' L. reuteri DSMZ17648 u infitsirovannykh Helicobacter pylori, ne imeiushchikh absoliutnykh pokazanii dlia eradikatsionnoĭ terapii. Lechashchii vrach. 2016; 5: 1–6 (in Russian).]
36. Shi X, Zhang J, Mo L et al. Efficacy and safety of probiotics in eradicating Helicobacter pylori: A network meta-analysis. Medicine (Baltimore) 2019; 98 (15): e15180. DOI: 10.1097/MD.0000000000015180
37. Bhatia SJ, Kochar N, Abraham P et al. Lactobacillus acidophilus inhibits growth of Campylobacter pylori in vitro. J Clin Microbiol 1989; 27: 2328–30.
38. Goderska K, Agudo Pena S, Alarcon T. Helicobacter pylori treatment: antibiotics or probiotics. Appl Microbiol Biotechnol 2018; 102: 1–7.
39. Mehling H, Busjahn A. Non-viable Lactobacillus reuteri DSMZ 17648 (Pylopass™) as a new approach to Helicobacter pylori control in humans. Nutrients 2013; 5 (8): 3062–73. DOI: 10.3390/nu5083062
40. Ивашкин В.Т., Алексеева О.П., Барановский А.Ю. и др. Значение Lactobacillus reuteri DSMZ17648 в эрадикационной терапии инфекции H. pylori (обзор литературы и резолюция Экспертного совета, 28 февраля 2018 г.). Рос. журн. гастроэнтерол., гепатол., колопроктол. 2018; 28 (3): 33–8. DOI: 10.22416/1382-4376-2018-28-3-33-38.
[Ivashkin V.T., Alekseeva O.P., Baranovskii A.Iu. et al. Znachenie Lactobacillus reuteri DSMZ17648 v eradikatsionnoi terapii infektsii H. pylori (obzor literatury i rezoliutsiia Ekspertnogo soveta, 28 fevralia 2018 g.). Ros. zhurn. gastroenterol., gepatol., koloproktol. 2018; 28 (3): 33–8. DOI: 10.22416/1382-4376-2018-28-3-33-38 (in Russian).]

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1. Petra CV, Rus A, Dumitraşcu DL et al. Gastric microbiota: tracing the culprit. Clujul Med 2017; 90 (4): 369–76. DOI: 10.15386/cjmed-854
2. Abelous M. Normal microbes in the human stomach. Science 1889; 13 (322): 258.
3. Bik EM, Eckburg PB, Gill SR et al. Molecular analysis of the bacterial microbiota in the human stomach. Proc Natl Acad Sci U S A 2006; 103 (3): 732–7.
4. Engstrand L, Lindberg M. Helicobacter pylori and the gastric microbiota. Best Pract Res Clin Gastroenterol 2013; 27 (1): 39–45.
5. Sahasakul Y, Takemura N, Sonoyama K. Different impacts of purified and nonpurified diets on microbiota and toll-like receptors in the mouse stomach. Biosci Biotechnol Biochem 2012; 76 (9): 1728–32.
6. Beasley DE, Koltz AM, Lambert JE et al. The evolution of stomach acidity and its relevance to the human microbiome. PLoS One 2015; 10 (7): e0134116. DOI: 10.1371/journal.pone.0134116
7. Lange K, Buerger M, Stallmach A et al. Effects of antibiotics on gut microbiota. Dig Dis 2016; 34 (3): 260–8.
8. Fisher L, Fisher A. Acid-Suppressive Therapy and Risk of Infections: Pros and Cons. Clin Drug Investig 2017; 37 (7): 587–624.
9. Minalyan A, Gabrielyan L, Scott D et al. The Gastric and Intestinal Microbiome: Role of Proton Pump Inhibitors. Curr Gastroenterol Rep 2017; 19 (8): 42. DOI: 10.1007/s11894-017-0577-6
10. Sanduleanu S, Jonkers D, De Bruine A et al. Non-Helicobacter pyloribacterial flora during acid-suppressive therapy: differential findings in gastric juice and gastric mucosa. Aliment Pharmacol Ther 2001; 15 (3): 379–88.
11. Paroni Sterbini F, Palladini A, Masucci L et al. Effects of proton pump inhibitors on the gastric mucosa-associated microbiota in dyspeptic patients. Appl Environm Microbiol 2016; 82 (22): 6633–44.
12. Li X-X, Wong GL-H, To K-F et al. Bacterial microbiota profiling in gastritis without Helicobacter pylori infection or non-steroidal anti-inflammatory drug use. PLoS One 2009; 4 (11): e7985.
13. Mason KL, Erb Downward JR, Falkowski NR et al. Interplay between the gastric bacterial microbiota and Candida albicans during postantibiotic recolonization and gastritis. Infect Immun 2012; 80 (1): 150–8.
14. Von Rosenvinge EC, Song Y, White JR et al. Immune status, antibiotic medication and pH are associated with changes in the stomach fluid microbiota. ISME J 2013; 7 (7): 1354–66.
15. Hooi J, Lai WY, Ng WK et al. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology 2017; 53 (2): 420–9. DOI: 10.1053/j.gastro.2017.04.022
16. Maldonado-Contreras A, Goldfarb KC, Godoy-Vitorino F et al. Structure of the human gastric bacterial community in relation to Helicobacter pylori status. ISME J 2011; 5 (4): 574–9.
17. Nardone G, Compare D. The human gastric microbiota: is it time to rethink the pathogenesis of stomach diseases? United Eur Gastroenterol J 2015; 3 (3): 255–60.
18. Aviles-Jimenez F, Vazquez-Jimenez F, Medrano-Guzman R et al. Stomach microbiota composition varies between patients with non-atrophic gastritis and patients with intestinal type of gastric cancer. Sci Rep 2014; 4: 4202.
19. Khosravi Y, Dieye Y, Loke MF et al. Streptococcus mitis induces conversion of Helicobacter pylori to coccoid cells during co-culture in vitro. PLoS One 2014; 9 (11): e112214.
20. Delgado S, Leite AM, Ruas-Madiedo P, Mayo B. Probiotic and technological properties of Lactobacillus spp. strains from the human stomach in the search for potential candidates against gastric microbial dysbiosis. Front Microbiol 2015; 5: 766.
21. Rolig AS, Cech C, Ahler E et al. The degree of Helicobacter pylori-triggered inflammation is manipulated by preinfection host microbiota. Infect Immun 2013; 81 (5): 1382–9.
22. Pereira V, Abraham P, Nallapeta S, Shetty A. Gastric bacterial flora in patients harbouring Helicobacter pylori with or without chronic dyspepsia: analysis with matrix-assisted laser desorption ionization time-of-flight mass spectroscopy. BMC Gastroenterology 2018; 18 (1): 20. DOI: 10.1186/s12876-018-0744-8
23. Sugano K, Tack J, Kuipers EJ. Kyoto global consensus report on Helicobacter pylori gastritis. Gut 2015; 64: 1353–67.
24. Ivashkin V.T., Maev I.V., Lapina T.L. et al. Klinicheskie rekomendatsii Rossiiskoi gastroenterologicheskoi assotsiatsii po diagnostike i lecheniiu infektsii Helicobacter pylori u vzroslykh. Ros. zhurn. gastroenterologii, gepatologii, koloproktologii. 2018; 28 (1): 55–70. https://doi.org/10.22416/1382-4376-2018-28-1-55-70 (in Russian).
25. Chen L, Xu W, Lee A et al. The impact of Helicobacter pylori infection, eradication therapy and probiotic supplementation on gut microenvironment homeostasis: An open-label, randomized clinical trial. EBioMedicine 2018; 35: 87–96. DOI: 10.1016/j.ebiom.2018.08.028
26. Jakobsson HE, Jernberg C, Andersson AF et al. Short-term antibiotic treatment has differing long-term impacts on the human throat and gut microbiome. PLoS One 2010; 5 (3): e9836. DOI: 10.1371/journal.pone.0009836
27. Adamsson I, Edlund C, Nord CE. Impact of treatment of Helicobacter pylori on the normal gastrointestinal microflora. Clin Microbiol Infect 2000; 6 (4): 175–7. DOI: 10.1111/j.1469-0691.2000.00028.x
28. Abadi ATB. Vaccine against Helicobacter pylori: inevitable approach. World J Gastroenterol 2016; 22 (11): 3150–7. DOI: 10.3748/wjg.v22.i11.3150
29. Ma F, Chen Y, Li J et al. Screening test for anti-Helicobacter pylori activity of traditional Chinese herbal medicines. World J Gastroenterol 2010; 16 (44): 5629–34. DOI: 10.3748/wjg.v16.i44.5629
30. Yee JK. C. Are the view of Helicobacter pylori colonized in the oral cavity an illusion? Exper Mol Med 2017; 49 (11, article e397). DOI: 10.1038/emm.2017.225
31. Wang Y, Wang B, Lv ZF et al. Efficacy and safety of ecabet sodium as an adjuvant therapy for Helicobacter pylori eradication: a systematic review and meta-analysis. Helicobacter 2014; 19 (5): 372–81. DOI: 10.1111/hel.12136
32. Eslami M, Yousefi B, Kokhaei P et al. Are probiotics useful for therapy of Helicobacter pylori diseases? Comp Immunol Microbiol Infect Dis 2019; 64: 99–108. DOI: 10.1016/j.cimid.2019.02.010
33. Song HY, Zhou L, Liu DY et al. What Roles Do Probiotics Play in the Eradication of Helicobacter pylori? Current Knowledge and Ongoing Research. Gastroenterol Res Pract 2018; 2018: 9379480. DOI: 10.1155/2018/9379480. eCollection 2018.
34. Dore MP, Bibbò S, Pes GM et al. Role of Probiotics in Helicobacter pylori Eradication: Lessons from a Study of Lactobacillus reuteri Strains DSM 17938 and ATCC PTA 6475 (Gastrus®) and a Proton-Pump Inhibitor. Can J Infect Dis Med Microbiol 2019; 2019: 3409820. DOI: 10.1155/2019/3409820. eCollection 2019.
35. Bordin D.S., Voinovan I.N., Khomeriki S.G., Ianova O.B. et al. Effektivnost' i bezopasnost' L. reuteri DSMZ17648 u infitsirovannykh Helicobacter pylori, ne imeiushchikh absoliutnykh pokazanii dlia eradikatsionnoĭ terapii. Lechashchii vrach. 2016; 5: 1–6 (in Russian).
36. Shi X, Zhang J, Mo L et al. Efficacy and safety of probiotics in eradicating Helicobacter pylori: A network meta-analysis. Medicine (Baltimore) 2019; 98 (15): e15180. DOI: 10.1097/MD.0000000000015180
37. Bhatia SJ, Kochar N, Abraham P et al. Lactobacillus acidophilus inhibits growth of Campylobacter pylori in vitro. J Clin Microbiol 1989; 27: 2328–30.
38. Goderska K, Agudo Pena S, Alarcon T. Helicobacter pylori treatment: antibiotics or probiotics. Appl Microbiol Biotechnol 2018; 102: 1–7.
39. Mehling H, Busjahn A. Non-viable Lactobacillus reuteri DSMZ 17648 (Pylopass™) as a new approach to Helicobacter pylori control in humans. Nutrients 2013; 5 (8): 3062–73. DOI: 10.3390/nu5083062
40. Ivashkin V.T., Alekseeva O.P., Baranovskii A.Iu. et al. Znachenie Lactobacillus reuteri DSMZ17648 v eradikatsionnoi terapii infektsii H. pylori (obzor literatury i rezoliutsiia Ekspertnogo soveta, 28 fevralia 2018 g.). Ros. zhurn. gastroenterol., gepatol., koloproktol. 2018; 28 (3): 33–8. DOI: 10.22416/1382-4376-2018-28-3-33-38 (in Russian).

Авторы

Н.В. Бакулина*1, Т.А. Ильчишина2, И.Г. Бакулин1, Ю.Г. Анучина3, С.С. Архипова4, А.А. Аскарова5, А.С. Гарегинян6, А.А. Горчаков2, А.В. Губина7, Н.В. Гурина8, Е.В. Денисова9, Н.Г. Калашникова10, Ю.В. Коковина1, Н.И. Король11, Е.Г. Нигороженко12, В.А. Ослопова13, А.О. Саблина14, К.А. Саладин15, А.В. Солонович16, Т.В. Спиридонова17, К.О. Теницкая18, З.Ф. Тибилова19, А.В. Тряпицын20, Е.В. Чернетова21, М.С. Журавлева1

1 ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России, Санкт-Петербург, Россия;

2 Многопрофильный медицинский холдинг «СМ-клиника», Санкт-Петербург, Россия;
3 СПб ГБУЗ «Консультативно-диагностический центр №85», Санкт-Петербург, Россия;
4 ООО «Медикал Он Груп – Люберцы», Люберцы, Россия;

5 ФГБУЗ «Поликлиника №3 Центральной клинической больницы» РАН, Москва, Россия;

6 ООО «Никор-Мед», Москва, Россия;
7 Медицинский центр «Институт здоровья», Москва, Россия;
8 ГНЦ ФГУП «Центральный аэрогидродинамический институт им. проф. Н.Е. Жуковского», Жуковский, Россия;
9 ООО «Медилюкс-ТМ», Санкт-Петербург, Россия;
10 ГБУЗ «Московский клинический научно-практический центр им. А.С. Логинова» Департамента здравоохранения г. Москвы, Москва, Россия;
11 ООО «Клиника Доктор Сан», Санкт-Петербург, Россия;

12 Отраслевой клинико-диагностический центр ПАО «Газпром», Санкт-Петербург, Россия;
13 ГБУЗ «Детская городская поликлиника №13» Департамента здравоохранения г. Москвы, Москва, Россия;

14 ФГБУ «Всероссийский центр экстренной и радиационной медицины им. А.М. Никифорова» МЧС России, Санкт-Петербург, Россия;
15 СПб ГБУЗ «Городская поликлиника №32», Санкт-Петербург, Россия;
16 ЗАО «Медицинский центр в Коломенском», Москва, Россия;
17 ООО «БалтЗдрав», Санкт-Петербург, Россия;
18 СПб ГБУЗ «Онкологический диспансер Московского района», Санкт-Петербург, Россия;
19 Медицинский центр «Будь здоров», Москва, Россия;
20 Клиника высоких медицинских технологий им. Н.И. Пирогова СПбГУ, Санкт-Петербург, Россия;
21 ООО «МСЧ №157», Санкт-Петербург, Россия
*nv_bakulina@mail.ru

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Natalya V. Bakulina*1, Tatyana A. Ilchishina2, Igor G. Bakulin1, Juliana G. Anuchina3, Svetlana S. Arhipova4, Aiman A. Askarova5, Ara S. Gareginyan6, Aleksey A. Gorchakov2, Alla V. Gubina7, Natalya V. Gurina8, Elena V. Denisova9, Natalia G. Kalashnikova10, Yulia V. Kokovina1, Natalia I. Korol11, Elena G. Nigorozhenko12, Valeria A. Oslopova13, Anastasia O. Sablina14, Konstantin A. Saladin15, Anna V. Solonovich16, Tatyana V. Spiridonova17, Kseniya O. Tenitskaya18, Zalina F. Tibilova19, Aleksander V. Tryapicin20, Elena V. Chernetova21, Mariia S. Zhuravleva1

1 Mechnikov North-Western State Medical University, Saint Petersburg, Russia;
2 Medical Holding "SM-Clinic", Saint Petersburg, Russia;

3 Consultative and Diagnostic Center №85, Saint Petersburg, Russia;
4 Medical On Group – Lyubersy, Lyubersy, Russia;
5 Policlinic №3 of the Central Clinical Hospital of the RAS, Moscow, Russia;
6 Nikor-Med, Moscow, Russia;
7 Medical Center Institute of the Health, Moscow, Russia;
8 Central Aerodynamic Institute, Zhukovsky, Russia;
9 Medilux-TM, Saint Petersburg, Russia;
10 Loginov Moscow Clinical Scientific and Practical Center, Moscow, Russia;
11 Clinic Doctor San, Saint Petersburg, Russia;
12 Consultive and Diagnostic Center of the Company "Gazprom", Saint Petersburg, Russia;
13 Сhildren’s Сity Policlinic №13, Moscow, Russia;
14 Nikiforov Russian Center of Emergency and Radiation Medicine, Saint Petersburg, Russia;
15 City Policlinic №32, Saint Petersburg, Russia;
16 Medical Center in Kolomensky, Moscow, Russia;
17 BaltZdrav, Saint Petersburg, Russia;
18 Oncological dispensary of the Moscow district, Saint Petersburg, Russia;
19 Medical Center "Be healthy", Moscow, Russia;
20 Pirogov Clinic of the High Medical Technologies, Saint Petersburg, Russia;
21 Medical Clinic №157, Saint Petersburg, Russia
*nv_bakulina@mail.ru

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