Коморбидность акне и нарушений кишечного микробиоценоза: теоретическая и реальная
Коморбидность акне и нарушений кишечного микробиоценоза: теоретическая и реальная
Трухан Д.И. Коморбидность акне и нарушений кишечного микробиоценоза: теоретическая и реальная. Consilium Medicum. 2020 (22); 7: 73–77.
DOI: 10.26442/20751753.2020.7.200280
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Trukhan D.I. Comorbidity of acne and disorders of intestinal microbiocenosis: theoretical and real. Consilium Medicum. 2020 (22); 7: 73–77.
DOI: 10.26442/20751753.2020.7.200280
Коморбидность акне и нарушений кишечного микробиоценоза: теоретическая и реальная
Трухан Д.И. Коморбидность акне и нарушений кишечного микробиоценоза: теоретическая и реальная. Consilium Medicum. 2020 (22); 7: 73–77.
DOI: 10.26442/20751753.2020.7.200280
________________________________________________
Trukhan D.I. Comorbidity of acne and disorders of intestinal microbiocenosis: theoretical and real. Consilium Medicum. 2020 (22); 7: 73–77.
DOI: 10.26442/20751753.2020.7.200280
Совершенствование диагностических возможностей обусловливает значимый рост клинических ситуаций, когда уже сложно говорить о наличии у пациента одного заболевания – в настоящее время в большинстве клинических случаев присутствует сочетанная или сопутствующая патология. В рамках обзора рассмотрены вопросы коморбидности акне и нарушений кишечного микробиоценоза в теоретическом и практическом аспектах.
В 1930 г. был сформулирован гастроэнтерологический механизм связи между эмоциональными и нервными состояниями (беспокойством, депрессией) и кожными заболеваниями (такими как прыщи/акне) и обозначен как gut–brain–skin axis (ось «кишечник–мозг–кожа»). В течение нескольких десятилетий эта гипотеза была бездействующей. Однако в обзорах последнего десятилетия приведены многочисленные факты, косвенно свидетельствующие о праве гипотезы «кишечник–мозг–кожа» на существование и являющиеся базисом предположительной коморбидности акне и нарушений кишечного микробиоценоза. В реальной клинической практике эта связь не представляется столь очевидной и требует дальнейшего изучения механизмов и эффектов оральных пробиотиков при акне.
Improving diagnostic capabilities leads to a significant increase in clinical situations, when it is already difficult to talk about the presence of a single disease in a patient – currently, in most clinical cases, there is a combined or concomitant pathology. The review considers the issues of acne comorbidity and disorders of intestinal microbiocenosis in theoretical and practical aspects. In 1930, the gastroenterological mechanism of the relationship between emotional and nervous conditions (anxiety, depression) and skin diseases (such as acne) was formulated and designated as the "gut-brain-skin axis". For several decades, this hypothesis was dormant. However, reviews of the last decade provide numerous facts that indirectly indicate the validity of the “intestine-brain-skin” hypothesis, and are the basis for the theoretical comorbidity of acne and intestinal microbiocenosis disorders. in real clinical practice, this relationship does not seem so obvious and requires further study of the mechanisms and effects of oral probiotics in acne.
Key words: acne, intestinal microbiocenosis disorders, comorbidity, "gut–brain–skin" hypothesis, probiotic, prebiotic, gastroenterologist, dermatologist.
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1. Van den Akker M, Buntinx F, Metsemakers JF et al. Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol 1998; 51 (5): 367–75. DOI: 10.1016/s0895-4356(97)00306-5
2. Lazebnik L.B., Konev Yu.V. Historical features and semantic di- culties of using the terms denoting multiplicity of diseases in one patient. Experimental and Clinical Gastroenterology. 2018; 154 (6): 4–9. https://www.nogr.org/jour/article/view/629/624 (in Russian).
3. Trukhan D.I. Nonsteroidal anti-inflammatory drugs through the prism comorbidity and drug safety: in focus amtolmetin guatsil. Consilium Medicum. 2015; 17 (2): 27–33. DOI: 10.26442/2075-1753_2015.2.27-33 (in Russian).
4. Trukhan D.I., Lebedev O.I., Sulimov A.F., Trukhan L.Yu. Change of the organ of vision, skin and mucosium shells in diseases of the intestine. Therapy. 2018; 2 (20): 34–40. https://www.elibrary.ru/item.asp?id=32706743 (in Russian).
5. Federal clinical guidelines for the management of patients with acne. 2013. http://www.minzdravrb.ru/minzdrav/docs/akne.pdf (in Russian).
6. Acne. Clinical guidelines 2016. https://medi.ru/klinicheskie-rekomendatsii/akne_13842/ (in Russian).
7. Clinical guidelines. Acne vulgaris. Project. Russian Society of Dermatovenereologists and Cosmetologists. 2020. http://www.rodv.ru/events/274.html (in Russian).
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Авторы
Д.И. Трухан*
ФГБОУ ВО «Омский государственный медицинский университет» Минздрава России, Омск, Россия
*dmitry_trukhan@mail.ru