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Значение повышенной проницаемости кишечника в патогенезе внутренних болезней
Значение повышенной проницаемости кишечника в патогенезе внутренних болезней
Парфенов А.И. Значение повышенной проницаемости кишечника в патогенезе внутренних болезней. Терапевтический архив. 2024;96(2):85–90. DOI: 10.26442/00403660.2024.02.202587
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
________________________________________________
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
В процессе эволюции в желудочно-кишечном тракте сформировалась система барьеров от попадания в кровь бактериальных и пищевых антигенов. Причинами повышенной проницаемости кишечника (ППК) могут быть дисбаланс микробиоты, длительное применение антибиотиков, нестероидных противовоспалительных препаратов, стресс, диета, богатая фруктозой, глюкозой, сахарозой и длинноцепочечными жирными кислотами. Появление ППК может иметь первостепенное значение в патогенезе аутоиммунных заболеваний. Уменьшению ППК способствует диета с низким содержанием ферментируемых олиго-, ди-, моносахаридов и полиолов, пре- и пробиотики, полифенолы, витамины, короткоцепочечные жирные кислоты, пищевые волокна, глютамин. Установлено, что цитопротектор ребамипид укрепляет барьерную функцию на всем протяжении желудочно-кишечного тракта, что отражено в практических рекомендациях по его применению при заболеваниях, сопровождающихся ППК. Изучение этого направления будет способствовать появлению новой стратегии лечения внутренних болезней.
Ключевые слова: синдром повышенной проницаемости кишечника, микрофлора, эпителиоциты, межэпителиальные соединения, аутоиммунные заболевания, пробиотики, ребамипид
Keywords: leaky gut syndrome, microflora, epitheliocytes, interepithelial junctions, autoimmune diseases, probiotics, rebamipide
Ключевые слова: синдром повышенной проницаемости кишечника, микрофлора, эпителиоциты, межэпителиальные соединения, аутоиммунные заболевания, пробиотики, ребамипид
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Keywords: leaky gut syndrome, microflora, epitheliocytes, interepithelial junctions, autoimmune diseases, probiotics, rebamipide
Полный текст
Список литературы
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16. Kelly JR, Kennedy PJ, Cryan JF, et al. Breaking down the barriers: the gut microbiome, intestinal permeability and stress-related psychiatric disorders. Front Cell Neurosci. 2015;9:392. DOI:10.3389/fncel.2015.00392
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18. Di Tommaso N, Gasbarrini A, Ponziani FR. Intestinal Barrier in Human Health and Disease. Int J Environ Res Public Health. 2021;18(23):12836. DOI:10.3390/ijerph182312836
19. Binienda A, Twardowska A, Makaro A, Salaga M. Dietary Carbohydrates and Lipids in the Pathogenesis of Leaky Gut Syndrome: An Overview. Int J Mol Sci. 2020;21(21):8368. DOI:10.3390/ijms21218368
20. Steinert RE, Feinle-Bisset C, Asarian L, et al. Ghrelin, CCK, GLP-1, and PYY(3-36): Secretory Controls and Physiological Roles in Eating and Glycemia in Health, Obesity, and After RYGB. Physiol Rev. 2017;97(1):411-63. DOI:10.1152/physrev.00031.2014
21. Aleman RS, Moncada M, Aryana KJ. Leaky Gut and the Ingredients That Help Treat It: A Review. Molecules. 2023;28(2):619. DOI:10.3390/molecules28020619
22. Bertiaux-Vandaële N, Youmba SB, Belmonte L, et al. The expression and the cellular distribution of the tight junction proteins are altered in irritable bowel syndrome patients with differences according to the disease subtype. Am J Gastroenterol. 2011;106(12):2165-73. DOI:10.1038/ajg.2011.257
23. Martínez C, Vicario M, Ramos L, et al. The jejunum of diarrhea-predominant irritable bowel syndrome shows molecular alterations in the tight junction signaling pathway that are associated with mucosal pathobiology and clinical manifestations. Am J Gastroenterol. 2012;107(5):736-46. DOI:10.1038/ajg.2011.472
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25. Hering NA, Fromm M, Schulzke JD. Determinants of colonic barrier function in inflammatory bowel disease and potential therapeutics. J Physiol. 2012;590(5):1035-44. DOI:10.1113/jphysiol.2011.224568
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Авторы
А.И. Парфенов*
ГБУЗ «Московский клинический научно-практический центр им. А.С. Логинова» Департамента здравоохранения г. Москвы, Москва, Россия
*asfold@mail.ru
Loginov Moscow Clinical Scientific Center, Moscow, Russia
*asfold@mail.ru
ГБУЗ «Московский клинический научно-практический центр им. А.С. Логинова» Департамента здравоохранения г. Москвы, Москва, Россия
*asfold@mail.ru
________________________________________________
Loginov Moscow Clinical Scientific Center, Moscow, Russia
*asfold@mail.ru
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