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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">nogr</journal-id><journal-title-group><journal-title xml:lang="ru">Экспериментальная и клиническая гастроэнтерология</journal-title><trans-title-group xml:lang="en"><trans-title>Experimental and Clinical Gastroenterology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1682-8658</issn><publisher><publisher-name>«Global Media Technologies»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.31146/1682-8658-ecg-202-6-61-75</article-id><article-id custom-type="elpub" pub-id-type="custom">nogr-2095</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>КЛИНИЧЕСКАЯ ГАСТРОЭНТЕРОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL GASTROENTEROLOGY</subject></subj-group></article-categories><title-group><article-title>Некротизирующий энтероколит у недоношенных детей: состояние кишечного барьера, особенности метаболизма витамина D и их генетическая регуляция</article-title><trans-title-group xml:lang="en"><trans-title>Necrotizing enterocolitis in preterm infants: state of the intestinal barrier, features of vitamin D metabolism and their regulation</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3043-8674</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лошкова</surname><given-names>Елена Владимировна</given-names></name><name name-style="western" xml:lang="en"><surname>Loshkova</surname><given-names>E. V.</given-names></name></name-alternatives><email xlink:type="simple">loshkova.ev@ssmu.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0339-2030</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Прудникова</surname><given-names>Валерия Константиновна</given-names></name><name name-style="western" xml:lang="en"><surname>Prudnikova</surname><given-names>V. K.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3281-803X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рафикова</surname><given-names>Юлия Сергеевна</given-names></name><name name-style="western" xml:lang="en"><surname>Rafikova</surname><given-names>Yu. S.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6638-7875</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ким</surname><given-names>Леонид Владимирович</given-names></name><name name-style="western" xml:lang="en"><surname>Kim</surname><given-names>L. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2048-1852</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Люлька</surname><given-names>Татьяна Сергеевна</given-names></name><name name-style="western" xml:lang="en"><surname>Lyulka</surname><given-names>T. S.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2133-665X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Желев</surname><given-names>Виктор Александрович</given-names></name><name name-style="western" xml:lang="en"><surname>Zhelev</surname><given-names>V. A.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9011-8720</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Саприна</surname><given-names>Татьяна Владимировна</given-names></name><name name-style="western" xml:lang="en"><surname>Saprina</surname><given-names>T. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9949-4562</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Боженко</surname><given-names>Екатерина Александровна</given-names></name><name name-style="western" xml:lang="en"><surname>Bozhenko</surname><given-names>E. A.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6395-0407</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кондратьева</surname><given-names>Елена Ивановна</given-names></name><name name-style="western" xml:lang="en"><surname>Kondratyeva</surname><given-names>E. I.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5214-8072</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Одинаева</surname><given-names>Нуринисо Джумаевна</given-names></name><name name-style="western" xml:lang="en"><surname>Odinaeva</surname><given-names>N. D.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5792-2012</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Янкина</surname><given-names>Галина Николаевна</given-names></name><name name-style="western" xml:lang="en"><surname>Yankina</surname><given-names>G. N.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7308-7280</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хавкин</surname><given-names>Анатолий Ильич</given-names></name><name name-style="western" xml:lang="en"><surname>Khavkin</surname><given-names>A. I.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное образовательное учреждение высшего образования «Сибирский государственный медицинский университет» Министерства здравоохранения Российской Федерации; Научно-исследовательский клинический институт детства Министерства здравоохранения Московской области</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Siberian State Medical University; Research Clinical Institute of Childhood of the Ministry of Health of the Moscow Region</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное образовательное учреждение высшего образования «Сибирский государственный медицинский университет» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Siberian State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Научно-исследовательский клинический институт детства Министерства здравоохранения Московской области; ФГБНУ «Медико-генетический научный центр имени академика Н. П. Бочкова»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Research Clinical Institute of Childhood of the Ministry of Health of the Moscow Region; Medical Genetic Research Center named after Academician N. P. Bochkova</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Научно-исследовательский клинический институт детства Министерства здравоохранения Московской области</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Research Clinical Institute of Childhood of the Ministry of Health of the Moscow Region</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>Научно-исследовательский клинический институт детства Министерства здравоохранения Московской области; Российский Национальный Исследовательский Медицинский Университет им. Н. И. Пирогова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Research Clinical Institute of Childhood of the Ministry of Health of the Moscow Region; Pirogov Russian National Research Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>21</day><month>11</month><year>2022</year></pub-date><volume>0</volume><issue>6</issue><fpage>61</fpage><lpage>75</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Лошкова Е.В., Прудникова В.К., Рафикова Ю.С., Ким Л.В., Люлька Т.С., Желев В.А., Саприна Т.В., Боженко Е.А., Кондратьева Е.И., Одинаева Н.Д., Янкина Г.Н., Хавкин А.И., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Лошкова Е.В., Прудникова В.К., Рафикова Ю.С., Ким Л.В., Люлька Т.С., Желев В.А., Саприна Т.В., Боженко Е.А., Кондратьева Е.И., Одинаева Н.Д., Янкина Г.Н., Хавкин А.И.</copyright-holder><copyright-holder xml:lang="en">Loshkova E.V., Prudnikova V.K., Rafikova Y.S., Kim L.V., Lyulka T.S., Zhelev V.A., Saprina T.V., Bozhenko E.A., Kondratyeva E.I., Odinaeva N.D., Yankina G.N., Khavkin A.I.</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://www.nogr.org/jour/article/view/2095">https://www.nogr.org/jour/article/view/2095</self-uri><abstract><p>Приоритетом национальной политики в области здравоохранения является сохранение жизни и высокого уровня качества жизни каждого недоношенного. В клиническом фокусе находятся дети, рожденные с ЭНМТ. Среди этой категории детей НЭК вносит основной вклад в структуру младенческой летальности. На основе анализа литературы авторы делают вывод - исследование клеточных маркеров, характеризующих различную глубину повреждения энтероцитов, позволяет: оценить вероятность развития НЭК у младенцев с ЭНМТ; провести раннюю диагностику НЭК; исключить НЭК у новорожденных со сходными симптомами; прогнозировать течение НЭК; предложить и обосновать персонифицированные подходы к коррекции низкой обеспеченности 25(ОН)D; проанализировать влияние генов-кандидатов на реализацию НЭК, его исходов и метаболизма 25(ОН)D. Для оценки повреждения на уровне энтероцита авторами для литературного анализа выбрана кишечная фракция белка, связывающего жирные кислоты (I-FABP). Для определения глубины повреждения межклеточных контактов кишечника - экспрессия трансмембранных (клаудин-2, клаудин-3, клаудин-4, окклюдин) и цитоплазматических (зонулин) белков плотных контактов. Анализ результатов исследований по экспрессии фекального кальпротектина, липокалина-2 (LCN2) и эозинофильного нейротоксина, показывающих активность локального воспаления, проведен с целью оценки как риска реализации НЭК, так и его течения. Повреждение кишечника связано с нарушением метаболизма 25(ОН)D, а метаболическое заболевание костей у недоношенных, реализовавших повреждение кишечного барьера вплоть до НЭК, регистрируется в десятки раз чаще на этапе выхаживания в ОРИТН. Огромным количеством исследований показано снижение выживаемости, повышение риска тяжелых осложнений на фоне низкой обеспеченности 25(ОН)D в популяции недоношенных. Авторы анализируют взаимосвязь обеспеченности 25(ОН)D с учетом влияния экзогенных и эндогенных факторов с характером повреждения стенки кишечника и реализацией НЭК, и делают акцент на существующие профилактические и лечебные подходы к назначению различных доз витамина D у недоношенных с НЭК.</p></abstract><trans-abstract xml:lang="en"><p>The priority of the national health policy is to preserve the life and a high level of quality of life for every premature baby. The clinical focus is on children born with ELBW. Among this category of children, NEC makes the main contribution to the structure of infant mortality. Based on the analysis of the literature, the authors conclude that the study of cell markers that characterize different depths of damage to enterocytes allows: to assess the likelihood of developing NEC in infants with ELMT; conduct early diagnosis of NEC; rule out NEC in neonates with similar symptoms; predict the course of NEC; propose and substantiate personalized approaches to correcting the low supply of 25(OH)D; to analyze the influence of candidate genes on the implementation of NEC, its outcomes, and 25(OH)D metabolism. To assess damage at the level of the enterocyte, the authors selected the intestinal fraction of fatty acid binding protein (I-FABP) for literature analysis. To determine the depth of damage to intercellular junctions of the intestine - the expression of transmembrane (claudin-2, claudin-3, claudin-4, occludin) and cytoplasmic (zonulin) tight junction proteins. Analysis of the results of studies on the expression of fecal calprotectin, lipocalin-2 (LCN2) and eosinophilic neurotoxin, showing the activity of local inflammation, was carried out in order to assess both the risk of NEC and its course. Intestinal damage is associated with impaired 25(OH)D metabolism, and metabolic bone disease in preterm infants with damage to the intestinal barrier up to NEC is recorded ten times more often at the stage of nursing in the NICU. A huge number of studies have shown a decrease in survival, an increase in the risk of severe complications against the background of a low supply of 25(OH)D in the preterm population. The authors analyze the relationship between 25(OH)D availability, taking into account the influence of exogenous and endogenous factors, the nature of damage to the intestinal wall and the implementation of NEC, and focus on the existing preventive and therapeutic approaches to prescribing various doses of vitamin D in preterm infants with NEC.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>некротизирующий энтероколит</kwd><kwd>недоношенность</kwd><kwd>I-FABP</kwd><kwd>клаудины</kwd><kwd>окклюдин</kwd><kwd>зонулин</kwd><kwd>кальпротектин</kwd><kwd>липокалин-2</kwd><kwd>эозинофильный нейротоксин</kwd><kwd>25(ОН)D</kwd></kwd-group><kwd-group xml:lang="en"><kwd>necrotizing enterocolitis</kwd><kwd>prematurity</kwd><kwd>I-FABP</kwd><kwd>claudins</kwd><kwd>occludin</kwd><kwd>zonulin</kwd><kwd>calprotectin</kwd><kwd>lipocalin-2</kwd><kwd>eosinophilic neurotoxin</kwd><kwd>25(OH)D</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">Jones I.H., Hall N. 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