nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-220-12-86-96nogr-2655Research ArticleМИКРОБИОТАMICROBIOTAРоль кишечной микробиоты и микробных метаболитов в развитии функционального запораThe role of intestinal microbiota and microbial metabolites in the development of functional constipationhttps://orcid.org/0000-0001-5129-9944ГалагудзаМ. М.GalagudzaM. M.noemail@neicon.ruhttps://orcid.org/0000-0003-3096-9747БорщевЮ. Ю.BorshchevYu. Yu.niscon@mail.ruБорщеваО. В.BorschevaO. V.noemail@neicon.ruКомарВ. В.KomarV. V.noemail@neicon.ruhttps://orcid.org/0000-0002-2436-3813ФоминыхЮ. А.FominykhYu. A.noemail@neicon.ruhttps://orcid.org/0000-0001-6434-1267УспенскийЮ. П.UspenskyYu. P.noemail@neicon.ruФГБУ НМИЦ им. В. А. Алмазова Минздрава России; ФГБОУ ВО ПСПбГМУ им. И. П. Павлова Минздрава РоссииРоссияFederal State Budgetary Institution National Medical Research Center named after. V. A. Almazova Ministry of Health of Russia; Federal State Budgetary Educational Institution of Higher Education PSPbSMU named after. I. P. Pavlova Ministry of Health of RussiaRussian FederationФГБУ НМИЦ им. В. А. Алмазова Минздрава России; ФГБУ НМИЦ онкологии им. Н. Н. Петрова Минздрава РоссииРоссияFederal State Budgetary Institution National Medical Research Center named after. V. A. Almazova Ministry of Health of Russia; Federal State Budgetary Institution National Medical Research Center of Oncology named after. N. N. Petrova Ministry of Health of RussiaRussian FederationФГБУ НМИЦ им. В. А. Алмазова Минздрава РоссииРоссияFederal State Budgetary Institution National Medical Research Center named after. V. A. Almazova Ministry of Health of RussiaRussian FederationФГБУ НМИЦ им. В. А. Алмазова Минздрава России; ФГБОУ ВО СПбГПМУ Минздрава РоссииРоссияFederal State Budgetary Institution National Medical Research Center named after. V. A. Almazova Ministry of Health of Russia; Federal State Budgetary Educational Institution of Higher Education St. Petersburg State Pediatric Medical University of the Ministry of Health of RussiaRussian FederationФГБОУ ВО ПСПбГМУ им. И. П. Павлова Минздрава России; ФГБОУ ВО СПбГПМУ Минздрава РоссииРоссияFederal State Budgetary Educational Institution of Higher Education PSPbSMU named after. I. P. Pavlova Ministry of Health of Russia; Federal State Budgetary Educational Institution of Higher Education St. Petersburg State Pediatric Medical University of the Ministry of Health of RussiaRussian Federation2023181220230128696Copyright © Галагудза М.М., Борщев Ю.Ю., Борщева О.В., Комар В.В., Фоминых Ю.А., Успенский Ю.П., 20232023Галагудза М.М., Борщев Ю.Ю., Борщева О.В., Комар В.В., Фоминых Ю.А., Успенский Ю.П.Galagudza M.M., Borshchev Y.Y., Borscheva O.V., Komar V.V., Fominykh Y.A., Uspensky Y.P.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/2655

В роли главного звена патогенеза функционального запора (ФЗ) с медленным кишечным транзитом выступает снижение моторной функции толстой кишки. Данные экспериментальных и клинических исследований показывают, что кишечная микробиота участвует в регуляции моторики толстой кишки за счет различных механизмов. При этом изучение молекулярных процессов, лежащих в основе влияния кишечной микробиоты и ее метаболитов на моторную функцию толстой кишки, находится на начальном этапе. В обзоре проведен анализ литературы, посвященной роли кишечной микробиоты в развитии ФЗ, представлены данные о механизмах действия различных микробных метаболитов на моторную и секреторную функцию толстой кишки и кратко описаны новые подходы к лечению ФЗ, основанные на модуляции состава кишечной микрофлоры. ФЗ сопровождается специфическими изменениями состава кишечной микробиоты, причем в последние годы исследователями установлены причинно-следственные отношения между определенными энтеротипами и развитием ФЗ. К настоящему времени идентифицированы основные микробные метаболиты, обладающие стимулирующим либо ингибирующим влиянием на пропульсивную перистальтику, а также на интенсивность секреции анионов и воды колоноцитами. Подходы к оптимизации состава микробиоты при ФЗ основаны на применении про- и пребиотиков, антибиотиков, а также использовании трансплантации кишечной микробиоты. Более глубокое понимание молекулярных механизмов, опосредующих влияние микробиоты и ее метаболитов на моторную функцию толстой кишки, может послужить основой для разработки новых подходов к лечению ФЗ.

The main link in the pathogenesis of functional constipation (FC) with slow intestinal transit is a decrease in the motor function of the colon. Data from experimental and clinical studies indicate that the gut microbiota is involved in the regulation of colonic motility through various mechanisms. At the same time, the study of the molecular processes underlying the influence of the intestinal microbiota and its metabolites on the motor function of the colon is at an early stage. The review analyzes the literature on the role of intestinal microbiota in the development of FD, presents data on the mechanisms of action of various microbial metabolites on the motor and secretory function of the colon, and briefly describes new approaches to the treatment of FD based on modulating the composition of the intestinal microflora. FZ is accompanied by specific changes in the composition of the intestinal microbiota, and in recent years, researchers have established cause-and-effect relationships between certain enterotypes and the development of FZ. To date, the main microbial metabolites have been identified that have a stimulating or inhibitory effect on propulsive peristalsis, as well as on the intensity of secretion of anions and water by colonocytes. Approaches to optimizing the composition of the microbiota in FZ are based on the use of pro- and prebiotics, antibiotics, as well as the use of intestinal microbiota transplantation. A deeper understanding of the molecular mechanisms mediating the influence of the microbiota and its metabolites on colonic motor function may serve as the basis for the development of new approaches to the treatment of FZ.

кишечная микробиотапробиотикимоторная функция толстой кишкифункциональный запорзапор с медленным транзитомтрансплантация кишечной микробиотыintestinal microbiotaprobioticscolon motor functionfunctional constipationslow transit constipationintestinal microbiota transplantationReferencesAlmario C. V., Ballal M. L., Chey W. D. et al. Burden of gastrointestinal symptoms in the United States: results of a nationally representative survey of over 71,000 Americans. Am J Gastroenterol. 2018;113(11):1701-1710. doi: 10.1038/s41395-018-0256-8.Almario C. V., Ballal M. L., Chey W. D. et al. Burden of gastrointestinal symptoms in the United States: results of a nationally representative survey of over 71,000 Americans. Am J Gastroenterol. 2018;113(11):1701-1710. doi: 10.1038/s41395-018-0256-8.Bharucha A. E., Lacy B. E. Mechanisms, evaluation, and management of chronic constipation. Gastroenterology. 2020;158(5):1232-1249.e3. doi: 10.1053/j.gastro.2019.12.034.Bharucha A. E., Lacy B. E. Mechanisms, evaluation, and management of chronic constipation. Gastroenterology. 2020;158(5):1232-1249.e3. doi: 10.1053/j.gastro.2019.12.034.Forootan M., Bagheri N., Darvishi M. Chronic constipation: a review of literature. Medicine (Baltimore). 2018;97(20): e10631. doi: 10.1097/MD.0000000000010631.Forootan M., Bagheri N., Darvishi M. Chronic constipation: a review of literature. Medicine (Baltimore). 2018;97(20): e10631. doi: 10.1097/MD.0000000000010631.De Giorgio R., Ruggeri E., Stanghellini V. et al. Chronic constipation in the elderly: a primer for the gastroenterologist. BMC Gastroenterol. 2015;15:130. doi: 10.1186/s12876-015-0366-3.De Giorgio R., Ruggeri E., Stanghellini V. et al. Chronic constipation in the elderly: a primer for the gastroenterologist. BMC Gastroenterol. 2015;15:130. doi: 10.1186/s12876-015-0366-3.Faigel D. O. A clinical approach to constipation. Clin Cornerstone. 2002;4(4):11-21. doi: 10.1016/s1098-3597(02)90002-5.Faigel D. O. A clinical approach to constipation. Clin Cornerstone. 2002;4(4):11-21. doi: 10.1016/s1098-3597(02)90002-5.Staller K., Olen O., Soderling J. et al. Chronic constipation as a risk factor for colorectal cancer: results from a nationwide, case-control study. Clin Gastroenterol Hepatol. 2022;20(8):1867-1876.e2. doi: 10.1016/j.cgh.2021.10.024.Staller K., Olen O., Soderling J. et al. Chronic constipation as a risk factor for colorectal cancer: results from a nationwide, case-control study. Clin Gastroenterol Hepatol. 2022;20(8):1867-1876.e2. doi: 10.1016/j.cgh.2021.10.024.Lazebnik L. B., Turkina S. V., Golovanova E. V., et al. Constipation in adults. Experimental and Clinical Gastroenterology. 2020;175(3):10-33. (In Russ.) doi: 10.31146/1682-8658-ecg-175-3-10-33.@@ Лазебник Л. Б., Туркина С. В., Голованова Е. В. и соавт. Запоры у взрослых. Экспериментальная и клиническая гастроэнтерология. 2020;175(3):10-33. doi: 10.31146/1682-8658-ecg-175-3-10-33.Lazebnik L. B., Turkina S. V., Golovanova E. V., et al. Constipation in adults. Experimental and Clinical Gastroenterology. 2020;175(3):10-33. (In Russ.) doi: 10.31146/1682-8658-ecg-175-3-10-33.@@ Лазебник Л. Б., Туркина С. В., Голованова Е. В. и соавт. Запоры у взрослых. Экспериментальная и клиническая гастроэнтерология. 2020;175(3):10-33. doi: 10.31146/1682-8658-ecg-175-3-10-33.Ravi K., Bharucha A. E., Camilleri M. et al. Phenotypic variation of colonic motor functions in chronic constipation. Gastroenterology. 2010;138(1):89-97. doi: 10.1053/j.gastro.2009.07.057.Ravi K., Bharucha A. E., Camilleri M. et al. Phenotypic variation of colonic motor functions in chronic constipation. Gastroenterology. 2010;138(1):89-97. doi: 10.1053/j.gastro.2009.07.057.Mearin F., Lacy B. E., Chang L. et al. Bowel disorders. Gastroenterology. 2016; S0016-5085(16)00222-5. doi: 10.1053/j.gastro.2016.02.031.Mearin F., Lacy B. E., Chang L. et al. Bowel disorders. Gastroenterology. 2016; S0016-5085(16)00222-5. doi: 10.1053/j.gastro.2016.02.031.Dinning P. G., Smith T. K., Scott S. M. Pathophysiology of colonic causes of chronic constipation. Neurogastroenterol Motil. 2009;21 Suppl 2(Suppl 2):20-30. doi: 10.1111/j.1365-2982.2009.01401.x.Dinning P. G., Smith T. K., Scott S. M. Pathophysiology of colonic causes of chronic constipation. Neurogastroenterol Motil. 2009;21 Suppl 2(Suppl 2):20-30. doi: 10.1111/j.1365-2982.2009.01401.x.Knowles C.H., Scott S. M., Lunniss P. J. Slow transit constipation: a disorder of pelvic autonomic nerves? Dig Dis Sci. 2001;46(2):389-401. doi: 10.1023/a:1005665218647.Knowles C.H., Scott S. M., Lunniss P. J. Slow transit constipation: a disorder of pelvic autonomic nerves? Dig Dis Sci. 2001;46(2):389-401. doi: 10.1023/a:1005665218647.Mawe G.M., Sanders K. M., Camilleri M. Overview of the enteric nervous system. Semin Neurol. 2023. doi: 10.1055/s-0043-1771466.Mawe G.M., Sanders K. M., Camilleri M. Overview of the enteric nervous system. Semin Neurol. 2023. doi: 10.1055/s-0043-1771466.Zhao Q., Chen Y. Y., Xu D. Q. et al. Action mode of gut motility, fluid and electrolyte transport in chronic constipation. Front Pharmacol. 2021;12:630249. doi: 10.3389/fphar.2021.630249.Zhao Q., Chen Y. Y., Xu D. Q. et al. Action mode of gut motility, fluid and electrolyte transport in chronic constipation. Front Pharmacol. 2021;12:630249. doi: 10.3389/fphar.2021.630249.Postler T.S, Ghosh S. Understanding the holobiont: how microbial metabolites affect human health and shape the immune system. Cell Metab. 2017;26(1):110-130. doi: 10.1016/j.cmet.2017.05.008.Postler T.S, Ghosh S. Understanding the holobiont: how microbial metabolites affect human health and shape the immune system. Cell Metab. 2017;26(1):110-130. doi: 10.1016/j.cmet.2017.05.008.Borschev Yu.I., Ermolenko E. I. Metabolic syndrome and intestinal microecology. Transl’atsionnaya Medicina = Translational Medicine. 2014;1:19-28. (In Russ.) doi: 10.18705/2311-4495-2014-0-1-23-31.@@ Борщев Ю. Ю., Ермоленко Е. И. Метаболический синдром и микроэкология кишечника. Трансляционная медицина. 2014;1:19-28. doi: 10.18705/2311-4495-2014-0-1-23-31.Borschev Yu.I., Ermolenko E. I. Metabolic syndrome and intestinal microecology. Transl’atsionnaya Medicina = Translational Medicine. 2014;1:19-28. (In Russ.) doi: 10.18705/2311-4495-2014-0-1-23-31.@@ Борщев Ю. Ю., Ермоленко Е. И. Метаболический синдром и микроэкология кишечника. Трансляционная медицина. 2014;1:19-28. doi: 10.18705/2311-4495-2014-0-1-23-31.Santos-Paulo S., Costello S. P., Forster S. C., Travis S. P., Bryant R. V. The gut microbiota as a therapeutic target for obesity: a scoping review. Nutr Res Rev. 2022;35(2):207-220. doi: 10.1017/S0954422421000160.Santos-Paulo S., Costello S. P., Forster S. C., Travis S. P., Bryant R. V. The gut microbiota as a therapeutic target for obesity: a scoping review. Nutr Res Rev. 2022;35(2):207-220. doi: 10.1017/S0954422421000160.Yudina Yu.V., Korsunsky A. A., Aminova A. I., Abdullaeva G. D., Prodeus A. P. Gut microbiota as a separate body system. Dokazatelnaya Gastroenterologiya = Russian Journal of Evidence-Based Gastroenterology. 2019;8(4):36-43. (in Russ.) doi: 10.17116/dokgastro2019804-05136.@@ Юдина Ю. В., Корсунский А. А., Аминова А. И., Абдуллаева Г. Д., Продеус А. П. Микробиота кишечника как отдельная система организма. Доказательная гастроэнтерология. 2019;8(4):36-43. doi: 10.17116/dokgastro2019804-05136.Yudina Yu.V., Korsunsky A. A., Aminova A. I., Abdullaeva G. D., Prodeus A. P. Gut microbiota as a separate body system. Dokazatelnaya Gastroenterologiya = Russian Journal of Evidence-Based Gastroenterology. 2019;8(4):36-43. (in Russ.) doi: 10.17116/dokgastro2019804-05136.@@ Юдина Ю. В., Корсунский А. А., Аминова А. И., Абдуллаева Г. Д., Продеус А. П. Микробиота кишечника как отдельная система организма. Доказательная гастроэнтерология. 2019;8(4):36-43. doi: 10.17116/dokgastro2019804-05136.Ibragimova L.I., Kolpakova E. A., Dzagakhova A. V. et al. The role of the gut microbiota in the development of type 1 diabetes mellitus. Saharnyj Diabet = Diabetes mellitus. 2021;24(1):62-69. (in Russ.) doi: 10.14341/DM10326.@@ Ибрагимова Л. И., Колпакова Е. А., Дзагахова А. В., Егшатян Л. В., Покровская Е. В., Никонова Т. В. Роль микробиоты кишечника в развитии сахарного диабета 1 типа. Сахарный диабет. 2021;24(1):62-69. doi: 10.14341/DM10326.Ibragimova L.I., Kolpakova E. A., Dzagakhova A. V. et al. The role of the gut microbiota in the development of type 1 diabetes mellitus. Saharnyj Diabet = Diabetes mellitus. 2021;24(1):62-69. (in Russ.) doi: 10.14341/DM10326.@@ Ибрагимова Л. И., Колпакова Е. А., Дзагахова А. В., Егшатян Л. В., Покровская Е. В., Никонова Т. В. Роль микробиоты кишечника в развитии сахарного диабета 1 типа. Сахарный диабет. 2021;24(1):62-69. doi: 10.14341/DM10326.Tierney B. T., Yang Z., Luber J. M. et al. The landscape of genetic content in the gut and oral human microbiome. Cell Host Microbe. 2019;26(2):283-295.e8. doi:10.1016/j.chom.2019.07.008.Tierney B. T., Yang Z., Luber J. M. et al. The landscape of genetic content in the gut and oral human microbiome. Cell Host Microbe. 2019;26(2):283-295.e8. doi:10.1016/j.chom.2019.07.008.Wu Y., Zhuang J., Zhang Q. et al. Aging characteristics of colorectal cancer based on gut microbiota. Cancer Med. 2023. doi: 10.1002/cam4.6414.Wu Y., Zhuang J., Zhang Q. et al. Aging characteristics of colorectal cancer based on gut microbiota. Cancer Med. 2023. doi: 10.1002/cam4.6414.Li Q., Zhou S., Wang Y., Cong J. Changes of intestinal microbiota and microbiota-based treatments in IBD. Arch Microbiol. 2022;204(7):442. doi: 10.1007/s00203-022-03069-4.Li Q., Zhou S., Wang Y., Cong J. Changes of intestinal microbiota and microbiota-based treatments in IBD. Arch Microbiol. 2022;204(7):442. doi: 10.1007/s00203-022-03069-4.Zhao Y., Zou D. W. Gut microbiota and irritable bowel syndrome. J Dig Dis. 2023. doi: 10.1111/1751-2980.13204;Zhao Y., Zou D. W. Gut microbiota and irritable bowel syndrome. J Dig Dis. 2023. doi: 10.1111/1751-2980.13204;Zhang S., Wang R., Li D. et al. Role of gut microbiota in functional constipation. Gastroenterol Rep (Oxf). 2021;9(5):392-401. doi: 10.1093/gastro/goab035.Zhang S., Wang R., Li D. et al. Role of gut microbiota in functional constipation. Gastroenterol Rep (Oxf). 2021;9(5):392-401. doi: 10.1093/gastro/goab035.Ohkusa T., Koido S., Nishikawa Y., Sato N. Gut microbiota and chronic constipation: a review and update. Front Med (Lausanne). 2019;6:19. doi: 10.3389/fmed.2019.00019.Ohkusa T., Koido S., Nishikawa Y., Sato N. Gut microbiota and chronic constipation: a review and update. Front Med (Lausanne). 2019;6:19. doi: 10.3389/fmed.2019.00019.Petersen C., Round J. L. Defining dysbiosis and its influence on host immunity and disease. Cell Microbiol. 2014;16(7):1024-1033. doi: 10.1111/cmi.12308.Petersen C., Round J. L. Defining dysbiosis and its influence on host immunity and disease. Cell Microbiol. 2014;16(7):1024-1033. doi: 10.1111/cmi.12308.Zoppi G., Cinquetti M., Luciano A. et al. The intestinal ecosystem in chronic functional constipation. Acta Paediatr. 1998;87(8):836-841. doi: 10.1080/080352598750013590.Zoppi G., Cinquetti M., Luciano A. et al. The intestinal ecosystem in chronic functional constipation. Acta Paediatr. 1998;87(8):836-841. doi: 10.1080/080352598750013590.Khalif I.L., Quigley E. M., Konovitch E. A., Maximova I. D. Alterations in the colonic flora and intestinal permeability and evidence of immune activation in chronic constipation. Dig Liver Dis. 2005;37(11):838-849. doi: 10.1016/j.dld.2005.06.008.Khalif I.L., Quigley E. M., Konovitch E. A., Maximova I. D. Alterations in the colonic flora and intestinal permeability and evidence of immune activation in chronic constipation. Dig Liver Dis. 2005;37(11):838-849. doi: 10.1016/j.dld.2005.06.008.Durban A., Abellan J. J., Jimenez-Hernandez N. et al. Structural alterations of faecal and mucosa-associated bacterial communities in irritable bowel syndrome. Environ Microbiol Rep. 2012;4(2):242-247. doi: 10.1111/j.1758-2229.2012.00327.x.Durban A., Abellan J. J., Jimenez-Hernandez N. et al. Structural alterations of faecal and mucosa-associated bacterial communities in irritable bowel syndrome. Environ Microbiol Rep. 2012;4(2):242-247. doi: 10.1111/j.1758-2229.2012.00327.x.Zhu L., Liu W., Alkhouri R. et al. Structural changes in the gut microbiome of constipated patients. Physiol Genomics. 2014;46(18):679-686. doi: 10.1152/physiolgenomics.00082.2014.Zhu L., Liu W., Alkhouri R. et al. Structural changes in the gut microbiome of constipated patients. Physiol Genomics. 2014;46(18):679-686. doi: 10.1152/physiolgenomics.00082.2014.Kim S. E., Choi S. C., Park K. S. et al. Change of fecal flora and effectiveness of the short-term VSL#3 probiotic treatment in patients with functional constipation. J Neurogastroenterol Motil. 2015;21(1):111-120. doi: 10.5056/jnm14048.Kim S. E., Choi S. C., Park K. S. et al. Change of fecal flora and effectiveness of the short-term VSL#3 probiotic treatment in patients with functional constipation. J Neurogastroenterol Motil. 2015;21(1):111-120. doi: 10.5056/jnm14048.Parthasarathy G., Chen J., Chen X. et al. Relationship between microbiota of the colonic mucosa vs feces and symptoms, colonic transit, and methane production in female patients with chronic constipation. Gastroenterology. 2016;150(2):367-379.e1. doi: 10.1053/j.gastro.2015.10.005.Parthasarathy G., Chen J., Chen X. et al. Relationship between microbiota of the colonic mucosa vs feces and symptoms, colonic transit, and methane production in female patients with chronic constipation. Gastroenterology. 2016;150(2):367-379.e1. doi: 10.1053/j.gastro.2015.10.005.Mancabelli L., Milani C., Lugli G. A. et al. Unveiling the gut microbiota composition and functionality associated with constipation through metagenomic analyses. Sci Rep. 2017;7(1):9879. doi: 10.1038/s41598-017-10663-w.Mancabelli L., Milani C., Lugli G. A. et al. Unveiling the gut microbiota composition and functionality associated with constipation through metagenomic analyses. Sci Rep. 2017;7(1):9879. doi: 10.1038/s41598-017-10663-w.Tian H., Chen Q., Yang B. et al. Analysis of gut microbiome and metabolite characteristics in patients with slow transit constipation. Dig Dis Sci. 2021;66(9):3026-3035. doi: 10.1007/s10620-020-06500-2.Tian H., Chen Q., Yang B. et al. Analysis of gut microbiome and metabolite characteristics in patients with slow transit constipation. Dig Dis Sci. 2021;66(9):3026-3035. doi: 10.1007/s10620-020-06500-2.Yu T., Ding Y., Qian D. et al. Characteristics of fecal microbiota in different constipation subtypes and association with colon physiology, lifestyle factors, and psychological status. Therap Adv Gastroenterol. 2023;16:17562848231154101. doi: 10.1177/17562848231154101.Yu T., Ding Y., Qian D. et al. Characteristics of fecal microbiota in different constipation subtypes and association with colon physiology, lifestyle factors, and psychological status. Therap Adv Gastroenterol. 2023;16:17562848231154101. doi: 10.1177/17562848231154101.Jama H. A., Beale A., Shihata W. A., Marques F. Z. The effect of diet on hypertensive pathology: is there a link via gut microbiota-driven immunometabolism? Cardiovasc Res. 2019;115(9):1435-1447. doi: 10.1093/cvr/cvz091.Jama H. A., Beale A., Shihata W. A., Marques F. Z. The effect of diet on hypertensive pathology: is there a link via gut microbiota-driven immunometabolism? Cardiovasc Res. 2019;115(9):1435-1447. doi: 10.1093/cvr/cvz091.Magne F., Gotteland M., Gauthier L. et al. The Firmicutes/Bacteroidetes ratio: a relevant marker of gut dysbiosis in obese patients? Nutrients. 2020;12(5):1474. doi: 10.3390/nu12051474.Magne F., Gotteland M., Gauthier L. et al. The Firmicutes/Bacteroidetes ratio: a relevant marker of gut dysbiosis in obese patients? Nutrients. 2020;12(5):1474. doi: 10.3390/nu12051474.Lu Y., Zhang Y., Zhao X. et al. Microbiota-derived short-chain fatty acids: implications for cardiovascular and metabolic disease. Front Cardiovasc Med. 2022;9:900381. doi: 10.3389/fcvm.2022.900381.Lu Y., Zhang Y., Zhao X. et al. Microbiota-derived short-chain fatty acids: implications for cardiovascular and metabolic disease. Front Cardiovasc Med. 2022;9:900381. doi: 10.3389/fcvm.2022.900381.Du Y., Li Y., Xu X. et al. Probiotics for constipation and gut microbiota in Parkinson’s disease. Parkinsonism Relat Disord. 2022;103:92-97. doi: 10.1016/j.parkreldis.2022.08.022.Du Y., Li Y., Xu X. et al. Probiotics for constipation and gut microbiota in Parkinson’s disease. Parkinsonism Relat Disord. 2022;103:92-97. doi: 10.1016/j.parkreldis.2022.08.022.Yang L., Wang Y., Zhang Y. et al. Gut microbiota: a new avenue to reveal pathological mechanisms of constipation. Appl Microbiol Biotechnol. 2022;106(21):6899-6913. doi: 10.1007/s00253-022-12197-2.Yang L., Wang Y., Zhang Y. et al. Gut microbiota: a new avenue to reveal pathological mechanisms of constipation. Appl Microbiol Biotechnol. 2022;106(21):6899-6913. doi: 10.1007/s00253-022-12197-2.Corsetti M., Costa M., Bassotti G. et al. First translational consensus on terminology and definitions of colonic motility in animals and humans studied by manometric and other techniques. Nat Rev Gastroenterol Hepatol. 2019;16(9):559-579. doi: 10.1038/s41575-019-0167-1.Corsetti M., Costa M., Bassotti G. et al. First translational consensus on terminology and definitions of colonic motility in animals and humans studied by manometric and other techniques. Nat Rev Gastroenterol Hepatol. 2019;16(9):559-579. doi: 10.1038/s41575-019-0167-1.Dinning P.G. A new understanding of the physiology and pathophysiology of colonic motility? Neurogastroenterol Motil. 2018;30(11): e13395. doi: 10.1111/nmo.13395.Dinning P.G. A new understanding of the physiology and pathophysiology of colonic motility? Neurogastroenterol Motil. 2018;30(11): e13395. doi: 10.1111/nmo.13395.Bharucha A. E. High amplitude propagated contractions. Neurogastroenterol Motil. 2012;24(11):977-982. doi: 10.1111/nmo.12019.Bharucha A. E. High amplitude propagated contractions. Neurogastroenterol Motil. 2012;24(11):977-982. doi: 10.1111/nmo.12019.Clemens C.H., Samsom M., Van Berge Henegouwen G. P., Smout A. J. Abnormalities of left colonic motility in ambulant nonconstipated patients with irritable bowel syndrome. Dig Dis Sci. 2003;48(1):74-82. doi: 10.1023/a:1021734414976.Clemens C.H., Samsom M., Van Berge Henegouwen G. P., Smout A. J. Abnormalities of left colonic motility in ambulant nonconstipated patients with irritable bowel syndrome. Dig Dis Sci. 2003;48(1):74-82. doi: 10.1023/a:1021734414976.Lyford G.L., He C. L., Soffer E. et al. Pan-colonic decrease in interstitial cells of Cajal in patients with slow transit constipation. Gut. 2002;51(4):496-501. doi: 10.1136/gut.51.4.496.Lyford G.L., He C. L., Soffer E. et al. Pan-colonic decrease in interstitial cells of Cajal in patients with slow transit constipation. Gut. 2002;51(4):496-501. doi: 10.1136/gut.51.4.496.Sanders K.M., Ward S. M., Koh S. D.Interstitial cells: regulators of smooth muscle function. Physiol Rev. 2014;94(3):859-907. doi: 10.1152/physrev.00037.2013.Sanders K.M., Ward S. M., Koh S. D.Interstitial cells: regulators of smooth muscle function. Physiol Rev. 2014;94(3):859-907. doi: 10.1152/physrev.00037.2013.Wang H., Ren B., Pan J. et al. Effect of miR-129-3p on autophagy of interstitial cells of Cajal in slow transit constipation through SCF C-kit signaling pathway. Acta Biochim Pol. 2022;69(3):579-586. doi: 10.18388/abp.2020_5877.Wang H., Ren B., Pan J. et al. Effect of miR-129-3p on autophagy of interstitial cells of Cajal in slow transit constipation through SCF C-kit signaling pathway. Acta Biochim Pol. 2022;69(3):579-586. doi: 10.18388/abp.2020_5877.Chiang J. Y. Bile acid metabolism and signaling.Compr Physiol. 2013;3(3):1191-1212. doi: 10.1002/cphy.c120023.Chiang J. Y. Bile acid metabolism and signaling.Compr Physiol. 2013;3(3):1191-1212. doi: 10.1002/cphy.c120023.Bunnett N. W. Neuro-humoral signalling by bile acids and the TGR5 receptor in the gastrointestinal tract. J Physiol. 2014;592(14):2943-2950. doi: 10.1113/jphysiol.2014.271155.Bunnett N. W. Neuro-humoral signalling by bile acids and the TGR5 receptor in the gastrointestinal tract. J Physiol. 2014;592(14):2943-2950. doi: 10.1113/jphysiol.2014.271155.Nakajima A., Seki M., Taniguchi S. et al. Safety and efficacy of elobixibat for chronic constipation: results from a randomised, double-blind, placebo-controlled, phase 3 trial and an open-label, single-arm, phase 3 trial. Lancet Gastroenterol Hepatol. 2018;3(8):537-547. doi: 10.1016/S2468-1253(18)30123-7.Nakajima A., Seki M., Taniguchi S. et al. Safety and efficacy of elobixibat for chronic constipation: results from a randomised, double-blind, placebo-controlled, phase 3 trial and an open-label, single-arm, phase 3 trial. Lancet Gastroenterol Hepatol. 2018;3(8):537-547. doi: 10.1016/S2468-1253(18)30123-7.Cao H., Liu X., An Y. et al. Dysbiosis contributes to chronic constipation development via regulation of serotonin transporter in the intestine. Sci Rep. 2017;7(1):10322. doi: 10.1038/s41598-017-10835-8.Cao H., Liu X., An Y. et al. Dysbiosis contributes to chronic constipation development via regulation of serotonin transporter in the intestine. Sci Rep. 2017;7(1):10322. doi: 10.1038/s41598-017-10835-8.Bhattarai Y., Jie S., Linden D. R. et al. Bacterially derived tryptamine increases mucus release by activating a host receptor in a mouse model of inflammatory bowel disease. iScience. 2020;23(12):101798. doi: 10.1016/j.isci.2020.101798.Bhattarai Y., Jie S., Linden D. R. et al. Bacterially derived tryptamine increases mucus release by activating a host receptor in a mouse model of inflammatory bowel disease. iScience. 2020;23(12):101798. doi: 10.1016/j.isci.2020.101798.Obata Y., Castano A., Boeing S. et al. Neuronal programming by microbiota regulates intestinal physiology. Nature. 2020;578(7794):284-289. doi: 10.1038/s41586-020-1975-8.Obata Y., Castano A., Boeing S. et al. Neuronal programming by microbiota regulates intestinal physiology. Nature. 2020;578(7794):284-289. doi: 10.1038/s41586-020-1975-8.Ye L., Bae M., Cassilly C. D. et al. Enteroendocrine cells sense bacterial tryptophan catabolites to activate enteric and vagal neuronal pathways. Cell Host Microbe. 2021;29(2):179-196.e9. doi: 10.1016/j.chom.2020.11.011.Ye L., Bae M., Cassilly C. D. et al. Enteroendocrine cells sense bacterial tryptophan catabolites to activate enteric and vagal neuronal pathways. Cell Host Microbe. 2021;29(2):179-196.e9. doi: 10.1016/j.chom.2020.11.011.Gribble F.M., Reimann F. Function and mechanisms of enteroendocrine cells and gut hormones in metabolism. Nat Rev Endocrinol. 2019;15(4):226-237. doi: 10.1038/s41574-019-0168-8.Gribble F.M., Reimann F. Function and mechanisms of enteroendocrine cells and gut hormones in metabolism. Nat Rev Endocrinol. 2019;15(4):226-237. doi: 10.1038/s41574-019-0168-8.Ghoshal U.C., Srivastava D., Misra A. A randomized double-blind placebo-controlled trial showing rifaximin to improve constipation by reducing methane production and accelerating colon transit: A pilot study. Indian J Gastroenterol. 2018;37(5):416-423. doi: 10.1007/s12664-018-0901-6.Ghoshal U.C., Srivastava D., Misra A. A randomized double-blind placebo-controlled trial showing rifaximin to improve constipation by reducing methane production and accelerating colon transit: A pilot study. Indian J Gastroenterol. 2018;37(5):416-423. doi: 10.1007/s12664-018-0901-6.Attaluri A., Jackson M., Valestin J., Rao S. S. Methanogenic flora is associated with altered colonic transit but not stool characteristics in constipation without IBS. Am J Gastroenterol. 2010;105(6):1407-1411. doi: 10.1038/ajg.2009.655.Attaluri A., Jackson M., Valestin J., Rao S. S. Methanogenic flora is associated with altered colonic transit but not stool characteristics in constipation without IBS. Am J Gastroenterol. 2010;105(6):1407-1411. doi: 10.1038/ajg.2009.655.Low K., Hwang L., Hua J. et al. A combination of rifaximin and neomycin is most effective in treating irritable bowel syndrome patients with methane on lactulose breath test. J Clin Gastroenterol. 2010;44(8):547-550. doi: 10.1097/MCG.0b013e3181c64c90.Low K., Hwang L., Hua J. et al. A combination of rifaximin and neomycin is most effective in treating irritable bowel syndrome patients with methane on lactulose breath test. J Clin Gastroenterol. 2010;44(8):547-550. doi: 10.1097/MCG.0b013e3181c64c90.Anitha M., Vijay-Kumar M., Sitaraman S. V. et al. Gut microbial products regulate murine gastrointestinal motility via Toll-like receptor 4 signaling. Gastroenterology. 2012;143(4):1006-1016.e4. doi: 10.1053/j.gastro.2012.06.034.Anitha M., Vijay-Kumar M., Sitaraman S. V. et al. Gut microbial products regulate murine gastrointestinal motility via Toll-like receptor 4 signaling. Gastroenterology. 2012;143(4):1006-1016.e4. doi: 10.1053/j.gastro.2012.06.034.Yarandi S. S., Kulkarni S., Saha M. et al.Intestinal bacteria maintain adult enteric nervous system and nitrergic neurons via toll-like receptor 2-induced neurogenesis in mice. Gastroenterology. 2020;159(1):200-213.e8. doi: 10.1053/j.gastro.2020.03.050.Yarandi S. S., Kulkarni S., Saha M. et al.Intestinal bacteria maintain adult enteric nervous system and nitrergic neurons via toll-like receptor 2-induced neurogenesis in mice. Gastroenterology. 2020;159(1):200-213.e8. doi: 10.1053/j.gastro.2020.03.050.Keely S.J., Urso A., Ilyaskin A. V. et al. Contributions of bile acids to gastrointestinal physiology as receptor agonists and modifiers of ion channels. Am J Physiol Gastrointest Liver Physiol. 2022;322(2): G201-G222. doi: 10.1152/ajpgi.00125.2021.Keely S.J., Urso A., Ilyaskin A. V. et al. Contributions of bile acids to gastrointestinal physiology as receptor agonists and modifiers of ion channels. Am J Physiol Gastrointest Liver Physiol. 2022;322(2): G201-G222. doi: 10.1152/ajpgi.00125.2021.Keely S.J., Walters J. R. The farnesoid X receptor: good for BAD. Cell Mol Gastroenterol Hepatol. 2016;2(6):725-732. doi: 10.1016/j.jcmgh.2016.08.004.Keely S.J., Walters J. R. The farnesoid X receptor: good for BAD. Cell Mol Gastroenterol Hepatol. 2016;2(6):725-732. doi: 10.1016/j.jcmgh.2016.08.004.Williams B. B., Van Benschoten A. H., Cimermancic P. et al. Discovery and characterization of gut microbiota decarboxylases that can produce the neurotransmitter tryptamine. Cell Host Microbe. 2014;16(4):495-503. doi: 10.1016/j.chom.2014.09.001.Williams B. B., Van Benschoten A. H., Cimermancic P. et al. Discovery and characterization of gut microbiota decarboxylases that can produce the neurotransmitter tryptamine. Cell Host Microbe. 2014;16(4):495-503. doi: 10.1016/j.chom.2014.09.001.Bhattarai Y., Williams B. B., Battaglioli E. J. et al. Gut microbiota-produced tryptamine activates an epithelial G-protein-coupled receptor to increase colonic secretion. Cell Host Microbe. 2018;23(6):775-785.e5. doi: 10.1016/j.chom.2018.05.004.Bhattarai Y., Williams B. B., Battaglioli E. J. et al. Gut microbiota-produced tryptamine activates an epithelial G-protein-coupled receptor to increase colonic secretion. Cell Host Microbe. 2018;23(6):775-785.e5. doi: 10.1016/j.chom.2018.05.004.Hayes C.L., Dong J., Galipeau H. J. et al.Commensal microbiota induces colonic barrier structure and functions that contribute to homeostasis. Sci Rep. 2018;8(1):14184. doi: 10.1038/s41598-018-32366-6.Hayes C.L., Dong J., Galipeau H. J. et al.Commensal microbiota induces colonic barrier structure and functions that contribute to homeostasis. Sci Rep. 2018;8(1):14184. doi: 10.1038/s41598-018-32366-6.Wrzosek L., Miquel S., Noordine M. L. et al. Bacteroides thetaiotaomicron and Faecalibacterium prausnitzii influence the production of mucus glycans and the development of goblet cells in the colonic epithelium of a gnotobiotic model rodent. BMC Biol. 2013;11:61. doi: 10.1186/1741-7007-11-61.Wrzosek L., Miquel S., Noordine M. L. et al. Bacteroides thetaiotaomicron and Faecalibacterium prausnitzii influence the production of mucus glycans and the development of goblet cells in the colonic epithelium of a gnotobiotic model rodent. BMC Biol. 2013;11:61. doi: 10.1186/1741-7007-11-61.Yesilyurt N., Yilmaz B., Agagunduz D., Capasso R. Involvement of probiotics and postbiotics in the immune system modulation. Biologics 2021;1:89-110. doi: 10.3390/biologics1020006.Yesilyurt N., Yilmaz B., Agagunduz D., Capasso R. Involvement of probiotics and postbiotics in the immune system modulation. Biologics 2021;1:89-110. doi: 10.3390/biologics1020006.Dargahi N., Johnson J., Donkor O. et al. Immunomodulatory effects of probiotics: Can they be used to treat allergies and autoimmune diseases? Maturitas. 2019;119:25-38. doi: 10.1016/j.maturitas.2018.11.002.Dargahi N., Johnson J., Donkor O. et al. Immunomodulatory effects of probiotics: Can they be used to treat allergies and autoimmune diseases? Maturitas. 2019;119:25-38. doi: 10.1016/j.maturitas.2018.11.002.Martoni C.J., Evans M., Chow C. T. et al. Impact of a probiotic product on bowel habits and microbial profile in participants with functional constipation: A randomized controlled trial. J Dig Dis. 2019;20(9):435-446. doi: 10.1111/1751-2980.12797.Martoni C.J., Evans M., Chow C. T. et al. Impact of a probiotic product on bowel habits and microbial profile in participants with functional constipation: A randomized controlled trial. J Dig Dis. 2019;20(9):435-446. doi: 10.1111/1751-2980.12797.Airaksinen K., Yeung N., Lyra A. et al. The effect of a probiotic blend on gastrointestinal symptoms in constipated patients: a double blind, randomized, placebo controlled 2-week trial. Benef Microbes. 2019;10(6):617-627. doi: 10.3920/BM2018.0163.Airaksinen K., Yeung N., Lyra A. et al. The effect of a probiotic blend on gastrointestinal symptoms in constipated patients: a double blind, randomized, placebo controlled 2-week trial. Benef Microbes. 2019;10(6):617-627. doi: 10.3920/BM2018.0163.Dimidi E., Christodoulides S., Fragkos K. C. et al. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2014;100(4):1075-1084. doi: 10.3945/ajcn.114.089151.Dimidi E., Christodoulides S., Fragkos K. C. et al. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2014;100(4):1075-1084. doi: 10.3945/ajcn.114.089151.Zhang C., Jiang J., Tian F. et al. Meta-analysis of randomized controlled trials of the effects of probiotics on functional constipation in adults. Clin Nutr. 2020;39(10):2960-2969. doi: 10.1016/j.clnu.2020.01.005.Zhang C., Jiang J., Tian F. et al. Meta-analysis of randomized controlled trials of the effects of probiotics on functional constipation in adults. Clin Nutr. 2020;39(10):2960-2969. doi: 10.1016/j.clnu.2020.01.005.Agrawal A., Houghton L. A., Morris J. et al. Clinical trial: the effects of a fermented milk product containing Bifidobacterium lactis DN-173 010 on abdominal distension and gastrointestinal transit in irritable bowel syndrome with constipation. Aliment Pharmacol Ther. 2009;29(1):104-114. doi: 10.1111/j.1365-2036.2008.03853.x.Agrawal A., Houghton L. A., Morris J. et al. Clinical trial: the effects of a fermented milk product containing Bifidobacterium lactis DN-173 010 on abdominal distension and gastrointestinal transit in irritable bowel syndrome with constipation. Aliment Pharmacol Ther. 2009;29(1):104-114. doi: 10.1111/j.1365-2036.2008.03853.x.Recharla N., Choi J., Puligundla P. et al. Impact of probiotics on cognition and constipation in the elderly: a meta-analysis. Heliyon. 2023;9(7): e18306. doi: 10.1016/j.heliyon.2023.e18306.Recharla N., Choi J., Puligundla P. et al. Impact of probiotics on cognition and constipation in the elderly: a meta-analysis. Heliyon. 2023;9(7): e18306. doi: 10.1016/j.heliyon.2023.e18306.Chu J.R., Kang S. Y., Kim S. E. et al. Prebiotic UG1601 mitigates constipation-related events in association with gut microbiota: A randomized placebo-controlled intervention study. World J Gastroenterol. 2019;25(40):6129-6144. doi: 10.3748/wjg.v25.i40.6129.Chu J.R., Kang S. Y., Kim S. E. et al. Prebiotic UG1601 mitigates constipation-related events in association with gut microbiota: A randomized placebo-controlled intervention study. World J Gastroenterol. 2019;25(40):6129-6144. doi: 10.3748/wjg.v25.i40.6129.Liang Y.X., Wen P., Wang Y. et al. The constipation-relieving property of D-tagatose by modulating the composition of gut microbiota.Int J Mol Sci. 2019;20(22):5721. doi: 10.3390/ijms20225721.Liang Y.X., Wen P., Wang Y. et al. The constipation-relieving property of D-tagatose by modulating the composition of gut microbiota.Int J Mol Sci. 2019;20(22):5721. doi: 10.3390/ijms20225721.Guo Y., Song L., Huang Y. et al. Latilactobacillus sakei Furu2019 and stachyose as probiotics, prebiotics, and synbiotics alleviate constipation in mice. Front Nutr. 2023;9:1039403. doi: 10.3389/fnut.2022.1039403.Guo Y., Song L., Huang Y. et al. Latilactobacillus sakei Furu2019 and stachyose as probiotics, prebiotics, and synbiotics alleviate constipation in mice. Front Nutr. 2023;9:1039403. doi: 10.3389/fnut.2022.1039403.Fu X., Li R., Zhang T. et al. Study on the ability of partially hydrolyzed guar gum to modulate the gut microbiota and relieve constipation. J Food Biochem. 2019;43(2): e12715. doi: 10.1111/jfbc.12715.Fu X., Li R., Zhang T. et al. Study on the ability of partially hydrolyzed guar gum to modulate the gut microbiota and relieve constipation. J Food Biochem. 2019;43(2): e12715. doi: 10.1111/jfbc.12715.Chen Z., Lin S., Jiang Y. et al. Effects of bread yeast cell wall beta-glucans on mice with loperamide-induced constipation. J Med Food. 2019;22(10):1009-1021. doi: 10.1089/jmf.2019.4407.Chen Z., Lin S., Jiang Y. et al. Effects of bread yeast cell wall beta-glucans on mice with loperamide-induced constipation. J Med Food. 2019;22(10):1009-1021. doi: 10.1089/jmf.2019.4407.Wang J.W., Kuo C. H., Kuo F. C. et al. Fecal microbiota transplantation: Review and update. J Formos Med Assoc. 2019;118(Suppl.1): S23-S31. doi: 10.1016/j.jfma.2018.08.011.Wang J.W., Kuo C. H., Kuo F. C. et al. Fecal microbiota transplantation: Review and update. J Formos Med Assoc. 2019;118(Suppl.1): S23-S31. doi: 10.1016/j.jfma.2018.08.011.Tian H., Ding C., Gong J. et al. Treatment of slow transit constipation with fecal microbiota transplantation: a pilot study. J Clin Gastroenterol. 2016;50(10):865-870. doi: 10.1097/MCG.0000000000000472.Tian H., Ding C., Gong J. et al. Treatment of slow transit constipation with fecal microbiota transplantation: a pilot study. J Clin Gastroenterol. 2016;50(10):865-870. doi: 10.1097/MCG.0000000000000472.Ge X., Tian H., Ding C. et al. Fecal microbiota transplantation in combination with soluble dietary fiber for treatment of slow transit constipation: a pilot study. Arch Med Res. 2016;47(3):236-242. doi: 10.1016/j.arcmed.2016.06.005.Ge X., Tian H., Ding C. et al. Fecal microbiota transplantation in combination with soluble dietary fiber for treatment of slow transit constipation: a pilot study. Arch Med Res. 2016;47(3):236-242. doi: 10.1016/j.arcmed.2016.06.005.Ding C., Fan W., Gu L. et al. Outcomes and prognostic factors of fecal microbiota transplantation in patients with slow transit constipation: results from a prospective study with long-term follow-up. Gastroenterol Rep (Oxf). 2018;6(2):101-107. doi: 10.1093/gastro/gox036.Ding C., Fan W., Gu L. et al. Outcomes and prognostic factors of fecal microbiota transplantation in patients with slow transit constipation: results from a prospective study with long-term follow-up. Gastroenterol Rep (Oxf). 2018;6(2):101-107. doi: 10.1093/gastro/gox036.Fang S., Wu S., Ji L. et al. The combined therapy of fecal microbiota transplantation and laxatives for functional constipation in adults: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2021;100(14): e25390. doi: 10.1097/MD.0000000000025390.Fang S., Wu S., Ji L. et al. The combined therapy of fecal microbiota transplantation and laxatives for functional constipation in adults: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2021;100(14): e25390. doi: 10.1097/MD.0000000000025390.Liu Q. H., Ke X., Xiao C. Current applications of fecal microbiota transplantation in functional constipation. Evid Based Complement Alternat Med. 2022;2022:7931730. doi: 10.1155/2022/7931730.Liu Q. H., Ke X., Xiao C. Current applications of fecal microbiota transplantation in functional constipation. Evid Based Complement Alternat Med. 2022;2022:7931730. doi: 10.1155/2022/7931730.Iakupova А.А., Abdulkhakov S. R., Safin A. G. et al. Fecal microbiota transplantation: donor selection criteria, storage and preparation of biomaterials (review of current recommendations). Terapevticheskii Arkhiv (Ter. Arkh.). 2021;93(2):215-221. (In Russ.) doi: 10.26442/00403660.2021.02.200615.@@ Якупова А. А., Абдулхаков С. Р., Сафин А. Г. и др. Трансплантация фекальной микробиоты: критерии выбора донора, подготовки и хранения биоматериала (обзор современных рекомендаций). Терапевтический архив. 2021;93(2):215-221. doi: 10.26442/00403660.2021.02.200615.Iakupova А.А., Abdulkhakov S. R., Safin A. G. et al. Fecal microbiota transplantation: donor selection criteria, storage and preparation of biomaterials (review of current recommendations). Terapevticheskii Arkhiv (Ter. Arkh.). 2021;93(2):215-221. (In Russ.) doi: 10.26442/00403660.2021.02.200615.@@ Якупова А. А., Абдулхаков С. Р., Сафин А. Г. и др. Трансплантация фекальной микробиоты: критерии выбора донора, подготовки и хранения биоматериала (обзор современных рекомендаций). Терапевтический архив. 2021;93(2):215-221. doi: 10.26442/00403660.2021.02.200615.

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