References

nogr

Экспериментальная и клиническая гастроэнтерология

Experimental and Clinical Gastroenterology

1682-8658

«Global Media Technologies»

10.31146/1682-8658-ecg-230-10-178-187

nogr-3016

Research Article

ОБЗОР

REVIEW

Микробиом кишечника и неалкогольная жировая болезнь печени: перспективы лекарственной терапии

The gut microbiome and nonalcoholic fatty liver disease: prospects for drug therapy

https://orcid.org/0000-0002-7628-8851

Теплюк

Д. А.

Teplyuk

D. A.

teplyouk@gmail.com

https://orcid.org/0000-0002-5814-4504

Левина

О. Н.

Levina

O. N.

noemail@neicon.ru

https://orcid.org/0000-0003-1949-914X

Павлов

Ч. С.

Pavlov

Ch. S.

noemail@neicon.ru

https://orcid.org/0000-0002-2637-8197

Сороколетов

С. М.

Sorokoletov

S. M.

noemail@neicon.ru

Пашкова

Е. Ю.

Pashkova

E. Yu.

noemail@neicon.ru

https://orcid.org/0000-0002-7936-7619

Аметов

А. С.

Ametov

A. S.

noemail@neicon.ru

https://orcid.org/0000-0002-4556-6740

Большаков

С. А.

Bolshakov

S. A.

noemail@neicon.ru

https://orcid.org/0000-0002-1047-0378

Шутов

Е. В.

Shutov

E. V.

noemail@neicon.ru

Государственное бюджетное учреждение здравоохранения города Москвы «Московский многопрофильный научно-клинический центр им. С.П. Боткина»; Федеральное государственное автономное образовательное учреждение высшего образования Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияBotkin Hospital; The State Education Institution of Higher Professional Training The First Sechenov Moscow State Medical University under Ministry of Health of the Russian FederationRussian Federation

Государственное бюджетное учреждение здравоохранения города Москвы «Московский многопрофильный научно-клинический центр им. С.П. Боткина»РоссияBotkin HospitalRussian Federation

Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education” of the Ministry of Healthcare of the Russian FederationRussian Federation

Государственное бюджетное учреждение здравоохранения города Москвы «Московский многопрофильный научно-клинический центр им. С.П. Боткина»; Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской ФедерацииРоссияBotkin Hospital; Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education” of the Ministry of Healthcare of the Russian FederationRussian Federation

2024

10122024

010178187

2024

Теплюк Д.А., Левина О.Н., Павлов Ч.С., Сороколетов С.М., Пашкова Е.Ю., Аметов А.С., Большаков С.А., Шутов Е.В.

Teplyuk D.A., Levina O.N., Pavlov C.S., Sorokoletov S.M., Pashkova E.Y., Ametov A.S., Bolshakov S.A., Shutov E.V.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.nogr.org/jour/article/view/3016

Неалкогольная жировая болезнь печени (НАЖБП) чаще всего является компонентном метаболического синдрома и глобальная распространенность ее составляет 25%, а количество пациентов продолжает увеличиваться. Согласно актуальным прогнозам, в скором времени НАЖБП станет наиболее распространенным показанием для трансплантации печени. Активно ведется поиск новых факторов риска развития и прогрессирования этого заболевания. В статье рассматривается роль микробиоты кишечника в провоспалительных процессах, обмене желчных кислот и липогенезе печени. Уделено внимание качественному составу микробиома в зависимости от стадии НАЖБП. Сделаны выводы о неоднородности результатов исследований при НАЖБП и отсносительно стабильной микробиоте при циррозе печени. Отдельно рассматриваются Faecalibacterium prausnitzii и ее роль в прогрессировании НАЖБП. Представлены вероятные причины разногласий результатов исследований. В части, посвященной лечению НАЖБП, фокус направлен на пути коррекции дисбиоза кишечника, влиянию различных микробиологических препаратов на липогенез и процесс воспаления в печени. Подробно обсуждается оптимальный состав пробиотических препаратов. Их сочетание с пребиотиками и изолированное назначение инулина, фруктоолигосахарида. Сделаны выводы о том, что в дальнейшем оценка микробиома кишечника поможет усовершенствовать терапевтические подходы в лечении пациентов НАЖБП.

Nonalcoholic fatty liver disease (NAFLD) is most commonly a component of the metabolic syndrome with a global prevalence of 25% and the number of patients continues to increase. According to current projections, in the near future, NAFLD will become the most common indication for liver transplantation. The search for new risk factors for the development and progression of this disease is actively underway. The article considers the role of intestinal microbiota in proinflammatory processes, bile acid metabolism and liver lipogenesis. Attention is paid to the qualitative composition of the microbiome depending on the stage of NAFLD. Conclusions are made about heterogeneity of the research results in case of NAFLD and relatively stable microbiota in liver cirrhosis. Faecalibacterium prausnitzii and its role in the progression of NAFLD are considered separately. Probable reasons for the disagreement of the results of the studies are presented. In the part devoted to the treatment of NAFLD, the focus is on the ways of correction of intestinal dysbiosis, the influence of various microbiological preparations on lipogenesis and the process of inflammation in the liver. The optimal composition of probiotic preparations is discussed in detail. Their combination with prebiotics and isolated administration of inulin, fructooligosaccharide. Conclusions are drawn that in the future the assessment of intestinal microbiome will help to improve therapeutic approaches in the treatment of NAFLD patients.

неалкогольная жировая болезнь печенинеалкогольный стеатогепатитмикробиом кишечникапробиотикипребиотикисинбиотикитрансплантация фекальной микробиоты

nonalcoholic fatty liver diseasenonalcoholic steatohepatitisgut microbiomeprobioticsprebioticssynbioticsfecal microbiota transplantation

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