nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-244-12-119-126nogr-3289Research ArticleСтатьиРанняя диагностика хронического панкреатита: современное состояние проблемыEarly diagnosis of chronic pancreatitis: current state of the problemhttps://orcid.org/0000-0002-1095-8787ГриневичВ. Б.GrinevichV. B.grinevich_vb@mail.ruКоржеваМ. Д.KorzhevaM. D.noemail@neicon.ruЛазебникЛ. Б.LazebnikL. B.noemail@neicon.ruФедеральное государственное бюджетное военное образовательное учреждение высшего образования Военно-медицинская академия имени С.М. Кирова Министерства обороны Российской ФедерацииРоссияMilitary Medical Academy named after S.M. KirovRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Российский университет медицины» Министерства здравоохранения Российской ФедерацииРоссияRussian University of MedicineRussian Federation202526022026012119126Copyright © Гриневич В.Б., Коржева М.Д., Лазебник Л.Б., 20262026Гриневич В.Б., Коржева М.Д., Лазебник Л.Б.Grinevich V.B., Korzheva M.D., Lazebnik L.B.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/3289

В последнее время термин «ранний хронический панкреатит» получает все большее признание. Разрозненные литературные источники освещают вопросы патогенеза, диагностики и терапевтических подходов к ранним стадиям хронического панкреатита до того, как изменения в ткани поджелудочной железы станут необратимыми. Последнее может помочь избежать развития осложнений и улучшить прогноз заболевания. Отчетливо видна тенденция в переходе от поиска методов визуализации в диагностике хронического панкреатита к поиску биомаркеров, которые позволят диагностировать заболевание на стадии функциональных нарушений поджелудочной железы с минимальными и обратимыми изменениями в ее ткани. В свою очередь данные об инициации заболевания измененным биототканевым комплексом желудочно-кишечного тракта находят все больше подтверждений. Дисбиотический провоспалительный состав микробиоты запускает континуум событий, приводящий к развитию хронического панкреатита, путем повышения проницаемости слизистой оболочки желудочно-кишечного тракта, развития эндотоксинемии, локального и системного воспаления. Таким образом следует ожидать, что состав кишечной микробиоты, оценка цитокинового профиля, определение выраженности активации иммунных клеток могут стать ранними диагностическими маркерами хронического панкреатита.

Recently, definition “early chronic pancreatitis”, describing the early stages of chronic pancreatitis, is gaining more recognition. Research on this topic includes issues of pathogenesis, early diagnosis and therapeutic approaches to early stages of chronic pancreatitis before changes in the pancreatic tissue become irreversible. It can help to avoid the development of complications and improve the prognosis of the disease. We can see a pronounced trend in diagnostic for visualization methods in diagnostic of chronic pancreatitis to searching for biomarkers that will allow diagnosing the disease at the stage of functional disorders of the pancreas with minimal and reversible changes in the tissue of the gland. Data on the initiation of chronic pancreatitis by an altered gut microbiota are increasingly confirmed. The dysbiotic proinflammatory composition of the microbiota triggers a continuum of events leading to the development of disease through increased gut permeability, development of endotoxemia, local and systemic inflammation. Thus, it should be expected that the composition of the intestinal microbiota, assessment of the cytokine profile and determination of the severity of immune cell activation could become early diagnostic markers of chronic pancreatitis.

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