Микробиом кишечника и неалкогольная жировая болезнь печени: перспективы лекарственной терапии

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.

неалкогольная жировая болезнь печени, неалкогольный стеатогепатит, микробиом кишечника, пробиотики, пребиотики, синбиотики, трансплантация фекальной микробиоты

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