gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2019-29-1-84-92gastro-j-330Research ArticleНАЦИОНАЛЬНАЯ ШКОЛА ГАСТРОЭНТЕРОЛОГИИ, ГЕПАТОЛОГИИNATIONAL COLLEGE OF GASTROENTEROLOGY, HEPATOLOGYСиндром раздраженного кишечника с позиций изменений микробиотыIrritable Bowel Syndrome in Terms of Changes in the Microbiotahttps://orcid.org/0000-0002-6815-6015ИвашкинВ.  Т. IvashkinVladimir T.

доктор медицинских наук, академик РАН, профессор, заведующий кафедрой пропедевтики внутренних болезней; главный специалист-гастроэнтеролог Министерства здравоохранения Российской Федерации

г. Москва

Dr. Sci. (Med.), RAS Academician, Prof., Departmental Head, Propaedeutics of Internal Diseases Department; Principal Gastroenterologist of the Ministry of Health of the Russian Federation

Moscow

https://orcid.org/0000-0002-6701-789XЗольникова О.  Ю. ZolnikovaOxana Yu.

кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней

119991, г. Москва, ул. Погодинская, д. 1, стр. 1.

Cand. Sci. (Med.), Assoc. prof., Propaedeutics of Internal Diseases Department

119991, Moscow, Pogodinskaya str., 1, building 1.

Ks.med@mail.ruФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский университет) Министерства здравоохранения Российской ФедерацииРоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation2019310320192916876Copyright © Ивашкин В.Т., Зольникова  .Ю., 20192019Ивашкин В.Т., Зольникова  .Ю.Ivashkin V.T., Zolnikova O.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/330Цель обзора

Цель обзора. Представить современные данные, подтверждающие патогенетическую роль кишечной микробиоты в формировании синдрома раздраженного кишечника (СРК).

Основные положения

Основные положения. Изменения кишечного биотопа служит причиной развития висцеральной гиперчувствительности, нарушенной двигательной активности кишки и нейроиммунной трансмиссии. В статье обсуждаются основные аспекты биологических свойств пробиотических бактерий в контексте их влияния на ось «микробиота — кишечник — головной мозг». Обобщены результаты экспериментальных и клинических исследований, позволившие расширить представления о механизмах действия пробиотитических культур и обоснованно назначать их пациентам с СРК. Рассмотрены основные положения, касающиеся пересадки фекальной микробиоты, перспективы и трудности реализации этой методики.

Выводы

Выводы. Термин «микробиота — кишка — мозг» четко демонстрирует корреляционную взаимосвязь основных функциональных составляющих СРК. Метаанализы и систематические обзоры подтверждают эффективность применения пробиотиков при СРК. Однако необходимо дальнейшее изучение возможностей терапии пробиотиками с целью выявления конкретных бактериальных штаммов с доказанной клинической эффективностью. Метод трансплантации фекальной микрофлоры нуждается в дальнейшем изучении, т. к. многие вопросы данной процедуры требуют детального изучения.

Aim

Aim: to review available data confirming the pathogenetic role of the intestinal microbiota in the formation of irritable bowel syndrome (IBS).

Key findings

Key findings. Changes in the intestinal biotope cause the development of visceral hypersensitivity and impaired intestinal motor activity, as well as neuroimmune transmission. This article discusses the main aspects of the biological properties of probiotic bacteria in terms of their action within the “brain — intestine — microbiota” chain. The results of experimental and clinical studies elucidating the mechanisms of action of probiotic cultures have been generalized. The understanding of these mechanisms allows practitioners to make informed decisions in prescribing probiotics to IBS patients. Key concepts concerning fecal microbiota transplantation, as well as the prospects and difficulties of implementing this approach are considered.

Conclusions

Conclusions. The term “microbiota — intestine — brain” clearly demonstrates the correlation between the main functional components of IBS. Meta-analyses and systematic reviews confirm the efficacy of probiotics in IBS. However, further research into probiotic therapy options is needed to identify specific bacterial strains with proven clinical efficacy. The fecal microbiota transplantation method also requires further research, since many issues associated with this approach remain unclear.

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