gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2020-30-4-52-59gastro-j-437Research ArticleНАЦИОНАЛЬНАЯ ШКОЛА ГАСТРОЭНТЕРОЛОГОВ, ГЕПАТОЛОГОВNATIONAL COLLEGE OF GASTROENTEROLOGISTS, HEPATOLOGISTSКишечный барьер, кишечная проницаемость, неспецифическое воспаление и их роль в формировании функциональных заболеваний желудочно-кишечного трактаIntestinal Barrier, Permeability and Nonspecific Inflammation in Functional Gastrointestinal Disordershttps://orcid.org/0000-0001-5965-2626КовалеваА. Л.KovalevaA. L.

Ковалева Александра Леонидовна — аспирант кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии.

119435, Москва, ул. Погодинская, д. 1, стр. 1.

Aleksandra L. Kovaleva — graduate student, Chair of Internal Diseases Propaedeutics, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sech-enov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1.

anawon@yandex.ruhttps://orcid.org/0000-0003-1312-120XПолуэктоваЕ. А.PoluektovaE. A.

Полуэктова Елена Александровна — доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии.

119435, Москва, ул. Погодинская, д. 1, стр. 1.

Elena A. Poluektova — Dr. Sci. (Med.), Prof., Departament of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology, I.M. Sechenov First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1.

polouektova@rambler.ruhttps://orcid.org/0000-0001-8148-2862ШифринО. С.ShifrinO. S.

Шифрин Олег Самуилович — доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней, заведующий отделением хронических заболеваний кишечника и поджелудочной железы клиники пропедевтики внутренних болезней, гастроэнтерологии и гепатологии им. В.Х. Василенко.

119435, Москва, ул. Погодинская, д. 1, стр. 1.

Oleg S. Shifrin — Dr. Sci. (Med.), Prof., Propaedeutics of Internal Diseases Department, Departmental Head, Department of Chronic Diseases of the Intestines and Pancreas, Vasilenko Clinic of the Propaedeutics of Internal Diseases, Gastroenterology and Gepatology, I.M. Sechenov First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1.

oleg_shifrin@mail.ruПервый Московский государственный университет им. И.М. Сеченова (Сеченовский Университет) Министерства здравоохранения Российской ФедерацииРоссияSechenov First Moscow State University (Sechenov University)Russian Federation2020140720203045259Copyright © Ковалева А.Л., Полуэктова Е.А., Шифрин О.С., 20202020Ковалева А.Л., Полуэктова Е.А., Шифрин О.С.Kovaleva A.L., Poluektova E.A., Shifrin O.S.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/437Цель обзора

Цель обзора. Представить причины нарушения проницаемости слизисто-эпителиального барьера и рассмотреть их как патогенетический фактор развития функциональных заболеваний желудочно-кишечного тракта (ЖКТ).

Основные положения

Основные положения. Слизисто-эпителиальный барьер ЖКТ включает в себя несколько компонентов: пре-эпителиальная защита — слой слизи, покрывающей эпителий; эпителиальная защита, к которой относится высокая регенерация эпителия и плотные межклеточные контакты; постэпителиальная защита — клетки иммунной системы и кровеносные сосуды. Состав кишечной микробиоты также может рассматриваться как часть слизисто-эпителиального барьера. У пациентов с функциональной диспепсией (ФД) и синдромом раздраженного кишечника (СРК) определяется ряд морфологических изменений. Так, у пациентов с ФД выявлено изменение экспрессии белков, образующих межэпителиальные контакты (клаудин-1, zonula occludens, окклюдин, Е-кадгерин, β-катенин и десмоглин-2), а у пациентов с СРК — повышенная экспрессия клауди-на-2. Нарушение проницаемости приводит к развитию воспалительных изменений в кишечной стенке, в результате которых формируются висцеральная и центральная сенситизация, а также нарушение моторики кишечника, что, в свою очередь, приводит к развитию симптомов СРК и ФД.

Заключение

Заключение: нарушение барьерной функции слизисто-эпителиального слоя ЖКТ может рассматриваться как один из патогенетических факторов развития ФД и СРК.

Aim of review

Aim of review. Description of intestinal mucosal barrier permeability disruption causes as morbid factors in gastrointestinal tract (GIT) functional disorders.

General provisions

General provisions. Intestinal mucosal barrier is composed of several elements: pre-epithelial barrier, a mucosal lining of epithelium; epithelial barrier that leverages tight junctional structures and high regenerative capacity of epithelium; post-epithelial barrier established by immune cells and blood vessels. Gut microbiota profile may also be constituent of the intestinal mucosal barrier. Functional dyspepsia (FD) and irritable bowel syndrome (IBS) leave distinct morphological imprint. For instance, FD patients exhibit variant expression of cell junction proteins (claudin-1, zonula occludens, occludin, E-cadherin, β-catenin and desmoglein-2), and IBS patients — overexpression of claudin-2. Permeability disruption leads to inflammatory changes in intestinal wall resulting in visceral and central sensitisation, as well as intestinal motor dysfunctions causal of IBS and FD.

Conclusion

Conclusion. Disruption of intestinal mucosal barrier may be considered a pathogenetic factor of PD and IBS progression.

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