gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2020-30-7-17gastro-j-509Research ArticleОБЗОРЫREVIEWSЖелудочная цитопротекция как основа защиты и восстановления слизистой оболочки желудочно-кишечного тракта при эрозивно-язвенном поражении различной этиологииGastric Cytoprotection as Basis of Gastrointestinal Mucosa Protection and Repair in Erosive Ulcerative Lesions of Various Aetiologieshttps://orcid.org/0000-0002-5699-541XИвашкинК. В.IvashkinK. V.

Ивашкин Константин Владимирович - кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней Института клинической медицины им. Н.В. Склифосовского

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

Konstantin V. Ivashkin - Cand. Sci. (Med.), Ass. Prof., Department of Internal Disease Propaedeutics, Sklifosovskiy Institute of Clinical Medicine

119435, Russian Federation, Moscow, Pogodinskaya str., 1, build. 1

2135833@mail.ruИзатуллаевЕ. А.IzatullaevE. A.

Изатуллаев Ельдос Абдыкаликович - доктор медицинских наук, профессор, академик АКФМ, Объединенная клиника

480072, Казахстан, Алматы, ул. Муратбаева, д. 211

Eldos A. Izatullaev - Academician of the AСFM, Dr. Sci. (Med.), Prof., United clinic of S.D. Asfendiyarov

480072, Kazakhstan, Almaty, Muratbaeva str., 211

iza2la@mail.ruhttps://orcid.org/0000-0002-3851-626XКорнееваВ. Р.KorneevaV. R.

Корнеева Василиса Романовна - ординатор кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии Института клинической медицины им. Н.В. Склифосовского

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

Vasilisa R. Korneeva - Clinical Intern, Department of Internal Disease Propaedeutics, Sklifosovskiy Institute of Clinical Medicine

119435, Russian Federation, Moscow, Pogodinskaya str., 1, build. 1

k.vasilis@mail.ruФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский Университет) Министерства здравоохранения Российской ФедерацииРоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationКазахстанский национальный медицинский университет им. С.Д. Асфендиярова, Центр гастроэнтерологии и эндоскопической диагностикиКазахстанAsfendiyarov Kazakh National Medical UniversityKazakhstan202031102020305717Copyright © Ивашкин К.В., Изатуллаев Е.А., Корнеева В.Р., 20202020Ивашкин К.В., Изатуллаев Е.А., Корнеева В.Р.Ivashkin K.V., Izatullaev E.A., Korneeva V.R.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/509Цель

Цель: проанализировать механизм действия и эффективность защиты слизистой оболочки (СО) желудочно-кишечного тракта (ЖКТ) в рамках актуальных схем лечения на примере метилметионинсульфония (витамина U) и представить возможности его применения при эрозивно-язвенном поражении различной этиологии.

Основные положения

Основные положения. Понятие «гастропротекция» включает в себя не только предотвращение повреждения при воздействии агрессивных агентов, но и ускорение процессов заживления в условиях сохраненной секреции соляной кислоты. Простагландины (ПГ) и SH-антиоксиданты служат ключевыми медиаторами «гастропротекции» при остром и хроническом повреждении. SH-содержащие эндогенные субстанции (L-цистеин, D,L-метионин, GSH) и экзогенные молекулы (метилметионинсульфония хлорид (MMSC), N-ацетилцистеин) предотвращают повреждение благодаря своей способности поглощать/нейтрализовывать свободные радикалы, образующиеся при клеточном повреждении под воздействием ксенобиотиков, ингибировать экспрессию TNF-α, уменьшать аспирин-индуцированную адгезию лейкоцитов к эндотелию, стимулировать высвобождение муцина. В эксперименте MMSC предотвращал этанол-индуцированное повреждение СО ЖКТ, стимулировал высвобождение муцина и перераспределение его на поверхность СО, в клинических исследованиях MMSC успешно поддерживал ремиссию дуоденальной язвы.

Заключение

Заключение: для усиления основных схем лечения и поддержания ремиссии при эрозивно-язвенном поражении верхних отделов ЖКТ в качестве вспомогательного средства могут выступать препараты, оказывающие защитное воздействие на гастродуоденальную слизистую оболочку, в частности метилметионинсульфония хлорид (витамин U).

Aim

Aim. Assessment of efficacy and the mechanism of action of gastrointestinal mucosa (GM) protection in current treatment settings with methylmethionine-sulfonium chloride (vitamin U) to illustrate its applicability in erosive ulcerative lesions of various aetiologies.

Key points

Key points. Aside to damage prevention in exposure to aggressive agents, gastroprotection implies healing promotion under the preserved level of hydrochloric acid secretion. Prostaglandins (PG) and SH-antioxidants are key mediators of gastroprotection in acute and chronic damage. SH-containing endogenous substances (L-cysteine, D,L-methionine, GSH) and exogenous molecules (methylmethionine-sulfonium chloride (MMSC), N-acetylcysteine) prevent damage due to the ability to absorb/neutralise free radicals released in xenobiotic-triggered cell damage, inhibit TNF-α expression, reduce the aspirin-induced leukocyte-endothelium adhesion and stimulate mucin release. In experiment, MMSC prevented the ethanol-induced GM damage, stimulated mucin release and its redistribution on the GM surface; in clinical trials, MMSC effectively facilitated remission in duodenal ulcer.

Conclusion

Conclusion. Preparations exerting a protective effect on gastroduodenal mucosa, such as methylmethionine-sulfonium chloride (vitamin U), may improve basic treatment settings and facilitate remission in erosive ulcerative lesions of upper gastrointestinal tract.

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