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Российский журнал гастроэнтерологии, гепатологии, колопроктологии

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Кишечный барьер, кишечная проницаемость, неспецифическое воспаление и их роль в формировании функциональных заболеваний желудочно-кишечного тракта

https://doi.org/10.22416/1382-4376-2020-30-4-52-59

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Аннотация

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

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

Об авторах

А. Л. Ковалева
Первый Московский государственный университет им. И.М. Сеченова (Сеченовский Университет) Министерства здравоохранения Российской Федерации
Россия

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

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



Е. А. Полуэктова
Первый Московский государственный университет им. И.М. Сеченова (Сеченовский Университет) Министерства здравоохранения Российской Федерации
Россия

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

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



О. С. Шифрин
Первый Московский государственный университет им. И.М. Сеченова (Сеченовский Университет) Министерства здравоохранения Российской Федерации
Россия

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.



Список литературы

1. Drossman D.A. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. 2016;S0016-5085(16)00223-7. DOI: 10.1053/j.gastro.2016.02.032

2. Aziz I., Palsson O.S., Tornblom H., Sperber A.D., Whitehead W.E., Simren M. The Prevalence and Impact of Overlapping Rome IV-Diagnosed Functional Gastrointestinal Disorders on Somatization, Quality of Life, and Healthcare Utilization: A Cross-Sectional General Population Study in Three Countries. Amer J Gastroenterol. 2017;113(1): 86-96. DOI: 10.1038/ajg.2017.421

3. Canavan C., West J., Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol. 2014;6:71-80. DOI: 10.2147/CLEP.S40245

4. Lovell R.M., Ford A.C. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol. 2012;10(7):712-21. e4. DOI: 10.1016/j.cgh.2012.02.029

5. Mahadeva S., Goh K.L. Epidemiology of functional dyspepsia: a global perspective. World J Gastroenterol. 2006; 12(17):2661-6. DOI: 10.3748/wjg.v12.i17.2661

6. Vakil N., Stelwagon M., Shea E.P., Miller S. Symptom burden and consulting behavior in patients with overlapping functional disorders in the US population. United European Gastroenterol J. 2016;4(3):413-22. DOI: 10.1177/2050640615600114

7. Perveen I., Rahman M.M., Saha M., Rahman M.M., Hasan M.Q. Prevalence of irritable bowel syndrome and functional dyspepsia, overlapping symptoms, and associated factors in a general population of Bangladesh. Indian J Gastroenterol. 2014; 33(3):265-73. DOI: 10.1007/s12664-014-0447-1

8. Lewis S.J., Heaton K.W. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 1997;32:920-4. DOI: 10.3109/00365529709011203

9. Lacy B., Mearin F., Chang L., Chey W.D., Lembo A.J, Simren M., Spiller R. Bowel disorders. Gastroenterology. 2016;150:1393-1407.e5. DOI: 10.1053/j.gastro.2016.02.031

10. Koloski N.A., Talley N.J., Boyce P.M. Epidemiology and health care seeking in the functional GI disorders: a population-based study. Am J Gastroenterol. 2002;97:2290-9. DOI: 10.1111/j.1572-0241.2002.05783.x

11. Stanghellini V., Chan F.C.L., Hasler W.L., Malagelada J.R., Suzuki H., Tack J., et al. Gastroduodenal disorders. Gastroenterology. 2016;150(6):1380-92. DOI: 10.1053/j.gastro.2016.02.011

12. Talley N.J. Functional Dyspepsia: Advances in Diagnosis and Therapy. Gut Liver. 2017;11(3):349-57. DOI: 10.5009/gnl16055

13. Wouters M.M., Lambrechts D., Knapp M., Cleynen I., Whorwell P., Agreus L., et al. Genetic variants in CDC42 and NXPH1 as susceptibility factors for constipation and diarrhoea predominant irritable bowel syndrome. Gut. 2013;63:1103-11. DOI: 10.1136/gutjnl-2013-304570

14. Ghoshal U.C., Ranjan P.J. Post-infectious irritable bowel syndrome: the past, the present and the future. Gastroenterol Hepatol. 2011;26 (Suppl 3):94-101. DOI: 10.1111/j.1440-1746.2011.06643.x

15. Sassone-Corsi M., Raffatellu M. No vacancy: how beneficial microbes cooperate with immunity to provide colonization resistance to pathogens. J Immunol. 2015;194:4081-7. DOI: 10.4049/jimmunol.1403169

16. Feng Y., Huang Y., Wang Y., Wang P., Song H., Wang F. Antibiotics induced intestinal tight junction barrier dysfunction is associated with microbiota dysbiosis, activated NLRP3 inflammasome and autophagy. PLoS One. 2019;14(6):e0218384. DOI: 10.1371/journal.pone.0218384

17. Creekmore A.L., Hong S., Zhu S., Xue J., Wiley J.W. Chronic stress-associated visceral hyperalgesia correlates with severity of intestinal barrier dysfunction. Pain. 2018;159(9):1777-89. DOI: 10.1097/j.pain.0000000000001271

18. Ng Q.X., Soh A.Y.S., Loke W., Lim D.Y., Yeo W-S. The role of inflammation in irritable bowel syndrome (IBS). J Inflamm Res. 2018;11:345-9. DOI: 10.2147/JIR.S174982

19. Scaldaferri F., Pizzoferrato M., Gerardi V., Lopetuso L., Gasbarrini A. The gut barrier: new acquisitions and therapeutic approaches. J Clin Gastroenterol. 2012;46(Suppl):S12-7. DOI: 10.1097/MCG.0b013e31826ae849

20. Muniz L.R., Knosp C., Yeretssian G. Intestinal antimicrobial peptides during homeostasis, infection, and disease. Front Immunol. 2012;3:310. DOI: 10.3389/fimmu.2012.00310

21. Vancamelbeke M., Vermeire S. The intestinal barrier: a fundamental role in health and disease. Expert Rev Gastroenterol Hepatol. 2017;26:1-14. DOI: 10.1080/17474124.2017.1343143

22. Amasheh S., Meiri N., Gitter A.H., Schoneberg T., Mankertz J., Schilzke J.D., et al. Claudin-2 expression induces cation-selective channels in tight junctions of epithelial cells. J Cell Sci. 2002;115:4969-76. DOI: 10.1242/jcs.00165

23. Zihni C., Mills C., Matter K., Balda M.S. Tight junctions: from simple barriers to multifunctional molecular gates. Nat Rev Mol Cell Biol. 2016;17(9):564-80. DOI: 10.1038/nrm.2016.80

24. Zhou Q., Zhang B., Verne G.N. Intestinal membrane permeability and hypersensitivity in the irritable bowel syndrome. Pain. 2009;146(1-2):41-6. DOI: 10.1016/j.pain.2009.06.017

25. Shulman R.J., Jarrett M.E., Cain K.C., Broussard E.K., Heitkemper M.M. Associations among gut permeability, inflammatory markers, and symptoms in patients with irritable bowel syndrome. J Gastroenterol. 2014;49:1467-76. DOI: 10.1007/s00535-013-0919-6

26. Ishigami H., Matsumura T., Kasamatsu S., Hamanaka S., Taida T., Okimoto K., et al. Endoscopy-guided evaluation of duodenal mucosal permeability in functional dyspepsia. Clin Transl Gastroenterol. 2017;8(4):e83. DOI: 10.1038/ctg.2017.12

27. McOmber M., Rafati D., Cain K., Devaraj S., Weidler E.M., Heitkemper M., et al. Increased Gut Permeability in First-degree Relatives of Children with Irritable Bowel Syndrome or Functional Abdominal Pain. Clin Gastroenterol Hepatol. 2020;18(2):375-384.e1. DOI: 10.1016/j.cgh.2019.05.011

28. Ji R., Wang P., Kou G.J., Zuo X.L., Wang X., Li Y.Q. Impaired gastric mucosal integrity identified by confocal endomicroscopy in Helicobacter pylori-negative functional dyspepsia. Neurogastroenterol Motil. 2019;1:e13719. DOI: 10.1111/nmo.13719

29. Pelaseyed T., Bergstrom J.H., Gustafsson J.K., Ermund A., Birchenough G.M.H., Schutte A., et al. The mucus and mucins of the goblet cells and enterocytes provide the first defense line of the gastrointestinal tract and interact with the immune system. Immunol Rev. 2014;260(1):8-20. DOI: 10.1111/imr.12182

30. Atuma C., Strugala V., Allen A., Holm L. The adherent gastrointestinal mucus gel layer: thickness and physical state in vivo. Am J Physiol Gastrointest Liver Physiol. 2001;280(5):G922-9. DOI: 10.1152/ajpgi.2001.280.5.g922

31. Schroeder B. Fight them or feed them: how the intestinal mucus layer manages the gut microbiota. Gastroenterol Rep (Oxf). 2019;7(1):3-12. DOI: 10.1093/gastro/goy052

32. Linden S.K., Sutton P., Karlsson N.G., Korolik V., McGuckin M.A. Mucins in the mucosal barrier to infection. Mucosal Immunol. 2008;1:183-97. DOI: 10.1038/mi.2008.5

33. Johansson M.E.V., Sjovall H., Hansson, G.C. The gastrointestinal mucus system in health and disease. Nat Rev Gastroenterol Hepatol. 2013;10(6):352-61. DOI: 10.1038/nrgastro.2013.35

34. Kim Y.S., Ho S.B. Intestinal Goblet Cells and Mucins in Health and Disease: Recent Insights and Progress. Curr Gastroenterol Rep. 2010;12(5):319-30. DOI: 10.1007/s11894-010-0131-2

35. Jakobsson H.E., Rodrfguez-Pineiro A.M., Schutte A., Ermund A., Boysen P., Bemark M., et al. The composition of the gut microbiota shapes the colon mucus barrier. EMBO Rep. 2015;16(2):164-77. DOI: 10.15252/embr.201439263

36. Sung N.H., Poong-Lyul R. Unraveling the ties between irritable bowel syndrome and intestinal microbiota. World J Gastroenterol. 2014;20(10):2470-81. DOI: 10.3748/wjg.v20.i10.2470

37. Swidsinski A., Loening-Baucke V., Theissig F., Engelhardt H., Bengmark S., Koch S., et al. Comparative study of the intestinal mucus barrier in normal and inflamed colon. Gut. 2007;56:343-50. DOI: 10.1136/gut.2006.098160

38. Derrien M., van Passel M.W., van de Bovenkamp J.H., Schipper R.G., de Vos W.M., Dekker J. Mucin-bacterial interactions in the human oral cavity and digestive tract. Gut Microbes. 2010;1:254268. DOI: 10.4161/gmic.1.4.12778

39. Raouf A.H., Tsai H.H., Parker N., Hoffman J., Walker R.J., Rhodes J.M. Sulphation of colonic and rectal mucin in inflammatory bowel disease: reduced sulphation of rectal mucus in ulcerative colitis. Clin Sci (Lond.). 1992;83:623-6. DOI: 10.1042/cs0830623

40. Cornick S., Tawiah A., Chadee K. Roles and regulation of the mucus barrier in the gut. Tissue Barriers. 2015;3(1-2):e982426. DOI: 10.4161/21688370.2014.982426

41. Salim S.Y., Soderholm J.D. Importance of disrupted intestinal barrier in inflammatory bowel diseases. In-flamm Bowel Dis. 2011;17(1):362-81. DOI: 10.1002/ibd.21403

42. Groschwitz K.R., Hogan S.P. Intestinal barrier function: molecular regulation and disease pathogenesis. J Allergy Clin Immunol. 2009;124:3-20. DOI: 10.1016/j.jaci.2009.05.038

43. Yamazaki Y., Okawa K., Yano T., Tsukita S., Tsukita S. Optimized proteomic analysis on gels of cell-cell adhering junctional membrane proteins. Biochemistry. 2008;47:5378-86. DOI: 10.1021/bi8002567

44. Schneeberger E.E., Lynch R.D. The tight junction: a multifunctional complex. Am J Physiol Cell Physiol. 2004; 286:C1213-28. DOI: 10.1152/ajpcell.00558.2003

45. Konig J., Wells J., Can P.D., Garcia-Rodenas C.L., MacDonald T., Mercenier A., et al. Human Intestinal Barrier Function in Health and Disease. Clin Transl Gastroenterol. 2016;7(10):e196. DOI: 10.1038/ctg.2016.54

46. Farre R., Vicario M. Abnormal Barrier Function in Gastrointestinal Disorders. In: Greenwood-Van Meerveld B., eds. Gastrointestinal Pharmacology. Handbook of Experimental Pharmacology, vol 239. Springer, Cham. 2016. DOI: 10.1007/164_2016_107

47. Garcia-Hernandez V., Quiros M., Nusrat A. Intestinal epithelial claudins: expression and regulation in homeostasis and inflammation. Ann N Y Acad Sci. 2017;1397(1):66-79. DOI: 10.1111nyas.13360

48. Krug S.M., Amasheh S., Richter J.F., Milatz S., Gunzel D., Westphal J.K., et al. Tricellulin forms a barrier to macromolecules in tricellular tight junctions without affecting ion permeability. Mol Biol Cell. 2009;20:3713-24. DOI: 10.1091/mbc.E09-01-0080

49. Roxas J.L., Koutsouris A., Bellmeyer A., Tesfay S., Royan S., Falzari K., et al. Enterohemorrhagic E. coli alters murine intestinal epithelial tight junction protein expression and barrier function in a Shiga toxin independent manner. Lab Invest. 2010;90(8):1152-68. DOI: 10.1038/labinvest.2010.91

50. Holthofer B., Windoffer R., Troyanovsky S., Leube R.E. Structure and function of desmosomes. Int Rev Cytol. 2007;264:65-163. DOI: 10.1016/S0074-7696(07)64003-0

51. Du L., Shen J., Kim J.J., He H., Chen B., Dai N. Impact of gluten consumption in patients with functional dyspepsia: A case-control study. J Gastroenterol Hepatol. 2018;33(1):128-33. DOI: 10.1111/jgh.13813

52. Vanheel H., Vicario M., Vanuytsel T., Van Oudenhove L., Martinez C., Keita A.V., et al. Impaired duodenal mucosal integrity and low-grade inflammation in functional dyspepsia. Gut. 2014;63:262-71. DOI: 10.1136/gutjnl-2012-303857

53. Luettig, J., Rosenthal R., Barmeyer C., Schulzke J.D. Claudin-2 as a mediator of leaky gut barrier during intestinal inflammation. Tissue Barriers. 2015;3:e977176. DOI: 10.4161/21688370.2014.977176

54. Yu Y., Liu Z.Q., Liu X.Y., Yang L., Geng X.-R., Liu Z.-G., et al. Stress-derived corticotropin releasing factor breaches epithelial endotoxin tolerance. PLoS One. 2013;8:e65760. DOI: 10.1371/journal.pone.0065760

55. Lechuga S., Ivanov A.I. Disruption of the epithelial barrier during intestinal inflammation: quest for new molecules and mechanisms. Biochim Biophys Acta. 2017;1864(7):1183-94. DOI: 10.1016/j.bbamcr.2017.03.007

56. Mearin F., Perez-Oliveras M., Perello A., Vinyet J., Ibanez A., Coderch J., et al. Dyspepsia and irritable bowel syndrome after a Salmonella gastroenteritis outbreak: one-year follow-up cohort study. Gastroenterology. 2005;129(1):98-104. DOI: 10.1053/j.gastro.2005.04.012

57. Fan W.-T., Ding C., Xu N.-N., Zong S., Ma P., Gu B. Close association between intestinal microbiota and irritable bowel syndrome. Eur J Clin Microbiol Infect Dis. 2017;36(12):2303-17. DOI: 10.1007/s10096-017-3060-2

58. Bischoff S.C., Barbara G., Buurman W., Ockhuizen T., Schulzke J.-D., Serino M., et al. M. Intestinal permeability — a new target for disease prevention and therapy. BMC Gastroenterol. 2014;14:189. DOI: 10.1186/s12876-014-0189-7

59. Sundin J., Rangel I., Repsilber D., Brummer R.-J. Cytokine Response after Stimulation with Key Commensal Bacteria Differ in Post-Infectious Irritable Bowel Syndrome (PI-IBS) Patients Compared to Healthy Controls. PLoS One. 2015;10(9):e0134836. DOI: 10.1371/journal.pone.0134836

60. J alanka-T uovinen J., Salojarvi J., Salonen A., Immonen O., Garsed K., Kelly F.M., de Vos W.M. Faecal microbiota composition and host-microbe cross-talk following gastroenteritis and in postinfectious irritable bowel syndrome. Gut. 2013;63(11):1737-45. DOI: 10.1136/gutjnl-2013-305994

61. Schmulson M., Bielsa M.V., Carmona-Sanchez R., Hernandez A. , Lopez-Colombo A., Lopez Vidal Y., et al. Microbiota, gastrointestinal infections, low-grade inflammation, and antibiotic therapy in irritable bowel syndrome: an evidence-based review. Rev Gastroenterol Mex. 2014;79:96-134. DOI: 10.1016/j.rgmx.2014.01.004

62. Grover M. Role of gut pathogens in development of irritable bowel syndrome. Indian J Med Res. 2014;139:11-8.

63. Morrison D.J., Preston T. Formation of short chain fatty acids by the gut microbiota and their impact on human metabolism. Gut Microbes. 2016;7:189- 200. DOI: 10.1080/19490976.2015.1134082

64. Angelakis E., Merhej V., Raoult D. Related actions of probiotics and antibiotics on gut microbiota and weight modification. Lancet Infect Dis. 2013;13:889-99. DOI: 10.1016/S1473-3099(13)70179-8

65. Oldak A., Zielinska D., Rzepkowska A., Koloiyn-Krajewska D. Comparison of Antibacterial Activity of Lactobacillus plantarum Strains Isolated from Two Different Kinds of Regional Cheeses from Poland: Oscypek and Korycinski Cheese. Biomed Res Int. 2017;2017:6820369. DOI: 10.1155/2017/6820369

66. Nes I.F., Kjos M., Diep D.B. Antimicrobial Components of Lactic Acid Bacteria. In: Lahtinen S., Ouwehand A.C., Salminen S, von Wright A., eds. Lactic Acid Bacteria, Microbiological and Functional Aspects. 4th ed. CRC Press, 2012:285-330.

67. Monteiro C., do Carmo M., Melo B., Alves M., dos Santos C., Monteiro S., et al. In Vitro Antimicrobial Activity and Probiotic Potential of Bifidobacterium and Lactobacillus against Species of Clostridium. Nutrients. 2019;11(2):448. DOI: 10.3390/nu11020448

68. Duan R., Zhu S., Wang B., Duan L. Alterations of Gut Microbiota in Patients With Irritable Bowel Syndrome Based on 16S rRNA-Targeted Sequencing. Clin Transl Gastroenterol. 2019;10(2):e00012. DOI: 10.14309/ctg.0000000000000012

69. Bhat M.I., Sowmya K., Kapila S., Kapila R. Escherichia coli K12: An evolving opportunistic commensal gut microbe distorts barrier integrity in human intestinal cells. Microb Pathog. 2019;133:103545. DOI: 10.1016/j.mic-path.2019.103545

70. Talley N.J., Walker M.M., Aro P., et al. Non-ulcer dyspepsia and duodenal eosinophilia: an adult endoscopic population-based case-control study. Clin Gastroenterol Hepatol. 2007;5:1175-83. DOI: 10.1016/j.cgh.2007.05.015

71. Walker M.M., Talley N.J., Prabhakar M., Aro P., Ronkainen J., et al. Duodenal mastocytosis, eosinophilia and intraepithelial lymphocytosis as possible disease markers in the irritable bowel syndrome and functional dyspepsia. Aliment Pharmacol Ther. 2009;29:765-73. DOI: 10.1111/j.1365-2036.2009.03937.x

72. Walker M.M., Salehian S.S., Murray C.E., Rajen-dran A., Hoare J.M., Negus R., et al. Implications of eosinophilia in the normal duodenal biopsy — an association with allergy and functional dyspepsia. Aliment Pharmacol Ther. 2010;31:1229-36. DOI: 10.1111/j.1365-2036.2010.04282.x

73. Vanheel H., Vicario M., Vanuytsel T., Tack J.F., Farre R. Eosinophils and mast cells infunctional dyspepsia: ultrastructural evaluation of activation. Gastroenterology. 2015;148:S49.

74. Martinez C., Lobo B., Pigrau M., Ramos L., Gonzalez-Castro A.M., Alonso C., et al. Diarrhoea-predominant irritable bowel syndrome: an organic disorder with structural abnormalities in the jejunal epithelial barrier. Gut. 2013;62:1160-8. DOI: 10.1136/gutjnl-2012-302093

75. Barbara G., Stanghellini V., DeGiorgio R., Cremon C., Cottrell G.S., Santini D., et al. Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome. Gastroenterology. 2004;126:693-702. DOI: 10.1053/j.gastro.2003.11.055

76. Barbara G., Wang B., Stanghellini V., de Giorgio R., Cremon C., Di Nardo G., et al. Mast cell-dependent excitation of visceral-nociceptive sensory neurons in irritable bowel syndrome. Gastroenterology. 2007;132(1):26-37. DOI: 10.1053/j.gastro.2006.11.039

77. Ivashkin V.T., Ivashkin K.V. Intestinal microbiome as effective regulator of enteral and central nervous system activity. Rus J Gastroenterol Hepatol Coloproctol. 2017;27(5):11-9 (In Russ.). DOI: 10.22416/1382-4376-2017-27-5-11-19

78. Lee K.N., Lee O.Y. The Role of Mast Cells in Irritable Bowel Syndrome. Gastroenterol Res Pract. 2016;2016:2031480. DOI: 10.1155/2016/2031480

79. Mertz H. Altered CNS Processing of visceral pain in IBS. Edited by In: Camilleri M., Spiller R.C., eds. Irritable Bowel Syndrome. Diagnosos and treatment. 1st ed. London: Sounders, 2002:55-68.

80. Coss-Adame E., Rao S.S. Brain and gut interactions in irritable bowel syndrome: new paradigms and new understandings. Curr Gastroenterol Rep. 2014;16(4):379. DOI: 10.1007/s11894-014-0379-z

81. Greenwoodvan Meerveld B. Importance of 5-hydroxytryptamine receptors on intestinal afferents in the regulation of visceral sensitivity. Neurogastroenterol Motil. 2007;19 (Suppl 2):13-8. DOI: 10.1111/j.1365-2982.2007.00964.x

82. Ludidi S., Conchillo J.M., Keszthelyi D., Van Avesaat M., Kruimel J.W., Jonkers D.M., et al. Rectal hypersensitivity as hallmark for irritable bowel syndrome: defining the optimal cutoff. Neurogastroenterol Motil. 2012;24:729-33. DOI: 10.1111/j.1365-2982.2012.01926.x

83. Ludidi S., Mujagic Z., Jonkers D., Keszthelyi D., Hesselink M., Kruimel J., et al. Markers for visceral hypersensitivity in patients with irritable bowel syndrome. Neurogastroenterol Motil. 2014;26(8):1104-11. DOI: 10.1111/nmo.12365

84. Tran K., Brun R., Kuo B. Evaluation of regional and whole gut motility using the wireless motility capsule: relevance in clinical practice. Therap Adv Gastroenterol. 2012;5:249-60. DOI: 10.1177/1756283X12437874

85. Agrawal A., Houghton L.A., Lea R., Morris J., Reilly B., Whorwell P.J. Bloating and distention in irritable bowel syndrome: the role of visceral sensation. Gastroenterology. 2008;134:1882-9. DOI: 10.1053/j.gastro.2008.02.096

86. Kanazawa M., Palsson O.S., Thiwan S.I.M., Turner M.J., van Tilburg, M.A.L., et al. Contributions of Pain Sensitivity and Colonic Motility to IBS Symptom Severity and Predominant Bowel Habits. Amer J Gastroenterol. 2018;103(10):2550-61. DOI: 10.1111/j.1572-0241.2008.02066.x

87. Farre R., Vanheel H., Vanuytsel T., Masaoka T., Tornblom H., Simren M., et al. In Functional Dyspepsia, Hypersensitivity to Postprandial Distention Correlates With Meal-Related Symptom Severity. Gastroenterology. 2013;145(3):566-73. DOI:10.1053/j.gastro.2013.05.018


Для цитирования:


Ковалева А.Л., Полуэктова Е.А., Шифрин О.С. Кишечный барьер, кишечная проницаемость, неспецифическое воспаление и их роль в формировании функциональных заболеваний желудочно-кишечного тракта. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2020;30(4):52-59. https://doi.org/10.22416/1382-4376-2020-30-4-52-59

For citation:


Kovaleva A.L., Poluektova E.A., Shifrin O.S. Intestinal Barrier, Permeability and Nonspecific Inflammation in Functional Gastrointestinal Disorders. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020;30(4):52-59. (In Russ.) https://doi.org/10.22416/1382-4376-2020-30-4-52-59

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