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
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. КовалеваРоссия
Ковалева Александра Леонидовна — аспирант кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии.
119435, Москва, ул. Погодинская, д. 1, стр. 1.
Е. А. Полуэктова
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
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.
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Рецензия
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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