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Экспериментальная и клиническая гастроэнтерология

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МИКРОБИОТА КИШЕЧНИКА ПРИ ЯЗВЕННОМ КОЛИТЕ И ЦЕЛИАКИИ

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Аннотация

Цель исследования: изучить количественный состав некоторых представителей симбиотической микробиоты толстой кишки и выявить особенности дисбиоза кишечника у пациентов с язвенным колитом и целиакией. Материалы и методы: В исследование было включено 40 пациентов с активным язвенным колитом (легкая и среднетяжелая атаки), получающих терапию препаратами месалазина, 43 пациента с целиакией, находящихся на безглютеновой диете, и 42 практически здоровых добровольца. Для количественного определения микроорганизмов ДНК, выделенную из образцов кала, подвергали полимеразной цепной реакции (ПЦР) в режиме реального времени. Результаты: У пациентов с язвенным колитом, как и у больных целиакией, количество Faecalibacterium prausnitzii было значимо меньше, чем у здоровых лиц (p = 0,043 и p = 0,036 соответственно). Общее количество бутират-продуцирующих бактерий, имеющих ген бутирил-КоA: ацетат-КоA-трансферазы (but), было снижено (по сравнению со здоровыми добровольцами) только у пациентов с язвенным колитом (p = 0,048). Несмотря на то, что общее количество бактероидов между группами пациентов не различалось, Bacteroides thetaiotaomicron существенно реже встречался у пациентов с язвенным колитом, чем у здоровых лиц (p = 0,016). Отсутствие Bacteroides thetaiotaomicron в кале или его уровень ниже порога обнаружения были значимо связаны с язвенным колитом (ОШ = 6,30; 95% ДИ: 1,33 - 29,95). У пациентов с целиакией уровень Bifidobacterium spp. был значимо снижен по сравнению как со здоровыми добровольцами, так и с больными язвенным колитом (p = 0,022 и p = 0,046 соответственно). Как при язвенном колите, так и при целиакии таксономический дисбиоз характеризовался повышенным отношением Bacteroides fragilis spp. к Faecalibacterium prausnitzii по сравнению со здоровыми лицами (p < 0,05 в обоих случаях). Выводы: Повышенное отношение Bacteroides fragilis к Faecalibacterium prausnitzii может рассматриваться в качестве потенциального биомаркера дисбиоза кишечника провоспалительного типа. Уменьшение численности бутират-продуцирующих бактерий подтверждает целесообразность восполнения дефицита масляной кислоты при обоих заболеваниях путем дополнительного назначения препаратов масляной кислоты, пробиотиков на основе бутират-продуцирующих бактерий, бутирогенных пребиотиков и метабиотиков. Bacteroides thetaiotaomicron может играть защитную роль в организме человека, возможно, предохраняя его от развития воспалительных заболеваний кишечника. Снижение уровня Bifidobacterium spp. у пациентов с целиакией может свидетельствовать о защитной функции некоторых видов бифидобактерий и целесообразности применения пробиотиков на основе бифидобактерий и пребиотиков инулинового типа.

Об авторах

С. И. Ситкин
СЗГМУ им. И. И. Мечникова, Санкт-Петербург; Гос. НИИ ОЧБ ФМБА России
Россия


Т. Я. Вахитов
Гос. НИИ ОЧБ ФМБА России
Россия


Е. И. Ткаченко
СЗГМУ им. И. И. Мечникова, Санкт-Петербург; Военно-медицинская академия имени С. М. Кирова
Россия


Л. С. Орешко
СЗГМУ им. И. И. Мечникова, Санкт-Петербург
Россия


Т. Н. Жигалова
СЗГМУ им. И. И. Мечникова, Санкт-Петербург
Россия


В. Г. Радченко
СЗГМУ им. И. И. Мечникова, Санкт-Петербург
Россия


П. В. Селиверстов
СЗГМУ им. И. И. Мечникова, Санкт-Петербург
Россия


Е. Б. Авалуева
СЗГМУ им. И. И. Мечникова, Санкт-Петербург
Россия


М. А. Суворова
Институт экспериментальной медицины
Россия


Э. В. Комличенко
ПСПбГМУ им. акад. И. П. Павлова
Россия


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Для цитирования:


Ситкин С.И., Вахитов Т.Я., Ткаченко Е.И., Орешко Л.С., Жигалова Т.Н., Радченко В.Г., Селиверстов П.В., Авалуева Е.Б., Суворова М.А., Комличенко Э.В. МИКРОБИОТА КИШЕЧНИКА ПРИ ЯЗВЕННОМ КОЛИТЕ И ЦЕЛИАКИИ. Экспериментальная и клиническая гастроэнтерология. 2017;(1):8-30.

For citation:


Sitkin S.I., Vakhitov T.Y., Tkachenko E.I., Oreshko L.S., Zhigalova T.N., Radchenko V.G., Seliverstov P.V., Avalueva E.B., Suvorova M.A., Komlichenko E.V. GUT MICROBIOTA IN ULCERATIVE COLITIS AND CELIAC DISEASE. Experimental and Clinical Gastroenterology. 2017;(1):8-30. (In Russ.)

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