Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya62959610.26442/00403660.2024.02.202587Editorial articleПередовая статьяResearch ArticleThe value of increased intestinal permeability in the pathogenesis of internal diseasesЗначение повышенной проницаемости кишечника в патогенезе внутренних болезнейhttps://orcid.org/0000-0002-9782-4860ParfenovAsfold I.ПарфеновАсфольд Иванович
Russian Federation

д-р мед. наук, проф., зав. отд. патологии кишечника

asfold@mail.ruLoginov Moscow Clinical Scientific CenterГБУЗ «Московский клинический научно-практический центр им. А.С. Логинова» Департамента здравоохранения г. Москвы30032024962Issues of gastroenterologyВопросы гастроэнтерологии85902903202429032024Copyright ©; 2024, Consilium MedicumCopyright ©; 2024, ООО "Консилиум Медикум"2024Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/629596

In the process of evolution in the gastrointestinal tract, a system of protection against bacterial and food antigens from getting into the blood was formed. The causes of increased intestinal permeability (IIP) can be microbiota imbalance, use of antibiotics, non-steroidal anti-inflammatory drugs, stress, diet rich in fructose, glucose, sucrose and long-chain fatty acids. The appearance of IIP may be of paramount importance in the pathogenesis of autoimmune diseases. A diet low in fermentable oligodimonosaccharides and polyols, pre- and probiotics, polyphenols, vitamins, short-chain fatty acids, dietary fiber, glutamine contributes to the reduction of IIP. It has been established that the cytoprotector rebamipide strengthens the barrier function throughout the gastrointestinal tract, which is reflected in practical recommendations for its use in diseases accompanied by IIP. The study of this direction will contribute to the emergence of a new strategy for the treatment of internal diseases.

В процессе эволюции в желудочно-кишечном тракте сформировалась система барьеров от попадания в кровь бактериальных и пищевых антигенов. Причинами повышенной проницаемости кишечника (ППК) могут быть дисбаланс микробиоты, длительное применение антибиотиков, нестероидных противовоспалительных препаратов, стресс, диета, богатая фруктозой, глюкозой, сахарозой и длинноцепочечными жирными кислотами. Появление ППК может иметь первостепенное значение в патогенезе аутоиммунных заболеваний. Уменьшению ППК способствует диета с низким содержанием ферментируемых олиго-, ди-, моносахаридов и полиолов, пре- и пробиотики, полифенолы, витамины, короткоцепочечные жирные кислоты, пищевые волокна, глютамин. Установлено, что цитопротектор ребамипид укрепляет барьерную функцию на всем протяжении желудочно-кишечного тракта, что отражено в практических рекомендациях по его применению при заболеваниях, сопровождающихся ППК. Изучение этого направления будет способствовать появлению новой стратегии лечения внутренних болезней.

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