medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2015-14-119-122medsovet-372Research ArticleТРУДНЫЙ ДИАГНОЗDIFFICULT DIAGNOSISДискуссионные вопросы профилактики целиакииControversial issues of prophylaxis of celiac diseaseЗахароваИ. Н.ZakharovaI. N.noemail@neicon.ruДмитриеваЮ. А.DmitrievaY. A.noemail@neicon.ruКлимовЛ. Я.KlimovL. Y.noemail@neicon.ruДзебисоваФ. С.DzebisovaF. S.noemail@neicon.ruРоссийская медицинская академия последипломного образованияРоссияRussian Medical Academy of Postgraduate EducationRussian FederationСтавропольский государственный медицинский университетРоссияStavropol State Medical UniversityRussian Federation201530122015014119122Copyright © Захарова И.Н., Дмитриева Ю.А., Климов Л.Я., Дзебисова Ф.С., 20152015Захарова И.Н., Дмитриева Ю.А., Климов Л.Я., Дзебисова Ф.С.Zakharova I.N., Dmitrieva Y.A., Klimov L.Y., Dzebisova F.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/372

С момента формирования современных представлений о патогенезе целиакии стало активно обсуждаться значение средовых факторов в ее развитии. Наибольший интерес ученых привлекало возможное влияние характера вскармливания ребенка в раннем возрасте на риск развития заболевания. В статье авторами проанализированы исследования, опубликованные в течение последних 15 лет, демонстрирующие изменение представлений о роли грудного вскармливания и сроков введения глю-тенсодержащих продуктов в патогенезе глютеновой энтеропатии. Результаты последних опубликованных крупных контролируемых исследований позволили достоверно показать, что возможность выработки оральной толерантности к глютену при целиакии как генетически детерминированном заболевании невозможно, при этом риск и сроки дебюта заболевания в первую очередь обусловлены особенностями генотипа пациентов.

From the moment the modern concepts of the pathogenesis of celiac disease were shaped, the role of environmental factors in its development has been widely discussed. The interest of a majority of researchers was attracted to the potential influence of the nature of infant feeding on the risk of the disease. The authors analyzed studies published over the last 15 years demonstrating the changing perceptions of the role of breastfeeding and timing of introducing gluten-containing products in the pathogenesis of celiac disease. Results of the largest recently published controlled trials provided reliable data that it is impossible to develop oral tolerance to gluten in genetically determined celiac disease, while the risk and timing of the disease onset are primarily conditioned by the specific genotype of the patient.

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