medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-1-196-204medsovet-6705Research ArticleКЛИНИЧЕСКИЙ СЛУЧАЙ/ПРАКТИКАCLINICAL CASE/PRACTICELactobacillus rhamnosus GG для предупреждения рецидивов реактивного артрита у детейLactobacillus rhamnosus GG for the prevention of reactive arthritis relapse in childrenhttps://orcid.org/0000-0002-6719-5805ЧелпаченкоО. Е.ChelpachenkoO. E.

 д.м.н., профессор, ведущий научный сотрудник лаборатории инфекционной симбиологии 

460000, Россия, Оренбург, ул. Пионерская, д. 11

 Dr. Sci. (Med.), Professor, Leading Researcher of Infectious Symbiology Laboratory

11, Pionerskaya St., Orenburg, 460000, Russia 

oech57@gmail.comhttps://orcid.org/0000-0003-0910-6525ДаниловаЕ. И.DanilovaE. I.

 к.м.н., доцент кафедры педиатрии Института последипломного образования 

460000, Россия, Оренбург, ул. Советская, д. 6 

 Cand. Sci. (Med.), Associate Professor of the Department of Pediatrics, Institute of Postgraduate Training

6, Sovetskaya St., Orenburg, 460000, Russia 

danilowa@list.ruhttps://orcid.org/0000-0002-8923-8829ЧайниковаИ. Н.ChainikovaI. N.

 д.м.н., профессор, ведущий научный сотрудник лаборатории инфекционной симбиологии ; профессор кафедры нормальной физиологии 

460000, Россия, Оренбург, ул. Пионерская, д. 11

460000, Россия, Оренбург, ул. Советская, д. 6 

 Dr. Sci. (Med.), Professor, Leading Researcher of Infectious Symbiology Laboratory; Professor of the Department of Normal Physiology

11, Pionerskaya St., Orenburg, 460000, Russia

6, Sovetskaya St., Orenburg, 460000, Russia 

inchainicova@yandex.ruhttps://orcid.org/0000-0002-7320-7331СуменкоВ. В.SumenkoV. V.

 к.м.н., доцент кафедры педиатрии Института последипломного образования 

460000, Россия, Оренбург, ул. Советская, д. 6 

 Cand. Sci. (Med.), Associate Professor of the Department of Pediatrics

6, Sovetskaya St., Orenburg, 460000, Russia 

sumenkovv@mail.ruhttps://orcid.org/0000-0002-4974-8947ИвановаЕ. В.IvanovaE. V.

 д.м.н., доцент, ведущий научный сотрудник лаборатории инфекционной симбиологии 

460000, Россия, Оренбург, ул. Пионерская, д. 11

460000, Россия, Оренбург, ул. Советская, д. 6 

 Dr. Sci. (Med.), Associate Professor, Leading Researcher of Infectious Symbiology Laboratory; Associate Professor

11, Pionerskaya St., Orenburg, 460000, Russia

6, Sovetskaya St., Orenburg, 460000, Russia 

walerewna13@gmail.comИнститут клеточного и внутриклеточного симбиоза Уральского отделения РАНРоссияInstitute of Cellular and Intracellular Symbiosis, Ural Branch of RASRussian FederationОренбургский государственный медицинский университетРоссияOrenburg State Medical UniversityRussian FederationИнститут клеточного и внутриклеточного симбиоза Уральского отделения РАН; Оренбургский государственный медицинский университетРоссияInstitute of Cellular and Intracellular Symbiosis, Ural Branch of RAS; Orenburg State Medical UniversityRussian FederationОренбургский государственный медицинский университетРоссияInstitute of Postgraduate Training, Orenburg State Medical UniversityRussian Federation20220303202201196204Copyright © Челпаченко О.Е., Данилова Е.И., Чайникова И.Н., Суменко В.В., Иванова Е.В., 20222022Челпаченко О.Е., Данилова Е.И., Чайникова И.Н., Суменко В.В., Иванова Е.В.Chelpachenko O.E., Danilova E.I., Chainikova I.N., Sumenko V.V., Ivanova E.V.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/6705

Введение. Результаты многочисленных исследований, свидетельствующих о связи развития реактивного артрита (РеА) с нарушением кишечного микробиоценоза, обусловливают интерес к составляющим микробиоту кишечника микроорганизмамкомменсалам как потенциальным инициаторам иммунозависимых воспалительных заболеваний суставов. В связи с этим представляет практический интерес вопрос о целесообразности использования пробиотических препаратов для коррекции кишечной микрофлоры у детей с РеА.Цель исследования – оценить эффективность Lactobacillus rhamnosus GG (LGG) в превентивном лечении детей с РеА для предупреждения развития рецидивов.Материалы и методы. Клинико-микробиологическое исследование включало 60 пациентов с РеА от 3 до 17 лет, которые были разделены на две группы по 30 детей в каждой. Пациенты 1-й группы получали курсы лечения LGG в неактивную фазу заболевания. Пациентам 2-й группы (сравнения) лечение пробиотиком не проводилось. Критериями эффективности терапии служили количество рецидивов РеА при наблюдении в катамнезе в течение 1 года; динамика состояния кишечного микробиоценоза по следующим параметрам: показатель микробной обсемененности (ПМО) кишечных микросимбионтов; способность к биопленкообразованию (БПО); уровни лактоферрина и лизоцима в копрофильтратах.Результаты. У больных РеА, получавших лечение LGG, достоверно реже отмечались РеА в течение 12 мес. Проспективного наблюдения относительно группы сравнения. У больных 1-й группы отмечалась положительная динамика состояния кишечного микробиоценоза: ослабление тяжести дисбиоза, снижение уровня лактоферрина, лизоцима в копрофильтратах, ПМО и способность к БПО условно-патогенных микроорганизмов на фоне повышения ПМО и БПО у бифидо- и лактобактерий.Выводы. Использование LGG в лечении детей с РеА в неактивную фазу заболевания способствует коррекции нарушений микробиоценоза кишечника и снижает количество рецидивов РеА.

Introduction. The results of numerous studies indicating the relationship between the development of reactive arthritis (ReA) and the disturbance of the intestinal microbiocenosis give rise to interest in commensal microorganisms that make up the intestinal microbiota as potential initiators of immune-dependent inflammatory diseases of the joints. In this regard, the question of the expediency of using probiotic preparations for the correction of ReA patients intestinal microflora is of practical interest.The purpose of the study was to evaluate the effectiveness of Lactobacillus rhamnosus LGG (LGG) in the preventive treatment of children with ReA to prevent the development of relapses.Materials and methods. Clinical and microbiological study included 60 patients with ReA from 3 to 17 years old, who were divided into two groups, 30 children each. Patients of the group 1 received courses of treatment with LGG in the inactive phase of the disease. Patients of the group 2 (comparison group) were not treated with probiotic. The criteria for the effectiveness of treatment were the number of relapses of ReA during follow-up observation for 1 year; dynamics of intestinal microbiocenosis condition according to the following parameters: indicator of microbial contamination (IMC) of intestinal microsymbionts; ability to biofilm formation (BF); levels of lactoferrin and lysozyme in coprofiltrates.Results. In patients treated with LGG, relapses of arthritis were significantly less frequent during 12 months of prospective observation relative to the comparison group. Patients of the group 1 showed positive dynamics of the state of intestinal microbiocenosis: a decrease in the severity of dysbiosis, a decrease of lactoferrin and lysozyme level in coprofiltrates, IMC and BF of opportunistic microorganisms against the increase IMC and BF in bifidobacteria and lactobacilli.Conclusions. The use of LGG in the treatment of children with ReA in the inactive phase of the disease contributes to the correction of intestinal microbiocenosis disorders and reduces the number of arthritis relapses.

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