medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-178medsovet-8433Research ArticleГАСТРОЭНТЕРОЛОГИЯGASTROENTEROLOGYМикробиота кишечника у детей с хроническими вирусными гепатитамиIntestinal microbiota in children with chronic viral hepatitishttps://orcid.org/0000-0003-1083-2807ПервишкоО. В.PervishkoO. V.

Первишко Олеся Валерьевна, к.м.н., доцент, заведующий кафедрой педиатрии №1

350063, Краснодар, ул. Митрофана Седина, д. 4

Olesya V. Pervishko, Cand. Sci. (Med.), Associate Professor, Head of the Department of Pediatrics No. 1

4, Mitrofan Sedin St., Krasnodar, 350063

ole-pervishko@yandex.ruhttps://orcid.org/0000-0002-1593-0732ДмитриеваД. К.DmitrievaD. K.

Дмитриева Диана Кирилловна, аспирант кафедры педиатрии имени акад. Г.Н. Сперанского

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Diana K. Dmitrieva, Postgraduate Student of the Department of Pediatrics named after Acad. G.N. Speransky

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

dmitrievadi@mail.ruhttps://orcid.org/0000-0003-4200-4598ЗахароваИ. Н.ZakharovaI. N.

Захарова Ирина Николаевна, д.м.н., профессор, заслуженный врач России, заведующая кафедрой педиатрии имени акад. Г.Н. Сперанского

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Irina N. Zakharova, Dr. Sci. (Med.), Professor, Head of the Department of Pediatrics named after Acad. G.N. Speransky

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

zakharova-rmapo@yandex.ruКубанский государственный медицинский университетРоссияKuban State Medical UniversityRussian FederationРоссийская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuous Professional EducationRussian Federation202407082024011100–105Copyright © Первишко О.В., Дмитриева Д.К., Захарова И.Н., 20242024Первишко О.В., Дмитриева Д.К., Захарова И.Н.Pervishko O.V., Dmitrieva D.K., Zakharova I.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8433

Статья посвящена обзору литературы по изучению микробиоты кишечника при хронических вирусных гепатитах у детей. Представлены результаты последних исследований микробного разнообразия содержимого толстой кишки с помощью секвенирования 16S рибосомной РНК. Научные исследования последних лет доказывают влияние изменений микробиоты и ее отдельных представителей на формирование осложнений у пациентов с хроническими вирусными гепатитами, развитие фиброза/цирроза. Измененные количественные и видовые соотношения микроорганизмов могут приводить к запуску патологических реакций в системе «кишечник – печень». Значительное сокращение количества бактерий, таких как Clostridia и Bacteroidia (Faecalibacterium, Roseburia inilinivorans, Roseburia intestinalis, Coprococcus comes) обусловливает низкую выработку короткоцепочечной жирной кислоты – бутирата, что может нарушать работу белков плотных контактов. Негерметичность и повышенная проницаемость кишечника создают условия для формирования воспаления из-за активности провоспалительных цитокинов. Нарушение барьерной функции кишечника создает возможность для проникновения бактерий, липополисахаридных комплексов, бактериальных лигандов и метаболитов, приводя к развитию иммунопатологических реакций. Данные изменения в детской популяции менее заметны, чем у взрослой когорты пациентов, так как клиническое течение хронических вирусных гепатитов у детей является более гладким. Однако периоды обострения, которые характеризуются клинико-лабораторными изменениями, могут сохранять риск развития активности фиброгенеза в более старших возрастных группах. Отдельно представлены данные по микробному разнообразию кишечника у взрослых пациентов с хроническими вирусными гепатитами В и С. Рассмотрены возможности использования пре- и пробиотической терапии в комплексном лечении хронических заболеваний печени у взрослых и детей.

The article is devoted to a review of the literature on the study of intestinal microbiota in chronic viral hepatitis in children. The results of recent studies of microbial diversity of colon contents using 16S ribosomal RNA sequencing are presented. Scientific research in recent years has proven the influence of changes in the microbiota and its individual representatives on the formation of complications in patients with chronic viral hepatitis, the development of fibrosis/cirrhosis. Changed quantitative and species ratios of microorganisms can lead to the launch of pathological reactions in the intestinal-liver axis system. A significant reduction in the number of bacteria such as Clostridia and Bacteroidia (Faecalibacterium, Roseburia inilinivorans, Roseburia intestinalis, Coprococcus comes) causes low production of short-chain fatty acid butyrate, which can interfere with the functioning of tight junction proteins. Leaks and increased intestinal permeability create conditions for the formation of inflammation due to the activity of pro-inflammatory cytokines. Violation of the intestinal barrier function creates the opportunity for the penetration of bacteria, lipopolysaccharide complexes, bacterial ligands and metabolites, leading to the development of immunopathological reactions. These changes in the pediatric population are less noticeable than in the adult cohort of patients, since the clinical course of chronic viral hepatitis in children has a smoother course. However, periods of exacerbation, which are characterized by clinical and laboratory changes, may maintain the risk of developing fibrogenesis activity in older age groups. Data on intestinal microbial diversity in adult patients with chronic viral hepatitis B and C are presented separately. The possibilities of using pre- and probiotic therapy in the complex treatment of chronic liver diseases in adults and children are considered.

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