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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/ms2025-402</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-9485</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>НЕОНАТОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>NEONATOLOGY</subject></subj-group></article-categories><title-group><article-title>Метаболомный подход к оценке эффективности лечения младенческих колик пробиотиком Lactobacillus reuteri LR92 у детей, находящихся на грудном вскармливании</article-title><trans-title-group xml:lang="en"><trans-title>Metabolomic approach to evaluating the effectiveness of Lactobacillus reuteri LR92 probiotic treatment for infantile colic in breastfed children</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0992-1709</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Новикова</surname><given-names>В. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Novikova</surname><given-names>V. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новикова Валерия Павловна, д.м.н., профессор, заведующая кафедрой пропедевтики детских болезней с курсом общего ухода за детьми</p><p>194100, Санкт-Петербург, Литовская ул., д. 2</p></bio><bio xml:lang="en"><p>Valeriya P. Novikova, Dr. Sci. (Med.), Professor, Head of the Department of Propaedeutics of Childhood Diseases with a course in General Child Care</p><p>2, Litovskaya St., St Petersburg, 194100</p></bio><email xlink:type="simple">novikova-vp@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-6280-8617</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Магамедова</surname><given-names>Д. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Magamedova</surname><given-names>D. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Магамедова Динара Мафрудиновна, аспирант кафедры пропедевтики детских болезней с курсом общего ухода за детьми</p><p>194100, Санкт-Петербург, Литовская ул., д. 2</p></bio><bio xml:lang="en"><p>Dinara M. Magаmedova, Postgraduate Student, Department of Propaedeutics of Childhood Diseases with a Сourse in General Child Care</p><p>2, Litovskaya St., St Petersburg, 194100</p></bio><email xlink:type="simple">dinaramagamedova09@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2275-6875</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кукес</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kukes</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кукес Евгения Александровна, врач-педиатр</p><p>107113, Москва, Поперечный просек, д. 3</p></bio><bio xml:lang="en"><p>Evgeniia A. Kukes, Pediatrician</p><p>3, Poperechny Prosek St., Moscow, 107113</p></bio><email xlink:type="simple">dr.antonova.ea@gmail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-2480-4727</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Янковская</surname><given-names>О. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Yankovskaya</surname><given-names>O. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Янковская Ольга Станиславовна, клинический ординатор кафедры пропедевтики детских болезней с курсом общего ухода за детьми</p><p>194100, Санкт-Петербург, Литовская ул., д. 2</p></bio><bio xml:lang="en"><p>Olga S. Yankovskaya, Postgraduate Student, Department of Propaedeutics of Childhood Diseases with a сourse in General Child Care</p><p>2, Litovskaya St., St Petersburg, 194100</p></bio><email xlink:type="simple">yankovskayaos@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-6257-8599</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чуков</surname><given-names>С. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Chukov</surname><given-names>S. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Чуков Серафим Серафимович, клинический ординатор кафедры пропедевтики детских болезней с курсом общего ухода за детьми</p><p>194100, Санкт-Петербург, Литовская ул., д. 2</p></bio><bio xml:lang="en"><p>Serafim S. Chukov, Postgraduate Student, Department of Propaedeutics of Childhood Diseases with a Сourse in General Child Care</p><p>2, Litovskaya St., St Petersburg, 194100</p></bio><email xlink:type="simple">serafim.chukov@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0008-2431-7447</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мыслинчук</surname><given-names>Е. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Myslinchuk</surname><given-names>E. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мыслинчук Екатерина Сергеевна, студент, лаборант кафедры пропедевтики детских болезней с курсом общего ухода за детьми</p><p>194100, Санкт-Петербург, Литовская ул., д. 2</p></bio><bio xml:lang="en"><p>Ekaterina S. Myslinchuk, Student, Laboratory Assistant, Department of Propaedeutics of Childhood Diseases with a Сourse in General Child Care</p><p>2, Litovskaya St., St Petersburg, 194100</p></bio><email xlink:type="simple">myslinchuk96@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Санкт-Петербургский государственный педиатрический медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Saint Petersburg State Pediatric Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Московская областная детская клиническая травматолого-ортопедическая больница</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow Regional Children’s Clinical Traumatological and Orthopedic Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>01</day><month>12</month><year>2025</year></pub-date><volume>0</volume><issue>19</issue><fpage>15</fpage><lpage>27</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Новикова В.П., Магамедова Д.М., Кукес Е.А., Янковская О.С., Чуков С.С., Мыслинчук Е.С., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Новикова В.П., Магамедова Д.М., Кукес Е.А., Янковская О.С., Чуков С.С., Мыслинчук Е.С.</copyright-holder><copyright-holder xml:lang="en">Novikova V.P., Magamedova D.M., Kukes E.A., Yankovskaya O.S., Chukov S.S., Myslinchuk E.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/9485">https://www.med-sovet.pro/jour/article/view/9485</self-uri><abstract><sec><title>Введение</title><p>Введение. Симптомы младенческих колик максимально проявляются на шестой неделе жизни и прекращаются самостоятельно после 4–6-месячного возраста, что позволяет считать их доброкачественным, самоизлечивающимся состоянием. Необходимость лечения колик обусловлена негативным влиянием на семью чрезмерного плача младенца и наличием отдаленных последствий у колик. Доказана эффективность бактерий Lactobacillus reuteri DSM 17938 у детей, находящихся на естественном вскармливании. Возрастает интерес к исследованию штамма LR92, однако механизм его действия не изучен. Цель. Оценить влияние и безопасность приема пробиотика Максилак® Бэби капли (Lactobacillus reuteri LR92) на выраженность младенческих колик и динамику продукции микробных метаболитов и нейропептидов кишечной микробиотой у детей на грудном вскармливании.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. Проведено клиническое пострегистрационное открытое наблюдательное проспективное одноцентровое исследование с минимальной интервенцией и группой сравнения: 38 детей в возрасте от 1 до 5 мес., находящихся на грудном вскармливании с диагнозом «младенческие колики». Пациенты были рандомизированы на две группы: основная группа (17 детей) получала пробиотик Максилак® Бэби, капли для приема внутрь, группа сравнения (21 детей) не получала пробиотиков. Исследование метаболома мочи проведено методом газовой хромато-масс-спектрометрии (ГХ-МС) с использованием современного хроматографического оборудования.</p></sec><sec><title>Результаты</title><p>Результаты. У детей с коликами выявлены значимые изменения метаболома мочи, отражающие нарушения кишечной абсорбции, энергетического метаболизма и микробиоценоза. На фоне приема пробиотика отмечено полное купирование колик к 14-му дню у 100% детей основной группы (в группе сравнения только у 20%); снижение содержания в моче короткоцепочечных жирных кислот; изменение уровней нейромедиаторов; отсутствие побочных эффектов.</p></sec><sec><title>Выводы</title><p>Выводы. Пробиотик Максилак® Бэби продемонстрировал высокую эффективность и безопасность в лечении младенческих колик, что подтверждено клиническими и метаболомными исследованиями. Механизм действия связан с нормализацией микробиоценоза, метаболических процессов и нейромедиаторного статуса.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. Symptoms typically peak around the sixth week of life and resolve spontaneously by 4–6 months of age, which is why colic is generally considered a benign and self-limiting condition. The need for treatment arises from the negative impact of excessive crying on the infant’s family, as well as the potential long-term consequences of colic. The effectiveness of Lactobacillus reuteri DSM 17938 in breastfed infants has been demonstrated. Recently, there has been growing interest in the LR92 strain; however, its mechanism of action remains unclear.</p></sec><sec><title>Aim</title><p>Aim. To study the urine metabolome in 1–4 month-old breastfed infants receiving Lactobacillus reuteri LR92 probiotic (Maxilac® Baby drops) for the treatment of infantile colic, identify probable mechanisms of action of this probiotic, and assess its safety.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. A clinical post-registration open observational prospective single-center study with minimal intervention and a comparison group was conducted: 38 children aged 1 to 5 months who were breastfed and diagnosed with infantile colic. Patients were divided into two groups: the main group (17 children) received Maxilac® Baby probiotic drops for oral administration, the comparison group (21 children) did not receive probiotics. Urine metabolome analysis was performed using gas chromatography-mass spectrometry (GC-MS) with modern chromatographic equipment.</p></sec><sec><title>Results and discussion</title><p>Results and discussion. Children with colic showed significant changes in urine metabolome, reflecting impaired intestinal absorption, energy metabolism, and microbiocenosis. Following treatment with probiotic, complete resolution of colic by day 14 was observed in 100% of children in the main group (compared to only 20% in the comparison group); decreased urine content of short-chain fatty acids; changes in neurotransmitter levels indicating suppression of excitatory and stimulation of inhibitory neurotransmitters; absence of side effects.</p></sec><sec><title>Conclusions</title><p>Conclusions. Maxilac® Baby probiotic demonstrated high efficacy and safety in treating infantile colic, confirmed by clinical and metabolomic studies. The mechanism of action is associated with normalization of microbiocenosis, metabolic processes, and neurotransmitter status.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>младенческие колики</kwd><kwd>Lactobacillus reuteri LR92</kwd><kwd>метаболом</kwd><kwd>короткоцепочечные жирные кислоты</kwd><kwd>органические кислоты в моче</kwd><kwd>газовая хроматография – масс-спектрометрия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>infantile colic</kwd><kwd>Lactobacillus reuteri LR92</kwd><kwd>metabolome</kwd><kwd>short-chain fatty acids</kwd><kwd>organic acids in urine</kwd><kwd>gas chromatography-mass spectrometry</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Steutel NF, Zeevenhooven J, Scarpato E, Vandenplas Y, Tabbers MM, Staiano A et al. Prevalence of functional gastrointestinal disorders in european infants and toddlers. 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