medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-023medsovet-9875Research ArticleГАСТРОЭНТЕРОЛОГИЯGASTROENTEROLOGYВозможности таргетной терапии пробиотиком, содержащим L. reuteri, при заболеваниях желудочно-кишечного тракта у детей раннего возрастаPotential for targeted therapy with probiotic containing L. reuteri for gastrointestinal diseases in young childrenhttps://orcid.org/0000-0002-2666-4759ГуроваМ. М.GurovaM. M.

Гурова Маргарита Михайловна - д.м.н., профессор кафедры педиатрии, НИУ БелГУ; профессор кафедры пропедевтики детских болезней с курсом общего ухода за детьми, СПбГПМУ; ведущий научный сотрудник лаборатории медико-социальных проблем в педиатрии, Консультативно-диагностический центр для детей.

308015, Белгород, ул. Победы, д. 85; 194100, Санкт-Петербург, ул. Литовская, д. 2; 192289, Санкт-Петербург, ул. Олеко Дундича, д. 36, корп. 2

Margarita M. Gurova - Dr. Sci. (Med.), Professor of the Department of Pediatrics, Belgorod State University; Professor of the Department of Propaedeutics of Pediatrics with a Course in General Child Care, St Petersburg State Pediatric Medical University; Leading Researcher of the Laboratory of Medical and Social Problems in Pediatrics, Clinical and Diagnostic Center for Children.

85, Pobedy St., Belgorod, 308015; 2, Litovskaya St., St Petersburg, 194100; 36, Bldg. 2, Oleko Dundich St., St Petersburg, 192289

itely@mail.ruБелгородский государственный национальный исследовательский университет; Санкт-Петербургский государственный педиатрический университет; Консультативно-диагностический центр для детейРоссияBelgorod State University; St Petersburg State Pediatric Medical University; Clinical and Diagnostic Center for ChildrenRussian Federation20262403202601124131Copyright © Гурова М.М., 20262026Гурова М.М.Gurova M.M.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/9875

При мультифакториальной патологии, к которой относятся хронические неинфекционные заболевания, этиологический фактор, запустив целый каскад патологических изменений, теряет свою значимость. В этом случае мишенями таргетной терапии, влияющей на течение основного заболевания, могут быть ключевые звенья патогенеза, изменения различных структур организма человека – от молекулярных до органных – и непосредственно сами микроорганизмы. К таким ключевым звеньям патогенеза неинфекционных и инфекционных заболеваний относится нарушение проницаемости кишечного барьера с активацией врожденного и адаптивного иммунитета, негативными сдвигами в составе кишечной микробиоты и появлением признаков локального и системного воспаления. Обзор посвящен анализу возможностей применения пробиотических препаратов, в частности имеющих в своем составе Limosilactobacillus reuteri. Поиск литературы проводился в базах данных PubMed/MEDLINE, Embase, Scopus, Cochrane Library и eLIBRARY.RU. В итоге для анализа были отобраны 49 литературных источников. Проанализированы и подробно описаны терапевтическая эффективность и потенциальные механизмы действия штаммов L. reuteri при различных заболеваниях желудочно-кишечного тракта. Принимая во внимание их эффективность в поддержании функциональной активности кишечного барьера и восстановлении его в случае повреждения, а также противовоспалительное и антибактериальное действие и участие в модуляции реакций врожденного и адаптивного иммунитета, пробиотические препараты, содержащие L. reuteri, можно рассматривать как мультитаргетную терапию, направленную на профилактику и лечение заболеваний желудочно-кишечного тракта. В статье изучена терапевтическая эффективность пробиотика, содержащего штамм L. reuteri LR92. Данный пробиотик зарекомендовал себя как эффективное средство для лечения колик и других функциональных нарушений гастроэнтерологического профиля у детей. Кроме того, препарат показал эффективность в профилактике подобных нарушений у детей с пищевой аллергией и атопическим дерматитом. Выявлено, что его применение способствовало улучшению консистенции стула, регулярности дефекаций и качества жизни (FLIP) у детей c атопическим дерматитом.

In multifactorial pathological disorders, to which chronic noncommunicable diseases belong, the etiological factor, once it triggered a whole cascade of pathological changes, becomes irrelevant. In this case, the targeted therapy affecting the clinical course of the underlying disease can target key components of pathogenesis, different structures of the human body – from molecules to organs – and the microorganisms themselves. These key components of pathogenesis of non-communicable and communicable diseases include impaired permeability of the intestinal barrier with activation of innate and adaptive immunity, negative shifts in gut microbiota composition, and the onset of clinical symptoms of local and systemic inflammation. This review analyses the potential for probiotic supplements, particularly those containing Limosilactobacillus reuteri. A search for scientific publications was conducted in PubMed/MEDLINE, Embase, Scopus, the Cochrane Library, and eLIBRARY.RU. databases. A total of 49 scientific publications were selected for analysis. The therapeutic efficacy and potential mechanisms of action of L. reuteri in various gastrointestinal diseases were analysed and described in detail. Due to high efficacy of probiotic supplements with L. reuteri in maintaining the functional activity of the intestinal barrier and restoring it in case of injury, as well as their anti-inflammatory and antibacterial effects and involvement in modulation of innate and adaptive immune responses, they can be considered as a multitarget therapy aimed at preventing and treating gastrointestinal diseases. This article explored the therapeutic efficacy of L. reuteri LR92. This probiotic supplement has a proven track record as an effective drug in treating colic and other functional gastrointestinal disorders in children. In addition, the supplement has demonstrated the clinical efficacy in preventing similar disorders in children with food allergies and atopic dermatitis. It is found that its use improved stool consistency, bowel movement frequency, and quality of life (FLIP) in children with atopic dermatitis.

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