Нарушения кишечного микробиоценоза: расширение сферы применения пробиотиков

Проблема взаимодействия человека и кишечного микробиома окружена множеством тайн и загадок. Бактериальная флора желудочно-кишечного тракта оказывает локальное и системное воздействие не только на органы пищеварения, но и на весь организм  в  целом.  Многочисленные  исследования  доказали   патогенетическую   связь  состояния   кишечного   биоценоза не только  с заболеваниями желудочно-кишечного  тракта, но и с патологическими  процессами  со  стороны  других органов    и систем организма. По своей роли в поддержании гомеостаза кишечная микрофлора не уступает любому другому жизненно важному органу. В представленном обзоре рассмотрены актуальные аспекты терминологии и клиники нарушений кишечного микробиоценоза. Важное место в комплексной терапии нарушений микробиоценоза кишечника и соответствующих им клинических проявлений занимают пробиотики. В рамках обзора рассмотрены основные механизмы взаимодействия «пробиотик/хозяин», неиммунологические и иммунологические эффекты пробиотиков и предъявляемые к ним требования, основные направления применения представителей нормальной микрофлоры Bifidobacterium и Lactobacillus. Приведены данные метаанализов и системных обзоров, свидетельствующих о расширении показаний к назначению пробиотиков, рассмотрены возможности пробиотиков в комплексной терапии хеликобактерной инфекции, синдрома повышенной эпителиальной проницаемости кишечника, профилактики респираторных инфекций. В заключении обзора приводятся результаты поиска в базе данных PubMed о возможности применения пробиотиков в профилактике и лечении новой коронавирусной инфекции COVID-19.

Наличие в арсенале практического врача (прежде всего терапевта и врача общей практики) современных, эффективных и безопасных пробиотиков и их применение способствуют оптимизации лекарственной терапии не только у пациентов гастроэнтерологического профиля, но и у пациентов с другой соматической патологией, в т. ч. и с новой коронавирусной инфекцией COVID-19.

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