Нейропсихическое развитие и аутизм: потенциальное влияние казоморфинов, получаемых из козьего молока

Понятие аутизма эволюционировало от трактовки как психопатологического симптома к признанию самостоятельного спектра нарушений нейроразвития. Среди потенциальных механизмов обсуждается дисфункция гематоэнцефалического барьера: повышение его проницаемости может облегчать транслокацию периферических цитокинов и иммунных клеток в центральной нервной системе (ЦНС), усиливая нейровоспаление и уязвимость нейронных сетей. В каскадных моделях расстройства аутистического спектра (РАС) эти изменения связывают с кишечным дисбиозом, ростом проницаемости эпителиальных барьеров и системным действием диетических опиоидоподобных пептидов, включая β-казоморфин-7. Цель обзора – обобщить данные 2020–2025 гг. о возможном влиянии казоморфинов, образующихся при расщеплении β-казеина козьего молока (включая β-казоморфин-7), на нейропсихическое развитие и проявления РАС. Поиск выполнен в PubMed по ключевым терминам, отражающим РАС, ось «кишечник – мозг», β-казеин A1, β-казоморфин-7, козье молоко, микробиоту и барьерную функцию; включались экспериментальные, клинические и обзорные исследования. Данные литературы указывают на биологически правдоподобные механизмы связи пищевых опиоидных пептидов с функциями ЦНС через ось «кишечник – мозг», включая модуляцию микробиоты, воспалительных реакций и барьерной функции кишечника. Вместе с тем клинические доказательства специфического влияния казоморфинов, связанных с козьим молоком, на симптомы РАС остаются ограниченными и неоднородными.

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