Взаимосвязь расстройств взаимодействия «кишечник — мозг» и заболеваний печени

Расстройства взаимодействия оси «кишечник–мозг» (РВКМ) и заболевания печени метаболического генеза, включая их терминальную стадию, — цирроз печени (ЦП), включены в патогенетический континуум, в рамках которого каждый из компонентов может быть значимым драйвером прогрессирования. Ключевым звеном выступает системное низкоинтенсивное воспаление (low–grade inflammation), индуцированное портальной эндотоксемией и нейроиммунной дисрегуляцией. Цель обзора. Систематизировать современные данные о механизмах взаимосвязи, методах лечения РВКМ и заболеваний печени. В статье приводятся концепции восходящей (Bottom–Up) и нисходящей (Top–Down) модуляции сигналов, актуальные данные об изменениях микробиоты при РВКМ и заболеваниях печени. Особое внимание уделено возможностям диагностики и терапевтическим методам для целевого воздействия на значимые патофизиологические звенья. Заключение. Понимание роли взаимосвязи РВКМ и заболеваний печени аргументируют необходимость организации междисциплинарных команд, основной задачей которых является комплексная терапия РВКМ. Будущие исследования должны быть сфокусированы на определении биомаркеров нарушений профиля микробиоты, разработке фармакотерапевтического влияния на ключевой механизм прогрессирования — системное воспаление.

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