ГЕНЕТИЧЕСКИЕ И ЭПИГЕНЕТИЧЕСКИЕ ФАКТОРЫ В ГЕНЕЗЕ ВОСПАЛИТЕЛЬНЫХ ЗАБОЛЕВАНИЙ КИШЕЧНИКА

Наталья Михайловна Богданова; Кира Александровна  Кравцова

doi:10.56871/CmN-W.2024.11.68.007

Наталья Михайловна Богданова Санкт-Петербургский государственный педиатрический медицинский университет. 194100, Российская Федерация, г. Санкт-Петербург, ул. Литовская, д. 2 https://orcid.org/0000-0002-4516-4194
Кира Александровна Кравцова Санкт-Петербургский государственный педиатрический медицинский университет. 194100, Российская Федерация, г. Санкт-Петербург, ул. Литовская, д. 2

DOI: https://doi.org/10.56871/CmN-W.2024.11.68.007

Ключевые слова: воспалительные заболевания кишечника, болезнь Крона, язвенный колит, генетика, генотип, молочные продукты, глютен, целикая, микробиота, витамин D, рецептор витамина D

Аннотация

Воспалительные заболевания кишечника (ВЗК) объединяют язвенный колит и болезнь Крона, ко-
торые характеризуются хроническим воспалением в гастроинтестинальном тракте. Заболевания имеют
многофакторную этиологию, включая генетическую предрасположенность, микробиоту кишечника, факторы окружающей среды, диету, образ жизни и социально-экономический статус. Во всем мире наблюдается неуклонный рост ВЗК, особенно в странах Скандинавии, Северной Америке, Канаде, Израиле. Вклад диеты в развитие и лечение ВЗК огромен. В 2020 году Европейское общество парентерального и энтерального питания (ESPEN — European Society of Parenteral and Enteral Nutrition) опубликовало рекомендации по диетотерапии при данной патологии и представило информацию о влиянии еды на риск развития данных заболеваний. Показано, что использование молочных продуктов может иметь преимущественно защитный эффект в этиологии как болезни Крона, так и язвенного колита. Хотя четкой зависимости «доза–реакция» не установлено, глютен способен запускать врожденный и адаптивный иммунный ответ, ответственный за воспаление кишечника. Кроме этого, имеются сообщения, которые указывают на целиакию как на потенциальный фактор риска ВЗК. Представлены доказательства того, что микробиота и витамин D играют важную роль в стимуляции и регуляции иммунной системы. В свою очередь, дисбиоз кишечника может быть либо причиной локального воспаления кишечника, либо одним из потенциальных факторов, приводящих к хроническому воспалению, так же как и дефицит витамина D.

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