lvrachЛечащий ВрачLechaschi Vrach1560-51752687-118110.26295/OS.2020.98.91.010lvrach-206Research ArticleСтатьиКишечный барьер и дерматологические заболеванияIntestinal barrier and dermatological diseasesОхлопковВ. А.OkhlopkovV. A.

Moscow

noemail@neicon.ruЛялюковаЕ. А.LyalyukovaE. A.

Omsk

lyalykova@rambler.ruЧернышеваЕ. Н.ChernyshevaE. N.

Astrakhan

noemail@neicon.ruНадейЕ. В.NadeyE. V.

Omsk

noemail@neicon.ruЛялюковА. В.LyalukovA. V.

Sochi

noemail@neicon.ruИВДПО ФНКЦ РРРоссияInstitute of Higher and Further Professional Education FNKTs RRRussian FederationФГБОУ ВО ОмГМУ Минздрава РоссииРоссияOmsk State Medical University of the Ministry of Health of the Russian FederationRussian FederationФГБОУ ВО Астраханский ГМУ Минздрава РоссииРоссияAstrakhan State Medical University of the Ministry of Health of the Russian FederationRussian FederationФГБОУ ВО СГУРоссияSochi State University of the Ministry of Health of the Russian FederationRussian Federation2020230620210104449Copyright © Охлопков В.А., Лялюкова Е.А., Чернышева Е.Н., Надей Е.В., Лялюков А.В., 20212021Охлопков В.А., Лялюкова Е.А., Чернышева Е.Н., Надей Е.В., Лялюков А.В.Okhlopkov V.A., Lyalyukova E.A., Chernysheva E.N., Nadey E.V., Lyalukov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.lvrach.ru/jour/article/view/206

Целью обзора является проведение анализа литературных данных о связи нарушений микробиоценоза кишечника с заболеваниями кожи, а также влиянии диеты на состояние кожи и особенности течения некоторых дерматологических заболеваний. При проведении анализа литературных данных была подтверждена тесная связь нарушений микробиоценоза кишечника и состояния кишечного барьера с заболеваниями кожи. Западный тип питания, низкое содержание клетчатки, витамина D, высокое содержание жира, избыток глютена и простых углеводов могут значительно изменять состав микробиома и проницаемость кишечника. В условиях нарушенного микробного баланса и изменения барьерной функции кишечника увеличивается проникновение в системный кровоток иммуногенных молекул, включая пищевые антигены, бактериальные токсины и патогены, которые могут накапливаться в коже, нарушать эпидермальный барьер, приводя к хроническому воспалению. Исходя из этого, важной целью в лечении дерматологических заболеваний является устранение повышенной проницаемости кишечника. Существует несколько путей, позволяющих восстановить функцию кишечного барьера: 1) уменьшение или исключение поступления антигенов, особенно в молодом возрасте (например, аглютеновая диета); 2) изменение состава микробиоты (пре-, про- и антибиотики); 3) модификация белков барьера кишечника и других регуляторных белков (цитопротекторы); 4) устранение воспаления, приводящего потенциально к иммунным реакциям.

The purpose of the review is to analyze the literature data on the relationship between intestinal microbiocenosis disorders and skin diseases, as well as the effect of diet on the skin condition and features of the course of certain dermatological diseases. When analyzing the literature data, a close relationship between violations of intestinal microbiocenosis and the state of the intestinal barrier with skin diseases was confirmed. Western diet, low in fiber, vitamin D, high in fat, excess of gluten and simple carbohydrates, improving microbiome composition and intestinal permeability. In conditions of disturbed microbial balance and changes in the barrier functions of the intestine, the penetration of immunogenic molecules into the systemic circulation, including food antigens, bacterial toxins and pathogens, which can accumulate in the skin, disrupt the epidermal barrier, leading to chronic perception, increases. The task in the treatment of dermatological diseases is to eliminate increased intestinal permeability. There are several ways to restore the function of the intestinal barrier: 1) reducing or eliminating the intake of antigens, especially at a young age (for example, gluten-free diet); 2) changes in the composition of the microbiota (pre-, pros-, and antibiotics); 3) modification of proteins, intestinal barrier and other regulatory proteins (cytoprotectors); 4) elimination of inflammation leading to immune reactions. 

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