Микробиота кишечника и заболевания почек. Обзор литературы

Технологические достижения последних лет привели к значительному росту понимания роли микробных сообществ, населяющих организм человека. Микробиота кишечника представляет собой одну из самых разнообразных микробиот организма человека и включает более 35 000 видов бактерий с 10 миллионами генов. По этой причине многие авторы называют микробиоту кишечника дополнительным органом. Микроорганизмы, населяющие кишечник, представляют собой динамическую экосистему, состав которой тем не менее относительно постоянен у каждого человека, но в то же время существенно зависит от экзо- и эндогенных факторов. Коллективно они функционируют как «второй геном», оказывая глубокое влияние на метаболические пути хозяина, управляя сложным гомеостатическим равновесием организма. Исследования механизмов, лежащих в основе взаимодействия «микроб–хозяин» как в здоровом состоянии, так и в ходе заболевания, являются предметом научного интереса во всем мире. Микробиота кишечника заметно изменяется при ХБП, а накопленные данные подтверждают теорию о том, что дисбиоз в значительной степени способствует прогрессированию почечной недостаточности. Уремические токсины кишечного происхождения, снижение синтеза короткоцепочечных жирных кислот, изменение pH кишечной среды, нарушение кишечного барьера и, как следствие, нарастание системного воспаления – неполный перечень патологических процессов, происходящих при непосредственном участии кишечной микробиоты. Описанные изменения у пациентов с заболеваниями почек требуют дальнейшего изучения их взаимосвязи с патогенезом, механизмами прогрессирования заболевания. Используемые для изучения состава микробиома: метагеномный и метатранскриптомный анализы, дополненные анализом белков, метаболитов и иммунома, а также механистическими экспериментами в модельных системах значительно улучшили нашу способность понимать структуру и функции микробиома, существенно расширяя наши знания о микробных сообществах и их влиянии на метаболизм. Целью множества исследований в настоящее время является рассмотрение этой двунаправленной связи между представителями микробиоты и хозяином и потенциальных вмешательств, которые могут помочь в восстановлении мутуалистических отношений.

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