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Склерозирующий холангит и воспалительные заболевания кишечника: что первично?

https://doi.org/10.21508/1027-4065-2021-66-1-39-46

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Аннотация

Склерозирующий холангит – одно из самых частых гепатологических внекишечных проявлений воспалительных заболеваний кишечника. Цель данного обзора – обсуждение фенотипа сочетания склерозирующего холангита и воспалительного заболевания кишечника. Представлены теории этиопатогенеза склерозирующего холангита при воспалительных заболеваниях кишечника, а также некоторые особенности фенотипа как смешанных, так и моногенных форм заболеваний.

Склерозирующий холангит в сочетании с воспалительным заболеванием кишечника обычно ассоциируется с панколитом, однако эндоскопически визуализируемая активность воспалительных заболеваний кишечника в этих случаях значительно ниже, а клинические симптомы менее выражены. Установлено, что существует повышенный риск развития злокачественных новообразований при сочетании склерозирующего холангита с воспалительным заболеванием кишечника. Подчеркивается, что механизмы формирования воспалительного заболевания кишечника в сочетании со склерозирующим холангитом остаются недостаточно изученными, хотя выявлено, что на развитие этой патологии влияют лимфоцитарная перекрестная реактивность, аберрантное распознавание микробиотических эпитопов и дисбаланс микробиоты кишечника. Новые биологические агенты, нацеленные на коррекцию взаимодействия между иммунной системой и органами-мишенями, могут обеспечить новые способы лечения склерозирующего холангита, сочетанного с воспалительным заболеванием кишечника.

Об авторах

А. А. Никитин
ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России; ОСП «Научно-исследовательский клинический институт педиатрии им. академика Ю.Е. Вельтищева» ФГАОУ ВО РНИМУ им. Н.И. Пирогова» Минздрава России
Россия

Никитин Артем Вячеславович – кандидат медицинских наук, ассистент кафедры гастроэнтерологии факультета дополнительного профессионального образования РНИМУ им. Н.И. Пирогова, старший научный сотрудник Научно-исследовательского клинического института педиатрии им. академика Ю.Е. Вельтищева

125412 Москва, ул. Талдомская, д. 2



Г. В. Волынец
ОСП «Научно-исследовательский клинический институт педиатрии им. академика Ю.Е. Вельтищева» ФГАОУ ВО РНИМУ им. Н.И. Пирогова» Минздрава России
Россия

Волынец Галина Васильевна – доктор медицинских наук, руководитель отдела  гастроэнтерологии 

125412 Москва, ул. Талдомская, д. 2



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Для цитирования:


Никитин А.А., Волынец Г.В. Склерозирующий холангит и воспалительные заболевания кишечника: что первично? Российский вестник перинатологии и педиатрии. 2021;66(1):39-46. https://doi.org/10.21508/1027-4065-2021-66-1-39-46

For citation:


Nikitin A.V., Volynets G.V. Sclerosing cholangitis and inflammatory bowel disease: which comes first? Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2021;66(1):39-46. (In Russ.) https://doi.org/10.21508/1027-4065-2021-66-1-39-46

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