docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2024-237-86-91docru-203Research ArticleОБЗОРЫREVIEWSГастроинтестинальные расстройства, ассоциированные с расстройством аутистического спектраGastrointestinal Disorders Associated with Autism Spectrum Disorderhttps://orcid.org/0000-0002-7328-5698ГенераловВ. О.GeneralovV. O.

Генералов Василий Олегович — д. м. н., профессор, врач-невролог, эпилептолог, руководитель

г. Москва

Moscow

planetamed@mail.ruhttps://orcid.org/0000-0001-5148-3864КлюшникТ. П.KlyushnikT. P.

Клюшник Татьяна Павловна — д. м. н., профессор, руководитель научного отдела

г. Москва

Moscow

klushnik2004@mail.ruhttps://orcid.org/0000-0003-3371-7537ОбодзинскаяТ. Е.ObodzinskayaT. E.

Ободзинская Татьяна Евгеньевна / Obodzinskaya, T.E. — врач-психиатр, психотерапевт, заведующий отделением митохондриальной медицины

г. Москва

Moscow

dr.obodzinskaya@gmail.comhttps://orcid.org/0000-0003-4238-5634АлександренковаА. Н.AleksandrenkovaA. N.

Александренкова Ангелина Николаевна — врач-биохимик

г. Москва

Moscow

a.aleksandrenkova@bk.ruhttps://orcid.org/0000-0002-8319-7106СадыковТ. Р.SadykovT. R.

Садыков Тимур Русланович — к. м. н., врач-невролог, заведующий стационарным отделением

г. Москва

Moscow

veeg.russia@gmail.comhttps://orcid.org/0009-0006-8893-6402ЛарионовГ. В.LarionovG. V.

Ларионов Геннадий Владимирович. — врач-биохимик

г. Москва

Moscow

videoeeg@mail.ruКлиника интегративной медицины «ПланетаМед»РоссияCenter "PlanetaMed"Russian Federation202418022025237НЕВРОЛОГИЯ ПСИХИАТРИЯ8691Copyright © Генералов В.О., Клюшник Т.П., Ободзинская Т.Е., Александренкова А.Н., Садыков Т.Р., Ларионов Г.В., 20252025Генералов В.О., Клюшник Т.П., Ободзинская Т.Е., Александренкова А.Н., Садыков Т.Р., Ларионов Г.В.Generalov V.O., Klyushnik T.P., Obodzinskaya T.E., Aleksandrenkova A.N., Sadykov T.R., Larionov G.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/203Цель обзора

Цель обзора. Обобщение данных научной литературы, посвященных ассоциации расстройств аутистического спектра (РАС) с дисфункцией желудочно-кишечного тракта и нарушением микробиоты кишечника.

Основные положения

Основные положения. РАС относятся к группе нарушений развития нервной системы, связанных с генетическими, эпигенетическими и средовыми факторами, и включают в себя гетерогенные по клинической картине и тяжести психопатологических симптомов состояния. При РАС часто наблюдаются различные симптомы нарушения функционирования желудочно-кишечного тракта, ассоциированные с изменением проницаемости кишечного барьера. Следствием является проникновение внешних агентов (пищевых антигенов, токсинов, бактериальных метаболитов) в кровь и инициирование или поддерживание воспалительного процесса, являющегося важнейшим патофизиологическим звеном РАС. Особое внимание уделено анализу механизмов нарушения проницаемости кишечного барьера. В комплексной терапии пациентов с РАС необходима разработка стратегий, направленных на снижение уровня воспаления.

Заключение

Заключение. Пациенты с РАС помимо психо-неврологической симптоматики нередко презентуют соматические проблемы, которые, однако, могут быть не распознаны своевременно ввиду их неспецифичности и сложностей дифференцировки поведенческих реакций, ассоциированных с расстройством или являющихся реакцией на соматическое неблагополучие. При этом совокупность клинических проявлений опосредована единой системной дисрегуляцией иммунологических и метаболических реакций и по своей сути является различным отражением одного процесса, требующего многопрофильного лечения и использования различных подходов терапии. 

Aim

Aim. A synthesis of scientific literature data on the association of autism spectrum disorders (ASD) with gastrointestinal dysfunction and disturbances of the intestinal microbiota.

Key points

Key points. ASDs belong to a group of neurodevelopmental disorders associated with genetic, epigenetic and environmental factors, and include conditions that are heterogeneous in clinical presentation and severity of psychopathological symptoms. ASD is often comes with various symptoms of gastrointestinal tract dysfunction referred to impaired intestinal barrier permeability. The consequence is the pervasion of external agents (food antigens, toxins, bacterial metabolites) into the blood and initiation or maintenance of the inflammatory process, which is the most important pathophysiological link in ASD. Particular attention is paid to the analysis of the mechanisms of impaired intestinal barrier permeability. It is necessary to develop strategies aimed at reducing the level of inflammation in complex therapy of patients with ASD.

Conclusion

Conclusion. Patients with ASD, in addition to psychoneurological symptoms, often present somatic problems, which, however, may not be timely recognized due to their nonspecificity and the difficulty of differentiating behavioral reactions either associated with the disorder or being just a reaction to somatic ill-being.Moreover, the whole complex of clinical manifestations is mediated by a single systemic dysregulation of immunological and metabolic reactions and is inherently a different reflection of one process, requiring profound multidisciplinary treatment and the use of various therapy approaches.

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