Биомаркеры повреждения кишечной стенки при синдроме мультиорганной дисфункции

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У пациентов, находящихся в тяжелом состоянии в отделении реанимации и интенсивной терапии (ОРИТ), из-за нарушений микроциркуляции, ишемии и гипоксии стенки кишечника увеличивается ее проницаемость, нарушается барьерная функция, вследствие чего бактерии и/или их эндотоксины проникают через поврежденный барьер слизистой оболочки кишечника. Это еще больше усиливает иммунный ответ, который становится системным и в конечном счете может привести к синдрому мультиорганной дисфункции, сепсису и даже летальному исходу. В данном обзоре рассмотрены механизмы нарушения кишечного барьера, а также наиболее надежные биомаркеры повреждения кишечной стенки, определяемые в сыворотке крови: зонулин (zonulin), кишечный белок, связывающий жирные кислоты (Intestinal fatty acidbinding protein — I-FABP), регенерирующий белок островкового происхождения 3-альфа (Regenerating islet-derived 3-alpha — REG3α), цитруллин (citrulline). Несмотря на различные ограничения исследований, эти биомаркеры являются интересными кандидатами для выявления пациентов с высоким риском развития осложнений и позволят проводить скрининг отдельных пациентов на предмет своевременных мер интенсивной терапии, которые могут сократить пребывание пациентов в ОРИТ и снизить летальность.

Ключевые слова:

синдром мультиорганной дисфункции

MODS

биомаркеры повреждения кишечной стенки

I-FABP

REG3α

зонулин

цитруллин

Авторы:

Тургунов Е.М.

НАО «Медицинский университет Караганды»

ORCID: 0000-0002-6486-3847

Огизбаева А.В.

НАО «Медицинский университет Караганды»

ORCID: 0000-0003-1006-1870

Мугазов М.М.

НАО «Медицинский университет Караганды»

ORCID: 0000-0002-7739-8999

Асамиданова С.Г.

НАО «Медицинский университет Караганды»

ORCID: 0000-0002-9819-3079

Дата поступления:

03.11.2023

Дата принятия в печать:

12.12.2023

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