МЕХАНИЗМЫ ВЗАИМОДЕЙСТВИЯ HELICOBACTER PYLORI C ЭПИТЕЛИЕМ СЛИЗИСТОЙ ОБОЛОЧКИ ЖЕЛУДКА. I. ФАКТОРЫ ПАТОГЕННОСТИ, СПОСОБСТВУЮЩИЕ УСПЕШНОЙ КОЛОНИЗАЦИИ
Аннотация
Helicobacter pylori — грамотрицательная, извитая, подвижная бактерия, способная колонизировать слизистую оболочку желудка (СОЖ) человека и выживать в этих крайне неблагоприятных условиях у более чем половины населения нашей планеты. Показано, что микроорганизм может обитать на СОЖ в течение всей жизни хозяина, но при этом вызывает клинически выраженные заболевания лишь у незначительной группы инфицированных лиц. К причинам, способствующим развитию заболеваний, как правило, относят: сопутствующие инфекции желудочно-кишечного тракта, неправильную стерилизацию медицинских инструментов (как правило эндоскопов), несоблюдение правил личной гигиены, длительный контакт с инфицированными или носителями, в том числе с членами семьи, и ряд других факторов. Хорошо известно, что персистирование H. pylori имеет этиологическое значение в развитии широкого спектра болезней желудочно-кишечного тракта, включая хронический гастрит, язвенную болезнь желудка и двенадцатиперстной кишки, аденокарциному желудка и MALT-лимфомы. Глобальное распространение носительства H. pylori позволяет предположить наличие у бактерии «умных» стратегий, способствующих ее адаптации к агрессивной среде желудка и пожизненному персистированию в организме человека. Даже спустя 34 года после открытия микроорганизма остается множество вопросов, не имеющих своего ответа, в том числе о роли факторов патогенности, способствующих выживанию микроорганизма в суровых условиях микробиома СОЖ. Изучение и понимание механизмов, способствующих колонизации и персистированию H. pylori, позволит оптимизировать прогноз повышенного риска тяжелых заболеваний у лиц, колонизированных этим микроорганизмом. Сложившийся в ходе эволюции долгосрочный баланс между человеком и H. pylori определяет микробное постоянство в микробиоме желудка, но в ряде случаев это совместное сосуществование приводит к риску развития вышеперечисленных тяжелых патологий. В данном обзоре предпринято обсуждение характера взаимоотношений H. pylori с эпителием, участие факторов патогенности бактерии (уреазы, ЛПС, комплекса поверхностных белков, токсинов и протеаз, способствующих инвазии) в колонизации и длительном персистировании на СОЖ. Приведенная информация о механизмах, связанных с колонизацией эпителия желудка H. pylori позволяет создать предпосылки для более эффективной терапии заболеваний гастродуоденальной зоны. Cведения, представленные в данном обзоре, важны для объяснения стратегий, используемых H. pylori для выживания в крайне неблагоприятных условиях микробиома желудка.
Об авторах
О. К. ПоздеевРоссия
д.м.н., профессор, зав. кафедрой микробиологии.
420012, Россия, г. Казань, ул. Бутлерова, 36.
Тел.: 8 919 693-02-04 (моб.).
А. О. Поздеева
Россия
ассистент кафедры терапии и семейной медицины.
Казань.Ю. В. Валеева
Россия
к.м.н., доцент кафедры неотложной медицинской помощи и симуляционной медицины.
Казань.П. Е. Гуляев
Россия
ассистент кафедры микробиологии.
Казань.
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Для цитирования:
Поздеев О.К., Поздеева А.О., Валеева Ю.В., Гуляев П.Е. МЕХАНИЗМЫ ВЗАИМОДЕЙСТВИЯ HELICOBACTER PYLORI C ЭПИТЕЛИЕМ СЛИЗИСТОЙ ОБОЛОЧКИ ЖЕЛУДКА. I. ФАКТОРЫ ПАТОГЕННОСТИ, СПОСОБСТВУЮЩИЕ УСПЕШНОЙ КОЛОНИЗАЦИИ. Инфекция и иммунитет. 2018;8(3):273-283. https://doi.org/10.15789/2220-7619-2018-3-273-283
For citation:
Pozdeev О.К., Pozdeeva А.О., Valeeva Yu.V., Gulyaev P.E. MECHANISMS OF INTERRACTION OF HELICOBACTER PYLORI WITH EPITHELIUM OF GASTRIC MUCOSA. I. PATHOGENIC FACTORS PROMOTING SUCCESSFUL COLONIZATION. Russian Journal of Infection and Immunity. 2018;8(3):273-283. (In Russ.) https://doi.org/10.15789/2220-7619-2018-3-273-283