Current view of the yesterday's medicine (review)

A. Zhangabylov, B. Bimbetov, Nurlan Jainakbayev, Каramyat Zordinova
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Abstract

Phospholipids (PL) – lipids that are not involved in accumulation of fatty deposits play a significant role and serve various functions. Firstly, as a component of cell membranes of all cells in the organism. In clinical practice, for the past decades, phospholipids were primarily used as hepaprotective substances, going by the name of “essential phospholipids (EPL)”. Becoming a popular, demanded, well-promoted remedy for the treatment of liver diseases. However, despite the many years of approbation, the existing and sufficientclinicalexperience, discussions regarding their benefits, effectiveness, safety and reliability are still underway and have brought up diametrically opposed views. From complete rejection of EPL as medicinal means, to full recognition of the advertised properties of EPL drugs based on the given manufacturer’s descriptions. For this reason, to clarify the issuing situation, we have conducted a literature search on the object of investigation. Purpose of the study. Search and critical analysis of modern literature sources on the topic of work using the principles of evidence-based medicine. Material and Methods. A critical online review of the literature sources chosen for the research has been carried out in the Web of Science Thompson Reuters, Springer Link and Pubmed databases, as well as in research works and online articles 10 years deep. Inclusion criteria: research papers with a high index of evidence base. Exclusion criteria: literature sources with no evidence, low quality works. Results and Discussion. The articleoutlines the natural role of proteins, lipids and the function of the cytolemma of intracellularorganoids in the restoration of damaged membranes of hepatocytes - de novo. Substantiating the obvious uselessness of using essential phospholipids in the treatment of liver diseases in general, fatty hepatosis in particular. The inability of penetration into liver cells for phospholipids in their native form and their alignment in thehepacyte membrane is indicated, since they belong to different biological species and have a mutually closed genetic system. In the literature search undertaken by us on this issue, the analytical and critical review of scientific literature have also shown that when ingested, essential phospholipids have low bioavailability, as the phospholipids in the chylomicrons do not directly enter the liver, but first the lymphatic system through which they are transported to the adipose tissue of the organism, where they are accumulated and metabolized. With parenteral administration, EPL spreading through the bloodstream can accumulate in other organs, systems, without reaching the liver tissue. For example, the largest amounts of EPL are usually found in the cell membranes of the nervous tissue and the brain. Conclusion. Essential phospholipids in the form of soy lecithin products cannot replace the endogenous phospholipids of the human body - in principle. Keywords: essentialphospholipids, liver cell membranes, hepaprotectors.
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对昨日医学的当前看法(综述)
磷脂(PL) -脂不参与脂肪沉积的积累发挥重要作用,并具有各种功能。首先,作为生物体内所有细胞细胞膜的组成部分。在过去几十年的临床实践中,磷脂主要被用作肝保护物质,被称为“必需磷脂(EPL)”。成为一种受欢迎的、需要的、推广良好的治疗肝病的药物。然而,尽管经过了多年的批准,现有的和充分的临床经验,关于它们的益处、有效性、安全性和可靠性的讨论仍在进行中,并提出了截然相反的观点。从完全拒绝EPL作为医疗手段,到完全认可基于给定制造商描述的EPL药物的广告特性。为此,为了厘清发行情况,我们对调查对象进行了文献检索。研究目的:使用循证医学原则对工作主题进行现代文献来源的搜索和批判性分析。材料和方法。对为这项研究选择的文献来源进行了批判性的在线审查,这些文献来源已在科学网汤普森路透、施普林格链接和Pubmed数据库中进行,以及10年前的研究著作和在线文章。纳入标准:证据基础指数高的研究论文。排除标准:文献来源无证据,作品质量低。结果和讨论。本文概述了蛋白质、脂质和细胞内类器官细胞膜在肝细胞受损膜新生修复中的作用。证实使用必需磷脂治疗一般肝脏疾病,特别是脂肪肝的明显无用性。由于磷脂属于不同的生物物种,并且具有相互封闭的遗传系统,因此它们不能以天然形式渗透到肝细胞中并在肝细胞膜上排列。在我们对这个问题进行的文献检索中,对科学文献的分析和批判性回顾也表明,当摄入时,必需磷脂具有低生物利用度,因为乳糜微粒中的磷脂不直接进入肝脏,而是首先进入淋巴系统,通过淋巴系统转运到生物体的脂肪组织,在那里它们被积累和代谢。通过肠外给药,EPL通过血液扩散可以在其他器官、系统中积累,而不会到达肝组织。例如,EPL的最大量通常存在于神经组织和大脑的细胞膜中。结论。大豆卵磷脂产品形式的必需磷脂原则上不能代替人体内源性磷脂。关键词:必需磷脂,肝细胞膜,肝保护剂。
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