Pub Date : 2022-04-25DOI: 10.33978/2307-3586-2022-18-13-12-16
D. Yukalchuk, D. M. Ponomarenko, T.N. Yukalchuk, S. S. Sidorova, A.V. Shevchuk, A. Novopashin
The clinical case presented in the article demonstrates the effectiveness of orange in combination with fulvestrant in metastatic estrogen receptor-positive HER2/neu-negative breast cancer with a mutation in the PIK3CA gene. The resistance of hormone therapy requires the search for new therapeutic options. The results of the SOLAR-1 and BYLieve studies have shown not only the effectiveness of alpelisib, but also new types of toxicity characteristic of this therapy. At the moment, recommendations have been developed for the prevention and treatment of the most frequent adverse events, allowing the drug to be used as safely as possible. With the introduction of alpelisib, the possibilities of non-chemotherapeutic treatment options for prognostically unfavorable patients have not only expanded, but there has also been a trend towards the use of personalized medicine and targeted therapy.
{"title":"The Use of Alpelisib in Metastatic Estrogen-Receptor-Positive HER2/Neu-Negative Breast Cancer","authors":"D. Yukalchuk, D. M. Ponomarenko, T.N. Yukalchuk, S. S. Sidorova, A.V. Shevchuk, A. Novopashin","doi":"10.33978/2307-3586-2022-18-13-12-16","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-13-12-16","url":null,"abstract":"The clinical case presented in the article demonstrates the effectiveness of orange in combination with fulvestrant in metastatic estrogen receptor-positive HER2/neu-negative breast cancer with a mutation in the PIK3CA gene. The resistance of hormone therapy requires the search for new therapeutic options. The results of the SOLAR-1 and BYLieve studies have shown not only the effectiveness of alpelisib, but also new types of toxicity characteristic of this therapy. At the moment, recommendations have been developed for the prevention and treatment of the most frequent adverse events, allowing the drug to be used as safely as possible. With the introduction of alpelisib, the possibilities of non-chemotherapeutic treatment options for prognostically unfavorable patients have not only expanded, but there has also been a trend towards the use of personalized medicine and targeted therapy.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85902058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-25DOI: 10.33978/2307-3586-2022-18-13-18-23
D. Yukalchuk, D. M. Ponomarenko, T.N. Yukalchuk, S. S. Sidorova, A.V. Shevchuk, A. Novopashin, S. Prokopchuk, G.N. Tepikina
The article presents a clinical case illustrating the effectiveness of abemaciclib in combination with anastrozole in metastatic estrogen receptor-positive HER2/neu-negative breast cancer (BC). CDK4/6 inhibitors have changed the paradigm of treatment of patients with hormone-positive HER2 metastatic BC. Thanks to the ability of palbociclib, ribociclib and abemaciclib to delay and overcome resistance to endocrine therapy, the effectiveness of treatment of patients not only with newly diagnosed disease, but also with endocrine – resistant, and taking into account the independent effectiveness of abemaciclib and chemorefractor BC has increased. The combination of aromatase inhibitors and abemaciclib is associated with an increase in the effectiveness of treatment in the most prognostically unfavorable contingent of patients.
{"title":"The Use of Abemaciclib in Combination with Aromatase Iinhibitors in Metastatic HR+ HER2/Neu-Negative Breast Cancer","authors":"D. Yukalchuk, D. M. Ponomarenko, T.N. Yukalchuk, S. S. Sidorova, A.V. Shevchuk, A. Novopashin, S. Prokopchuk, G.N. Tepikina","doi":"10.33978/2307-3586-2022-18-13-18-23","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-13-18-23","url":null,"abstract":"The article presents a clinical case illustrating the effectiveness of abemaciclib in combination with anastrozole in metastatic estrogen receptor-positive HER2/neu-negative breast cancer (BC). CDK4/6 inhibitors have changed the paradigm of treatment of patients with hormone-positive HER2 metastatic BC. Thanks to the ability of palbociclib, ribociclib and abemaciclib to delay and overcome resistance to endocrine therapy, the effectiveness of treatment of patients not only with newly diagnosed disease, but also with endocrine – resistant, and taking into account the independent effectiveness of abemaciclib and chemorefractor BC has increased. The combination of aromatase inhibitors and abemaciclib is associated with an increase in the effectiveness of treatment in the most prognostically unfavorable contingent of patients.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"135 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79557082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-18DOI: 10.33978/2307-3586-2021-17-39-80-86
V. I. Mordasova, D. V. Kopylova, G.V. Dobrosotskih
Effective methods of treating UC patients is one of the most important problems. The inclusion of biological drugs in clinical practice leads to an improvement in the treatment of moderate and severe UC, but from 10 to 20% of patients lose their response within a year, which leads to the need to optimize the dose or switch to another drug. The use of janus kinase inhibitors – a new class of targeted synthetic drugs for the treatment of active ulcerative colitis – allows for a rapid clinical response when switching from TNF-α inhibitors. Pronounced clinical efficacy is usually observed 2-8 weeks after the start of treatment. A clinical case of a patient with ulcerative colitis who did not respond to treatment with anti-TNF is presented. Modern approaches to the diagnosis of ulcerative colitis and treatment tactics are reflected, as well as therapeutic possibilities for overcoming the secondary inefficiency of TNF inhibitors by using janus kinase inhibitors
{"title":"Management of Patients with Ulcerative Colitis Who Did Not Respond to Anti-TNF Treatment","authors":"V. I. Mordasova, D. V. Kopylova, G.V. Dobrosotskih","doi":"10.33978/2307-3586-2021-17-39-80-86","DOIUrl":"https://doi.org/10.33978/2307-3586-2021-17-39-80-86","url":null,"abstract":"Effective methods of treating UC patients is one of the most important problems. The inclusion of biological drugs in clinical practice leads to an improvement in the treatment of moderate and severe UC, but from 10 to 20% of patients lose their response within a year, which leads to the need to optimize the dose or switch to another drug. The use of janus kinase inhibitors – a new class of targeted synthetic drugs for the treatment of active ulcerative colitis – allows for a rapid clinical response when switching from TNF-α inhibitors. Pronounced clinical efficacy is usually observed 2-8 weeks after the start of treatment. A clinical case of a patient with ulcerative colitis who did not respond to treatment with anti-TNF is presented. Modern approaches to the diagnosis of ulcerative colitis and treatment tactics are reflected, as well as therapeutic possibilities for overcoming the secondary inefficiency of TNF inhibitors by using janus kinase inhibitors","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91055093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-18DOI: 10.33978/2307-3586-2021-17-39-74-78
E. Vinnitskaya, A. N. Ivanov, Y. Sandler
Vaccination of SARS-CoV-2 infection is an obvious and significant component of the fight against the COVID-19 pandemic. Vaccination of groups of patients with the weakened immunological response to the vaccine, such as patients with chronic liver diseases (CLD), is especially important. Due to constantly updated data, general practitioners may lose sight of the features of immunization of patients with CLD from the professional field of view. The purpose is to highlight current ideas on the immunization of patients with CLD of various etiologies, to consider possible risks of vaccination, to identify prospects for further research in this area. Conclusion. All patients with CLD, regardless of the etiology and stage of the disease, are recommended to be vaccinated against COVID-19, which reduces the risk of decompensation of both the main and concomitant chronic diseases, the onset of adverse outcomes and leads to the formation of collective immunity of the population
{"title":"Issues of Vaccination of SARS-CoV-2 Infection in Chronic Liver Diseases","authors":"E. Vinnitskaya, A. N. Ivanov, Y. Sandler","doi":"10.33978/2307-3586-2021-17-39-74-78","DOIUrl":"https://doi.org/10.33978/2307-3586-2021-17-39-74-78","url":null,"abstract":"Vaccination of SARS-CoV-2 infection is an obvious and significant component of the fight against the COVID-19 pandemic. Vaccination of groups of patients with the weakened immunological response to the vaccine, such as patients with chronic liver diseases (CLD), is especially important. Due to constantly updated data, general practitioners may lose sight of the features of immunization of patients with CLD from the professional field of view. The purpose is to highlight current ideas on the immunization of patients with CLD of various etiologies, to consider possible risks of vaccination, to identify prospects for further research in this area. Conclusion. All patients with CLD, regardless of the etiology and stage of the disease, are recommended to be vaccinated against COVID-19, which reduces the risk of decompensation of both the main and concomitant chronic diseases, the onset of adverse outcomes and leads to the formation of collective immunity of the population","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77064041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-18DOI: 10.33978/2307-3586-2021-17-39-88-93
A. Sutyagin, S. V. Shchelochenkov, T. Shchelochenkova, O. N. Guskova, D. Bordin
Intrahepatic cholangiocarcinoma (ICH) is one of the most aggressive malignant neoplasms of the gastrointestinal tract, which accounts for 10–15% of all primary liver tumors. Among the risk factors for ICH in Europe and Russia, diseases accompanied by the formation of concretions in the intrahepatic bile ducts, which include Karoli's disease (KD), are of primary importance. The article presents a clinical observation of HPV that developed against the background of KD, a literature review is conducted.
{"title":"Intrahepatic Cholangiocarcinoma on the Background of Multiple Cholangiolithiasis as a Poorly Diagnosed Problem in Clinical Practice","authors":"A. Sutyagin, S. V. Shchelochenkov, T. Shchelochenkova, O. N. Guskova, D. Bordin","doi":"10.33978/2307-3586-2021-17-39-88-93","DOIUrl":"https://doi.org/10.33978/2307-3586-2021-17-39-88-93","url":null,"abstract":"Intrahepatic cholangiocarcinoma (ICH) is one of the most aggressive malignant neoplasms of the gastrointestinal tract, which accounts for 10–15% of all primary liver tumors. Among the risk factors for ICH in Europe and Russia, diseases accompanied by the formation of concretions in the intrahepatic bile ducts, which include Karoli's disease (KD), are of primary importance. The article presents a clinical observation of HPV that developed against the background of KD, a literature review is conducted.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81703883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-18DOI: 10.33978/2307-3586-2021-17-39-40-47
O. Knyazev, K. Nikolskaya, M. Chebotareva, E. Zhulina, A. Kagramanova, N. Fadeeva, A. Parfenov, D. Bordin
Relevance. Therapy of Crohn's disease (CD) and ulcerative colitis (UC) still remains an urgent problem in modern gastroenterology. Unfortunately, currently there are not enough medications to achieve clinical, endoscopic, histological remission of inflammatory bowel diseases (IBD). The aim is to retrospectively evaluate the efficacy and tolerability of ustekinumab (UST) therapy in patients with moderate and severe CD and UC in real clinical practice. Material and methods. To assess the effectiveness and safety of UST, we included in the study 54 patients with IBD (42 – BC, 12 – UC) who received at least one UST injection from December 2019 to November 2021 at the A.S. Loginov Moscow Clinical Scientific and Practical Center (MCSC). The average age is 35.5 years. Anamnesis of the disease – from 1 to 26 years – 9.5 (95% CI 7.9–11.1). The vast majority (92.6%) of them received previous therapy with genetically engineered biological drugs (GIBD). Results. A rapid clinical response on the third day of treatment, characterized by a decrease in stool frequency, a decrease in the intensity of abdominal pain syndrome and an improvement in general well-being, was observed in 46 (85.2%) of 54 patients. Four months after the first oral injection, 19 patients (CD – 16, UC – 3) underwent a full examination at the A.S. Loginov MCSC. Subsequently, therapy was canceled for three of them for reasons: primary inefficiency, secondary inefficiency, unknown. A decrease in disease activity was noted in all patients during therapy: the initial values of the indices of all patients were from 8 to 11 points, after four months only two patients with CD had a Best index of 9, the rest had an interval from 2 to 5, in three patients with UC the Mayo index was 4 points. The mean baseline value of the CDAI decreased after four months compared to the baseline from 9.31 (95% CI 8.52–10.11) points to 3.81 (95% CI 2.66–4.97) (p < 0.001), the Mayo index – from 9.33 (95% CI 3.6–15.07) to 3.33 (95% CI 0.46–6.2) points (p = 0.11), respectively. In no case has the appearance of adverse events that could cause the withdrawal of the drug been noted. Conclusion. Clinical observation of a group of patients with CD and UC, as well as previous multicenter studies, demonstrated the high effectiveness of UST in induction and maintenance therapy of a cohort of patients with severe and moderate forms of CD and UC resistant to basic drugs and GIBP
的相关性。克罗恩病(CD)和溃疡性结肠炎(UC)的治疗仍然是现代胃肠病学亟待解决的问题。不幸的是，目前没有足够的药物来实现炎症性肠病(IBD)的临床、内镜、组织学缓解。目的是回顾性评估ustekinumab (UST)治疗在实际临床实践中重度CD和UC患者中的疗效和耐受性。材料和方法。为了评估UST的有效性和安全性，我们在研究中纳入了54例IBD患者(42 - BC, 12 - UC)，这些患者于2019年12月至2021年11月在as Loginov莫斯科临床科学与实践中心(MCSC)接受了至少一次UST注射。平均年龄为35.5岁。疾病的记忆- 1至26岁- 9.5 (95% CI 7.9-11.1)。绝大多数(92.6%)患者既往接受过基因工程生物药物(GIBD)治疗。结果。54例患者中有46例(85.2%)在治疗的第三天出现了快速的临床反应，其特点是排便次数减少，腹痛综合征强度减轻，总体健康状况改善。第一次口服注射4个月后，19例患者(CD - 16, UC - 3)在A.S. Loginov MCSC接受了全面检查。随后，治疗被取消了三个原因:原发性无效，继发性无效，未知。在治疗期间，所有患者的疾病活动度均有所下降:所有患者的指数初始值为8至11点，四个月后，只有两名乳糜泻患者的最佳指数为9点，其余患者的间隔为2至5点，三名UC患者的Mayo指数为4点。与基线相比，4个月后CDAI的平均基线值从9.31 (95% CI 8.52-10.11)降至3.81 (95% CI 2.66-4.97) (p < 0.001)， Mayo指数分别从9.33 (95% CI 3.6-15.07)降至3.33 (95% CI 0.46-6.2)点(p = 0.11)。在任何情况下都没有出现可能导致停药的不良事件。结论。一组CD和UC患者的临床观察以及之前的多中心研究表明，UST在对基础药物和GIBP耐药的重症和中度CD和UC患者的诱导和维持治疗中具有很高的有效性
{"title":"Efficacy and Safety of Ustekinumab in Patients with Inflammatory Bowel Diseases in Real Clinical Practice","authors":"O. Knyazev, K. Nikolskaya, M. Chebotareva, E. Zhulina, A. Kagramanova, N. Fadeeva, A. Parfenov, D. Bordin","doi":"10.33978/2307-3586-2021-17-39-40-47","DOIUrl":"https://doi.org/10.33978/2307-3586-2021-17-39-40-47","url":null,"abstract":"Relevance. Therapy of Crohn's disease (CD) and ulcerative colitis (UC) still remains an urgent problem in modern gastroenterology. Unfortunately, currently there are not enough medications to achieve clinical, endoscopic, histological remission of inflammatory bowel diseases (IBD). The aim is to retrospectively evaluate the efficacy and tolerability of ustekinumab (UST) therapy in patients with moderate and severe CD and UC in real clinical practice. Material and methods. To assess the effectiveness and safety of UST, we included in the study 54 patients with IBD (42 – BC, 12 – UC) who received at least one UST injection from December 2019 to November 2021 at the A.S. Loginov Moscow Clinical Scientific and Practical Center (MCSC). The average age is 35.5 years. Anamnesis of the disease – from 1 to 26 years – 9.5 (95% CI 7.9–11.1). The vast majority (92.6%) of them received previous therapy with genetically engineered biological drugs (GIBD). Results. A rapid clinical response on the third day of treatment, characterized by a decrease in stool frequency, a decrease in the intensity of abdominal pain syndrome and an improvement in general well-being, was observed in 46 (85.2%) of 54 patients. Four months after the first oral injection, 19 patients (CD – 16, UC – 3) underwent a full examination at the A.S. Loginov MCSC. Subsequently, therapy was canceled for three of them for reasons: primary inefficiency, secondary inefficiency, unknown. A decrease in disease activity was noted in all patients during therapy: the initial values of the indices of all patients were from 8 to 11 points, after four months only two patients with CD had a Best index of 9, the rest had an interval from 2 to 5, in three patients with UC the Mayo index was 4 points. The mean baseline value of the CDAI decreased after four months compared to the baseline from 9.31 (95% CI 8.52–10.11) points to 3.81 (95% CI 2.66–4.97) (p < 0.001), the Mayo index – from 9.33 (95% CI 3.6–15.07) to 3.33 (95% CI 0.46–6.2) points (p = 0.11), respectively. In no case has the appearance of adverse events that could cause the withdrawal of the drug been noted. Conclusion. Clinical observation of a group of patients with CD and UC, as well as previous multicenter studies, demonstrated the high effectiveness of UST in induction and maintenance therapy of a cohort of patients with severe and moderate forms of CD and UC resistant to basic drugs and GIBP","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89296909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-18DOI: 10.33978/2307-3586-2021-17-39-48-52
Zh.V. Fadina, A. Pavlov, A. Khovanov
The article highlights the methods of treating diarrhea in non-infectious diseases of the gastrointestinal tract. In particular, the effectiveness of using modern enterosorbents – polymethylasiloxane polyhydrate and dioctahedral smectite in complex pathogenetic therapy. The interrelation of endotoxemia with the pathogenesis of diarrheal syndrome was disclosed, and the LAL-test (methods for determining blood serum endotoxin) was proposed as additional criteria for functional and inflammatory diarrhea. In addition, the effect of the use of the polymethylsiloxane polyhydrate on endotoxemia has been shown
{"title":"The Place of Enterosorbents in the Therapy of Non-Infectious Diarrhea","authors":"Zh.V. Fadina, A. Pavlov, A. Khovanov","doi":"10.33978/2307-3586-2021-17-39-48-52","DOIUrl":"https://doi.org/10.33978/2307-3586-2021-17-39-48-52","url":null,"abstract":"The article highlights the methods of treating diarrhea in non-infectious diseases of the gastrointestinal tract. In particular, the effectiveness of using modern enterosorbents – polymethylasiloxane polyhydrate and dioctahedral smectite in complex pathogenetic therapy. The interrelation of endotoxemia with the pathogenesis of diarrheal syndrome was disclosed, and the LAL-test (methods for determining blood serum endotoxin) was proposed as additional criteria for functional and inflammatory diarrhea. In addition, the effect of the use of the polymethylsiloxane polyhydrate on endotoxemia has been shown","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74242037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-18DOI: 10.33978/2307-3586-2021-17-39-60-65
S. Bykova, E. Sabelnikova, S. Silvestrova, T. Kuzmina, E. Baulo, A. Parfenov
The aim is to study the effect of the gluten-free diet (GFD) on the spectrum of short-chain fatty acids (SСFAs) in the intestine in patients with celiac disease. Material and methods. 61 patients with celiac disease were examined, confirmed by positive serological tests and histological examination of the mucous membrane of the small intestine. Men were 17 (13.7%), median age – 41 years; women – 44 (86.3%), median age – 45 years. The first group included patients with newly diagnosed celiac disease (n = 21); the second group included patients who observe GFD, consciously or unconsciously violate it (n = 20); the third group consisted of patients who strictly observe GFD (n = 20). The duration of dietary treatment of patients of the second group ranged from two hundred months to seven years, in patients of the third group – from one year to eight years.The level of SСFAs in feces was determined by gas-liquid chromatography on the Crystal 2000 M chromatograph. The control group consisted of 22 healthy volunteers, among them were 6 (27.3%) men, 16 (72.7%) women, the median age was 42 years (Q1-Q3: 32–58 years; Shapiro p-value < 0.01). Statistical analysis was performed using parametric and nonparametric methods according to the Statistica 13.3 program (StatSoft Inc., USA). Results. The total level of SCFAs in the coprofiltrate of patients of the first group was slightly higher than in the control group (13.15 ± 1.52 vs 9.8 ± 2.1 mg/g; p = 0.278), the anaerobic index was significantly higher (1.43 ± 0.23 vs 0.754 ± 0.15 mg/g; p = 0.017), which indicated an increase in the metabolic activity of anaerobic bacteria. Significant differences in patients of the first group and in the control group were obtained in the levels of propionic acid (3.85 ± 0.62 vs 1.65 ± 0.46 mg/g; p = 0.006); isobutyric acid (0.67 ± 0.1 vs 0.28 ± 0.1 mg/g; p = 0.009) and valerian acid (0.83 ± 0.13 vs 0.32 ± 0.09 mg/g; p = 0.002). In patients of the second group, a significant decrease in the total amount of SCFAs was found compared with the control group (4.6 ± 0.9 vs 9.8 ± 2.1 mg/g; p = 0.034). Also, in the second group, compared with the control group, a significant decrease in the concentration of acetic acid was revealed (1.9 ± 1.2 vs 5.36 ± 1.1 mg/g; p = 0.045). The level of isovaleric acid was increased in the second group compared to the third group (0.66 ± 0.14 vs 0.22 ± 0.13 mg/g; p = 0.04), and the level of capronic acid concentration was reduced (0.05 ± 0.1 vs 0.35 ± 0.1 mg/g; p = 0.04). These data indirectly indicated a decrease in the number of representatives of the saccharolytic microflora in the second group. Conclusion. When studying the spectrum and concentration of SCFAs in the feces of patients with celiac disease who are at different stages of treatment of GFD and recovery of MMSI, there is a tendency to multidirectional metabolic activity of the colonic microbiota. As the GFD is observed, the overall level of SCFAs decreases, there is a shift in the ratio
目的是研究无麸质饮食(GFD)对乳糜泻患者肠道短链脂肪酸谱(SСFAs)的影响。材料和方法。对61例乳糜泻患者进行了检查，经血清学试验和小肠粘膜组织学检查阳性证实。男性17岁(13.7%)，中位年龄41岁;女性44岁(86.3%)，中位年龄45岁。第一组包括新诊断为乳糜泻的患者(n = 21);第二组包括自觉或不自觉违反GFD的患者(n = 20);第三组为严格遵守GFD的患者(n = 20)。第二组患者的饮食治疗时间从200个月到7年不等，第三组患者的饮食治疗时间从1年到8年不等。采用Crystal 2000m色谱仪气液色谱法测定粪便中SСFAs的含量。对照组22例健康志愿者，其中男性6例(27.3%)，女性16例(72.7%)，中位年龄42岁(Q1-Q3: 32-58岁;Shapiro p值< 0.01)。根据Statistica 13.3程序(StatSoft Inc.， USA)，采用参数和非参数方法进行统计分析。结果。第一组患者共廓中SCFAs总水平略高于对照组(13.15±1.52 vs 9.8±2.1 mg/g;P = 0.278)，厌氧指数显著高于对照组(1.43±0.23 vs 0.754±0.15 mg/g;P = 0.017)，说明厌氧菌的代谢活性增加。第一组患者丙酸水平与对照组有显著差异(3.85±0.62 vs 1.65±0.46 mg/g;P = 0.006);异丁酸(0.67±0.1 vs 0.28±0.1 mg/g;P = 0.009)和缬草酸(0.83±0.13 vs 0.32±0.09 mg/g;P = 0.002)。在第二组患者中，与对照组相比，scfa总量显著降低(4.6±0.9 vs 9.8±2.1 mg/g;P = 0.034)。此外，与对照组相比，第二组的乙酸浓度显著降低(1.9±1.2 vs 5.36±1.1 mg/g);P = 0.045)。与第三组相比，第二组的异戊酸水平升高(0.66±0.14 vs 0.22±0.13 mg/g;P = 0.04)，己酸浓度水平降低(0.05±0.1 vs 0.35±0.1 mg/g;P = 0.04)。这些数据间接表明第二组中糖溶菌群的代表数量有所减少。结论。在研究处于GFD治疗和MMSI恢复不同阶段的乳糜泻患者粪便中SCFAs的谱和浓度时，发现结肠微生物群有多向代谢活动的趋势。随着GFD的观察，SCFAs总体水平降低，厌氧菌与好氧菌的比例发生变化，异戊酸水平升高，异丁酸升高的趋势减弱，乙酸和己酸水平降低。为了优化乳糜泻患者的治疗，需要进一步监测肠道菌群在动态观察过程中的代谢活性。
{"title":"The Effect of the Gluten-Free Diet on the Metabolic Activity of the Intestinal Microbiota in Patients with Celiac Disease","authors":"S. Bykova, E. Sabelnikova, S. Silvestrova, T. Kuzmina, E. Baulo, A. Parfenov","doi":"10.33978/2307-3586-2021-17-39-60-65","DOIUrl":"https://doi.org/10.33978/2307-3586-2021-17-39-60-65","url":null,"abstract":"The aim is to study the effect of the gluten-free diet (GFD) on the spectrum of short-chain fatty acids (SСFAs) in the intestine in patients with celiac disease. Material and methods. 61 patients with celiac disease were examined, confirmed by positive serological tests and histological examination of the mucous membrane of the small intestine. Men were 17 (13.7%), median age – 41 years; women – 44 (86.3%), median age – 45 years. The first group included patients with newly diagnosed celiac disease (n = 21); the second group included patients who observe GFD, consciously or unconsciously violate it (n = 20); the third group consisted of patients who strictly observe GFD (n = 20). The duration of dietary treatment of patients of the second group ranged from two hundred months to seven years, in patients of the third group – from one year to eight years.The level of SСFAs in feces was determined by gas-liquid chromatography on the Crystal 2000 M chromatograph. The control group consisted of 22 healthy volunteers, among them were 6 (27.3%) men, 16 (72.7%) women, the median age was 42 years (Q1-Q3: 32–58 years; Shapiro p-value < 0.01). Statistical analysis was performed using parametric and nonparametric methods according to the Statistica 13.3 program (StatSoft Inc., USA). Results. The total level of SCFAs in the coprofiltrate of patients of the first group was slightly higher than in the control group (13.15 ± 1.52 vs 9.8 ± 2.1 mg/g; p = 0.278), the anaerobic index was significantly higher (1.43 ± 0.23 vs 0.754 ± 0.15 mg/g; p = 0.017), which indicated an increase in the metabolic activity of anaerobic bacteria. Significant differences in patients of the first group and in the control group were obtained in the levels of propionic acid (3.85 ± 0.62 vs 1.65 ± 0.46 mg/g; p = 0.006); isobutyric acid (0.67 ± 0.1 vs 0.28 ± 0.1 mg/g; p = 0.009) and valerian acid (0.83 ± 0.13 vs 0.32 ± 0.09 mg/g; p = 0.002). In patients of the second group, a significant decrease in the total amount of SCFAs was found compared with the control group (4.6 ± 0.9 vs 9.8 ± 2.1 mg/g; p = 0.034). Also, in the second group, compared with the control group, a significant decrease in the concentration of acetic acid was revealed (1.9 ± 1.2 vs 5.36 ± 1.1 mg/g; p = 0.045). The level of isovaleric acid was increased in the second group compared to the third group (0.66 ± 0.14 vs 0.22 ± 0.13 mg/g; p = 0.04), and the level of capronic acid concentration was reduced (0.05 ± 0.1 vs 0.35 ± 0.1 mg/g; p = 0.04). These data indirectly indicated a decrease in the number of representatives of the saccharolytic microflora in the second group. Conclusion. When studying the spectrum and concentration of SCFAs in the feces of patients with celiac disease who are at different stages of treatment of GFD and recovery of MMSI, there is a tendency to multidirectional metabolic activity of the colonic microbiota. As the GFD is observed, the overall level of SCFAs decreases, there is a shift in the ratio ","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83984248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-18DOI: 10.33978/2307-3586-2021-17-39-54-58
Yu.V. Osipenko, T. Kuzmina, S. Silvestrova, E. Dubtsova, D. Bordin
The aim was to evaluate the metabolic activity of the colonic microbiota in patients with chronic pancreatitis (CP) as a marker of changes in the functional state of the pancreas. Material and methods. 40 patients (20 men and 20 women) aged 35 to 74 years (50.6 ± 9.4 years) were examined, 26 patients of which had external secretory pancreatic insufficiency (ESPI), which was confirmed by the data of the elastase test, and 14 patients had no ESPI. The diagnosis of CP was established on the basis of instrumental data. Patients with proven ESPI received enzyme replacement therapy (ERT) in accordance with international and Russian recommendations. The concentration and spectrum of short-chain fatty acids were evaluated by gas-liquid chromatography. The control group consisted of 22 healthy volunteers (13 women and nine men aged 43.4± 6.2 years). Results. As a result of the analysis of the profiles of short-chain fatty acids (SCFAs), a significant change in the content of propionic acid was revealed in patients with CP without GNP when compared with a group of healthy volunteers, no differences were found between the groups of patients with CP. These studies indicate a decrease in the activity of certain types of colon microbiota that produce C3 (propionic acid) in patients with CP without ESPI and, accordingly, who did not receive ERT. This, apparently, is due to the violation of the fermentation of individual substrates entering the lumen of the colon. Conclusion. Indicators of the concentration and spectrum of SCFAs can serve as additional tools for detecting changes in the metabolic activity of the colonic microbiota as a marker of the functional state of the pancreas in CP.
{"title":"Spectrum of Short Chain Fatty Acids in Chronic Pancreatitis","authors":"Yu.V. Osipenko, T. Kuzmina, S. Silvestrova, E. Dubtsova, D. Bordin","doi":"10.33978/2307-3586-2021-17-39-54-58","DOIUrl":"https://doi.org/10.33978/2307-3586-2021-17-39-54-58","url":null,"abstract":"The aim was to evaluate the metabolic activity of the colonic microbiota in patients with chronic pancreatitis (CP) as a marker of changes in the functional state of the pancreas. Material and methods. 40 patients (20 men and 20 women) aged 35 to 74 years (50.6 ± 9.4 years) were examined, 26 patients of which had external secretory pancreatic insufficiency (ESPI), which was confirmed by the data of the elastase test, and 14 patients had no ESPI. The diagnosis of CP was established on the basis of instrumental data. Patients with proven ESPI received enzyme replacement therapy (ERT) in accordance with international and Russian recommendations. The concentration and spectrum of short-chain fatty acids were evaluated by gas-liquid chromatography. The control group consisted of 22 healthy volunteers (13 women and nine men aged 43.4± 6.2 years). Results. As a result of the analysis of the profiles of short-chain fatty acids (SCFAs), a significant change in the content of propionic acid was revealed in patients with CP without GNP when compared with a group of healthy volunteers, no differences were found between the groups of patients with CP. These studies indicate a decrease in the activity of certain types of colon microbiota that produce C3 (propionic acid) in patients with CP without ESPI and, accordingly, who did not receive ERT. This, apparently, is due to the violation of the fermentation of individual substrates entering the lumen of the colon. Conclusion. Indicators of the concentration and spectrum of SCFAs can serve as additional tools for detecting changes in the metabolic activity of the colonic microbiota as a marker of the functional state of the pancreas in CP.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78129217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-18DOI: 10.33978/2307-3586-2021-17-39-66-73
M. Livzan, O. Gaus, S.I. Mozgovoj, N. Bodunova, T.I. Yаnova, V. Polyakova, Y. Embutnieks, D. Bordin
This publication summarizes and systematizes the data available in the literature on chronic autoimmune gastritis (CAG) in order to increase the awareness of specialists about the modern possibilities of diagnosing the disease, including in the early stages. Possible variants of the disease clinical manifestation include gastrointestinal, hematological (primarily, the formation of iron deficiency and B12-deficiency anemia), as well as neurological. Patients with CAG are characterized by comorbidity with other autoimmune diseases. Presented the data on the most informative serological markers of the diagnosis of CAG, as well as laboratory tests to detect micronutrient deficiency, information about characteristic changes in the gastric mucosa and the prognosis of the disease. The diagnosis of CAG should be based on a multidisciplinary approach that combines a thorough analysis of patient complaints with a mandatory assessment of nutritional status, the results of serological, endoscopic and histological methods of research
{"title":"Chronic Autoimmune Gastritis: Risk Factors, Clinical Manifestations and Diagnostic Principles","authors":"M. Livzan, O. Gaus, S.I. Mozgovoj, N. Bodunova, T.I. Yаnova, V. Polyakova, Y. Embutnieks, D. Bordin","doi":"10.33978/2307-3586-2021-17-39-66-73","DOIUrl":"https://doi.org/10.33978/2307-3586-2021-17-39-66-73","url":null,"abstract":"This publication summarizes and systematizes the data available in the literature on chronic autoimmune gastritis (CAG) in order to increase the awareness of specialists about the modern possibilities of diagnosing the disease, including in the early stages. Possible variants of the disease clinical manifestation include gastrointestinal, hematological (primarily, the formation of iron deficiency and B12-deficiency anemia), as well as neurological. Patients with CAG are characterized by comorbidity with other autoimmune diseases. Presented the data on the most informative serological markers of the diagnosis of CAG, as well as laboratory tests to detect micronutrient deficiency, information about characteristic changes in the gastric mucosa and the prognosis of the disease. The diagnosis of CAG should be based on a multidisciplinary approach that combines a thorough analysis of patient complaints with a mandatory assessment of nutritional status, the results of serological, endoscopic and histological methods of research","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88534175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：