营养风险因素对多发性硬化症发病的影响

L. I. Gomanova, Y. A. Balanova
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摘要

本文献综述考虑了有关评估膳食因素对严重神经系统疾病--多发性硬化症(MS)发病影响的数据。多发性硬化症是一种多病原性疾病,其发病风险受感染性因素(Epstein-Barr 病毒、单纯疱疹病毒、流感病毒等)和非感染性因素(遗传易感性、吸烟、居住地域等)的影响。多发性硬化症是中枢神经系统(CNS)的一种进行性脱髓鞘疾病,会导致神经变性,并伴有多种临床表现。多发性硬化症的发病机制以免疫介导的神经纤维髓鞘损伤为特征,表现为炎症、神经突触损伤以及白质、轴突和血管的破坏。在城市化、工业化和食品市场全球化的推动下,非进化性的饮食和生活方式迅速改变,导致包括多发性硬化症在内的大多数慢性非传染性疾病增加。膳食因素诱发的影响是由于胃肠道(GIT)的微生物组成、免疫细胞功能、酶系统功能等发生了变化。这项工作的目的是研究微量/微量营养素以及饮食性质对多发性硬化症发病风险的影响,以评估营养在多发性硬化症一级预防中的作用。研究表明,动物脂肪和反式脂肪酸异构体(TFA)含量高、肉制品消费量增加,但蔬菜、水果和全谷物产品含量低的饮食与多发性硬化症发病风险较高有关。在饮食中定期摄入多不饱和脂肪酸(PUFAs)(植物油、种子、坚果、海鱼)和维生素 D(肥鱼、鱼子酱、黄油、蛋黄)可降低多发性硬化症患者的复发率,减少新的脑损伤。文献综述是通过电子数据库中的公开资料来源进行的:PubMed, Medline, Scopus, Google Scholar, World Bank publications, WHO, eLibrary, Cyberleninka, Web of Science。
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Impact of nutritional risk factors on the development of multiple sclerosis
The literature review considers the data on the assessment of the influence of alimentary factors on the development of a severe neurological disease - multiple sclerosis (MS). MS is a polyetiologic disease, the risk of development of which is influenced by both infectious (Epstein-Barr virus, herpes simplex virus, influenza virus, etc.) and noninfectious factors (genetic predisposition, smoking, geographic region of residence, etc.). MS is a progressive demyelinating disease of the central nervous system (CNS), which leads to neurodegeneration accompanied by a variety of clinical manifestations. The pathogenesis of MS is characterized by immune-mediated damage to the myelin sheaths of nerve fibers, which is manifested by inflammation, neurosynaptic damage, and destruction of white matter, axons, and blood vessels. Rapid non-evolutionary dietary and lifestyle changes, which are driven by urbanization, industrialization and globalization of the food market, are leading to an increase in most chronic non-communicable diseases, including MS. The effects induced by alimentary factors are due to changes in the microbial composition of the gastrointestinal tract (GIT), immune cell function, enzyme systems functioning, etc. The aim of the work is to study the influence of micro/macronutrients, as well as the nature of the diet on the risk of MS development, to assess the role of nutrition in the primary prevention of MS. It has been shown that a diet characterized by a high content of animal fats and trans-isomers of fatty acids (TFA), increased consumption of meat products, but low content of vegetables, fruits and whole-grain products is associated with a higher risk of MS development. Regular inclusion in the diet of sources of polyunsaturated fatty acids (PUFAs) (vegetable oils, seeds, nuts, marine fish) and vitamin D (fatty fish, caviar, butter, egg yolk) leads to lower relapse rates and less new brain lesions among MS patients. The literature review was conducted using open sources posted in electronic databases: PubMed, Medline, Scopus, Google Scholar, World Bank publications, WHO, eLibrary, Cyberleninka, Web of Science.
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