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Aim: systemically assessed characteristics of intestinal microbiota taxonomic composition in relation to parameters of hormonal and immune status in patients with external genital endometriosis (EGE).Materials and Methods. The controlled cross-sectional study included 33 patients with EGE comprising main group, and 30 healthy women enrolled to control group. All women underwent assessment of hormonal status and cytokine expression levels in peripheral blood. Level of blood hormones estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) was carried out using enzyme-linked immunosorbent and chemiluminescent assays. Expression levels of cytokines such as interleukin (IL) IL-6, IL-8, tumor necrosis factor alpha (TNF-α) were analyzed by an enzyme-linked immunosorbent assay. Taxonomic composition of intestinal microbiota at the level of phyla and genera was carried out by 16S ribosomal RNA gene sequencing. Microbial community a-diversity, the Chao1, ACE, and Sobs indices were used.Results. The concentration of blood E2 in main group was significantly higher compared to control group. Also, women with EGE had higher plasma concentrations for IL-6, IL-8, IL-17 and TNF-a compared to those in control group (p < 0.001). While analyzing bacterial community a-diversity in main group, Chao1 index was found to be significantly decreased. At the phylum level, the Firmicutes/Bacteroidetes ratio was increased in patients with EGE compared with that in control group. Among the 20 largest genera in patients with EGE, significant abundance was observed for Lachnospira, Blautia, Dorea, Streptococcus, Eubacterium hallii_group paralleled with significant decline in Bifidobacterium and Eubacterium eligens_group. A positive correlation was obtained between estrogen levels and the number of representatives from the genera Eubacterium hallii_group and Streptococcus, IL-8 and Streptococcus, TNF-α and Streptococcus and Lachnospira, as well as a negative correlation between TNF-α and Bifidobacterium.Conclusion. A relation between dysbiotic intestinal alterations and developing endometriosis was found. The identified correlations between altered taxonomic composition of the intestinal microflora and parameters of hormonal and immune status in patients with EGE suggest that intestinal microbiota is involved in pathophysiology of endometriosis.

Aim: to analyze the scientific literature on the role of various factors in the mechanisms of development of functional constipation and to summarize the current data on its leading pathogenetic mechanisms.Key points. Constipation occurs in 15 % of the adult population in the world and leads to a significant decrease in the quality of life, and in combination with some other symptoms may indicate the presence of an organic pathology of the gastrointestinal tract. The pathogenetic basis of functional constipation (FC) with slow intestinal transit is a decrease in colonic motor function, which is confirmed by the results of high-resolution manometry. FC is characterized by disturbances in such motor patterns of the colon as low and high amplitude propagating contractions, segmental non-propagating contractions, and general increases in pressure. The main FC mechanisms associated with neurogenic dysregulation include impaired function of the gray and white matter of the brain, as well as an increase in the tone of the sympathetic nervous system with a concomitant decrease in the influence of cholinergic nerves innervating the large intestine. A key role in the FC development belongs to a decrease in the pool of interstitial cells, which play the role of an intestinal pacemaker, due to slowing of their self-renewal. FC-associated changes in the enteric nervous system include a relative excess of the contribution of inhibitory influences and a decrease in the activity of cholinergic and serotonergic neurons that stimulate intestinal motility. A certain role in the occurrence of reduced motor function of the colon may have an imbalance in the production of intestinal hormones synthesized by enteroendocrine cells, namely, a deficiency of motility stimulants, which include motilin, gastrin, ghrelin and cholecystokinin, as well as a relative excess of hormones that suppress motility (somatostatin and vasoactive intestinal polypeptide). Changes in the composition of the intestinal microbiota can also contribute to the FC occurrence, which is associated with a dysfunction of the metabolite profile produced by intestinal bacteria.Conclusions. Functional constipation is a classic multifactorial disease, in the etiology of which the adverse effects of the genotype are combined with multiple acquired risk factors. A more complete understanding of the molecular mechanisms of the FC development can serve as the basis for the emergence of new effective treatments for this common pathology.

The intestinal microbiota, having enormous metabolic potential, makes a significant contribution to the physiological and pathological processes of humans and animals and is currently considered as an important factor in the pathogenesis of cancer. The aim of this study is to determine changes in the quantitative and qualitative composition of the intestinal microbiota in Wistar rats during chemical induction of breast cancer (BC). Material and methods. The work was performed on female Wistar rats (n = 40) aged 3 months, weighing 200–210 g, using cultural methods for studying fecal microbiota in intact rats (1 group) on the 1st, 14th, 35th days and in rats with induction of breast cancer and and in rats, whereby N-methyl-N-nitrosourea was administered to induce breast cancer (2 group) on the 1st (before injection of N-methyl-N-nitrosourea), 14th, 35th days after injection of N-methyl-N-nitrosourea. Results and discussion. In all experimental animals, representatives characteristic of the intestinal normobiota of warm-blooded animals predominated, namely: Bifidobacterium spp., Lactobacillus spp., Escherichia coli with pronounced enzymatic properties, Enterococcus spp., Clostridium spp. In addition, Staphylococcus spp., yeast-like fungi of the genus Candida and mold. Escherichia coli with reduced enzymatic activity was also detected. It was established that the isolated bacteria belonged to 3 types, 4 classes, 5 orders, 6 families, 6 genera of the bacterial domain. Also, 2 genera of fungi belonging to the order Saccharomycetales were isolated. The most significant changes in the composition of the intestinal microbiota were noted in rats with chemically induced breast cancer on the 35th day tumor induction: the appearance of pathogenic microflora in the intestine was revealed.

The pathogenesis of inflammatory bowel diseases still remains unclear nowadays. Genetic disposition, impaired immune regulation, disturbance in intestinal microbiota composition, exposure to environmental factors are associated with the development of inflammation in intestinal mucosa and increased epithelial penetrance that define disease's development and progression. There is a theory in scientific literature that vitamin D deficiency (among other environmental factors) increases the risk of inflammatory bowel disease. However, the role of vitamin D in the development of gastrointestinal tract diseases remains poorly studied. This article presents current data on the vitamin D effect on the intestinal mucosa barrier function, on the immune system and on the intestinal microbiota in the context of inflammatory bowel diseases pathogenesis.

Diabetes mellitus has now assumed an epidemic character and acquired the characteristics of a pandemic disease. In recent decades, special attention has been paid to the importance of the intestinal microbiome in the pathogenesis of diabetes. The purpose of the review was to study the correlation between the intestinal microbiota and type 2 diabetes mellitus (DM 2), to assess the prospects for the prevention and treatment of DM 2 by correcting dysbiotic disorders. Studies of the intestinal microbiota have shown a correlation between plasma glucose levels and changes in the composition of the microbiota, namely with a decrease in representatives of the Firmicutes type and an increase in Proteobacteria, a change in the ratio of Bacteroidetes to Firmicutes. In patients with DM 2, the population of butyrate-producing bacteria decreases against the background of the growth of opportunistic opportunists, mucin-decomposing bacteria and sulfite-reducing bacteria. The presence of a link between the composition of intestinal microbiota and DM 2 was confirmed during experimental studies on animal models and on groups of volunteers. New approaches to studying the risk of developing DM 2 and dysbiotic disorders may be associated with the use of artificial intelligence. A promising direction for the use of probiotic microorganisms for the correction of metabolic disorders of DM 2 is the use of both classical probiotics – representatives of the genera Lactobacillus and Bifidobacterium, as well as new probiotics from the intestinal normobiota Akkermansia muciniphila, Faecalibacterium prausnitzii and genetically modified microorganisms Lactococcus lactis (LL-pUBGLP-1). One of the new techniques for correcting dysbiotic disorders in DM 2 is fecal microbiota transplantation. The intestinal microbiota can be used not only as a diagnostic biomarker of DM 2, but also as a potential target for the development of new therapeutic approaches. The use of prebiotics, probiotics, postbiotics and pharmacobiotics, which can have a therapeutic effect by influencing the pathogenetic mechanisms in DM 2, requires further multicenter studies using multiomic technologies.

This review summarizes stages of intestinal microbiota development in infant and immune responses modulation associated to these stages. The leading role of breastfeeding in the optimal microbiota and associated immune responses development during the first half of child’s life is presented. The biological feasibility of supplemental feeding implementation at the second window of opportunity (4–6 months) is justified, as well as role of supplementation products (including cereal) in adult microbiota development.

Autoimmune diseases are characterized by dysregulation of immune responses and damage to healthy body tissues. Their complete cure remains elusive, and existing therapies are often accompanied by side effects. Recent studies have shown a signifi cant role of disturbances in the composition of the microbiome in the development of autoimmune reactions. Moreover, modulation of the microbiome through various therapeutic interventions represents a promising direction in the framework of complex therapy of the underlying disease. Extracellular vesicles, in particular exosomes, transport biologically active substances between cells, and a number of studies have shown their therapeutic effect in autoimmune diseases. However, the role of extracellular vesicles in modulating the microbiome remains poorly understood, and further research is needed to better understand their impact on the pathogenesis of autoimmune diseases and associated microbiome changes, as well as to develop new treatment strategies. The presented literature review, based on a study of English-language sources, examines the importance of the microbiota of different loci of the human body (intestines, skin, oral cavity) in the development of autoimmune diseases such as multiple sclerosis, psoriasis and Sjögren’s disease. The role of extracellular vesicles in modulating the microbiome during autoimmune diseases therapy is discussed.

Аim: the clinical practice guidelines intended for gastroenterologists, internal medicine specialists, infectious disease specialists, general practitioners (family doctors), coloproctologists, surgeons and endoscopists present modern methods of diagnosis, prevention and treatment of C. difficile-associated disease.Key points. C. difficile-associated disease is a disease that develops when the diversity of the intestinal microbiota decreases and C. difficile excessively colonizes the colon, the toxins of which damage the intestinal muco-epithelial barrier, followed by the development of inflammation in the colon wall, with diarrhea being a characteristic clinical manifestation. The clinical presentation of the disease can vary from asymptomatic carriage, mild to moderate diarrhea that resolves on its own, to profuse watery diarrhea and pseudomembranous colitis with development of life-threatening complications. The diagnosis of C. difficile-associated disease is based on an assessment of the clinical presentation, medical history, an objective examination of the patient and laboratory stool tests. The disease severity is determined by clinical symptoms and laboratory findings. Additional diagnostic methods that are used according to indications and contribute to the assessment of severity include endoscopy of the colon and abdominal cavity imaging methods. Treatment should be initiated in cases of characteristic clinical presentation of C. difficile-associated disease and positive laboratory stool testing. The choice of drug and treatment regimen depends on the severity of the episode, the presence of complications, and whether the episode is initial, recurrent, or reinfection.Conclusion. Determination of target groups of patients for the diagnosis of clostridial infection is important in preventing overdiagnosis and subsequent unnecessary treatment. Timely diagnosis and treatment of C. difficile-associated disease help avoiding the development of life-threatening complications and improve the prognosis and quality of life of patients.

This review provides data on the use of yogurts in infants’ nutrition. The properties of these fermented milk products and associated urgent and delayed sanogenetic effects are described. The experience of yogurts (enriched with pre- and probiotics) implementation in the nutrition therapy of children who have undergone infectious diseases is shown. The yogurt usage for intestinal microbiota disorders correction in children with functional digestive disorders and chronic somatic pathology is discussed.

Aim: to review the modern approaches to the diagnosis and treatment of C. difficile-associated disease in adults and present the resolution of the Expert Council held on March 25, 2023 in Moscow.General provisions. C. difficile is the most important nosocomial pathogen which spores are also commonly found in the environment. Microbiota impairment, primarily due to the use of antibacterial drugs, is a key stage in the development of C. difficile-associated disease. A search for an infection should be carried out only in patients with diarrhea, and it is advisable to use at least 2 laboratory methods. The drug of choice for first-line treatment is vancomycin. If drug treatment is ineffective or the patient has recurrent clostridial infection, fecal microbiota transplantation should be considered. The probiotic strain Saccharomyces boulardii CNCM I-745 has a direct inhibitory effect on C. difficile toxin A, promotes normalization of the intestinal microbiota composition, and decreases the inflammatory reaction in colonic mucosa colonized with a toxigenic strain of C. difficile.Conclusions. Addition of the probiotic strain Saccharomyces boulardii CNCM I-745 to antibacterial therapy promotes both primary and secondary prevention of C. difficile-associated disease.

Irritable bowel syndrome (IBS) is a widespread disease that affects working-age people and significantly reduces their quality of life. Many experts have suggested that the colon microflora in patients with IBS is characterized by dysbiosis, which leads to increased fermentation, excessive gas formation, and symptoms typical of the disease. Currently, alterations of the intestinal microbiota are considered one of the main mechanisms of IBS development, which warrants the use of probiotics with proven effectiveness as a part of the complex therapy. Certain probiotic strains (including Bifidobacterium longum 35624 and Saccharomyces boulardii CNCM I-745) have been shown to be effective in normalizing stool frequency and consistency in IBS patients, regressing abdominal pain, and normalizing quality of life.

Background. Exocrine pancreatic insufficiency (EPI) is a critical host factor in determining the composition of the gut microbiota. Diseases that cause exocrine insufficiency can affect the gut microbiome, which can potentiate disease progression and complications. To date, the relationship of exocrine insufficiency in various pancreatic (PA) pathologies, in chronic pancreatitis (CP), with dysbiotic changes in the intestinal microbiota (IM) has not been reliably studied. The available data are heterogeneous and contradictory, which determines the need for further research. Aim. To conduct a comparative analysis of the taxonomic composition of the intestinal microbiota in patients with CP of various etiologies, without or with the presence of EPI of varying severity, as well as patients with severe EPI with a history of surgical intervention (SI) on the pancreas. Materials and methods. A total of 85 patients were included in the study. Patients were divided into groups according to the severity of EPI: Group 1 (n=16) patients with CP without EPI; Group 2 (n=11) patients with CP and mild EPI; Group 3 (n=17) patients with severe CP and EPI; Group 4 (n=41) severe EPI in persons with a history of SI on the pancreas. Verification of CP was carried out according to clinical, anamnestic and instrumental data. The degree of EPI was determined by the level of pancreatic elastase-1 (PE-1) feces. Informed consent for the study was obtained for each patient, an anamnesis was collected, physical and laboratory examinations were performed, and a stool sample was obtained. DNA was extracted from each stool sample, the taxonomic composition of BM was determined by sequencing the bacterial 16S rRNA genes, followed by bioinformatic analysis. Results. We followed the changes in the gut microbiota from a group of patients with CP without EPI to a group with severe EPI, in those who underwent SI. At the level of the phylum, the IM of all groups showed the dominance of Firmicutes, with the lowest representation in the severe EPI group, both with SI and CP, and the growth of the Actinobacteria, Verrucomicrobiota and Fusobacteria types. The differential representation of childbirth varied: in patients with severe EPI and CP, compared with mild, statistically significant genera Akkermansia, Ruminococcus gauvreauii group and Holdemanella; compared with CP without exocrine insufficiency, Prevotella, Ruminococcus gauvreauii group, Peptostreptococcus and Blautia dominated. The CP group with mild EPI was dominated by the following genera: Lachnospiraceae_ND 2004 group, Faecalitalea, Fusobacterium, Catenibacterium, Roseburia, Atopobium, Cloacibacillus, Clostridium innococum group, Ruminococcus torques group. All groups showed a low diversity of taxa with a predominance of opportunistic flora, including participants in oncogenesis. Conclusion. The results of the study show that patients with CP of various etiologies and patients with severe EPI who underwent specific intervention on the pancreas have intestinal microbiota dysbiosis, the severity of which is significantly influenced by the degree of EPI.

Parkinson's disease (PD) is a neurodegenerative disease characterized by the progressive death of dopaminergic neurons in the substantia nigra of the brain and the deposition of α-synuclein in the form of Lewy bodies in other parts of the brain. Characteristic manifestations of this disease, along with motor symptoms, are the gastrointestinal tract disorders, accompanied by a change in the cellular composition of the intestinal biocenosis. This made it possible to propose the so-called "intestinal" theory of the PD origin. According to this theory, degenerative changes begin in the nervous apparatus of the large intestine, and then spread to the brain. Changes in the intestinal microbiota composition can contribute to the development of the neurodegenerative process through neural, immune, endocrine mechanisms, as well as through biologically active substances.

This review summarizes the benefits of goat’s milk as the basis to produce adapted milk formulas according to relevant infants feeding issues. The characteristics of main nutrients of modern goat’s milk formulas are presented. A balanced protein composition enriched with [1]-palmitate, presence of prebiotics-oligosaccharides, natural nucleotides and probiotics advances these formulas closer to breast milk and provide their multipotent sanogenetic effects. The unique composition of goat’s milk formulas allows to ensure normal physical growth of a baby, induces tissue and systemic immunity via adequate intestinal microbiota formation, maintains normal functioning of gut-brain axis, that promotes vegetative and visceral disorders (due to functional digestive disorders) correction. Thus, it is possible to recommend goat’s milk formulas in cases of forced mixed or formula feeding of healthy infants and children with functional digestive disorders.

This article covers the issues of remodeling breast milk’s protective properties during creating infant milk formulas. First of all, this concerns the conditions for normal intestinal microbiota development in growing organism. Its quantitative and qualitative features are the trigger of either sanogenetic, or pathological immune and metabolic reactions, and also determine gut-brain axis functioning. The protective significance of prebiotic composition diversity of mammalian milk and the inductive role of breast milk oligosaccharides are shown. The modern concept of synbiotics role in gastrointestinal tract and other systems functioning, as well as the use of modern synbiotics in the creation of infant formulas (available Russian formula included) are presented.

BACKGROUND: The problem of metabolic syndrome is considered a demographic catastrophe. According to WHO experts,«by 2025, the prevalence of metabolic syndrome (MS) in the world will amount to more than 300 million people, and in the next 25 years it is expected to increase by 50%.» The pathophysiological mechanisms of MS formation and the role of unhealthy diet on the development of intestinal dysbiosis, mitochondrial insufficiency remain unclear.AIM: To study the effect of unhealthy diet on the state of the intestinal microbiota and the development of metabolicmitochondrial insufficiency in the formation of a multi-organ metabolic syndrome, evaluation of ways of correction.MATERIALS AND METHODS: Clinical picture assessment, anthropometric data (body mass index), laboratory results (glucose, cholesterol and fractions) were carried out in patients with MS, triglycerides, aspartate aminotransferase, alanine aminotransferase, C-reactive protein, lipid peroxidation indicators: malondialdehyde, diene conjugates, schiff bases, hydroperoxides, catalase, superoxide dismutase, succinate dehydrogenase (ASDH), α-glycerophosphate dehydrogenase (α-AGFDH). Hemorheological parameters were evaluated by the apparent viscosity of blood, the yield strength, the aggregation coefficient of erythrocytes and platelets. The microbiota and microbiome of the intestine were evaluated by species, strain composition and the level of metabolites-propionic, butyric, acetic acid, lipopolysaccharides, peptidoglycans. A questionnaire was conducted to study the nature of nutrition.RESULTS: The study included 128 patients with MS and 25 healthy individuals. According to medical outpatient records from anamnesis, questioning of each patient, complaints and clinical picture, 26.2% of patients had type 2 diabetes, 3.74% of men had erectile dysfunction, 7.5% of women had polycystic ovaries, 15.1% had night apnea syndrome, 8.7% hyperuricemic syndrome, 96.5% of patients had metabolic fatty liver steatosis. According to the results of the survey, it was revealed that 99.8% of patients adhered to an unhealthy and unbalanced, high-calorie diet, 46.4% of patients had a low level of physical activity, 48.7% had an average. The revealed disorders of lipid, carbohydrate metabolism, microbiota and intestinal microbiome were associated with increased lipid peroxidation, decreased levels of antioxidant defense enzymes, indicators reflecting mitochondrial function against the background of hemorheological disorders.CONCLUSION: In multi-organ MS, unhealthy diet can be considered as a targeted risk factor triggering pathophysiological mechanisms at the level of the intestinal microbiota, followed by a cascade of metabolic disorders in the form of activation of lipid peroxidation with inhibition of antioxidant defense enzymes, the development of multi-organ mitochondrial insufficiency and the development of latent hemorheological syndrome. The revealed metabolic complex obviously constitutes a multiorgan morphological cluster underlying the development of multi-organ metabolic syndrome. Based on the identified disorders, pathogenetically justified correction of MS should include a balanced diet with mitochondrial protective therapy.

Purpose of the study: to investigate the composition of the intestinal microbiota and determine the feasibility of using it in diagnosis and prognosis of colorectal cancer (CRC). Material and methods. The study included 75 patients with CC (study group I) and 25 healthy individuals (control group II) who were treated at Chita State Medical Academy from 2017 to 2021. Group I patients underwent surgery and adjuvant chemotherapy. To determine the composition of the intestinal microbiota, biopsy specimens were taken from the tumor tissue and from the visually unchanged colon mucosa after the completion of surgery in the study group and from the visually unchanged colon mucosa during colonoscopy in the control group. Results. The counts of Bifidobacterium spp., E. Coli (typical) in the intestinal microbiota were significantly lower and the concentration of Clostridium spp. Was higher in CRC patients than in healthy individuals. Significant relationships between the counts of Lactobacillus spp., Bifidobacterium spp., Bacteroides spp., E. Coli and the patient’s gender; Lactobacillus spp., Bifidobacterium spp., Staphylococcus spp. (CNS) and the tumor grade; conditionally pathogenic microflora and the form of tumor growth were found. Some combinations of the composition of the intestinal microbiota in CRC patients are predictive factors for the development of postoperative complications (Lactobacillus spp., Bacteroides spp., E. Coli

Currently, there is a growing interest in one of the most common diseases in hepatology non-alcoholic fatty liver disease (NAFLD). There is evidence that approximately 75% of cases of NAFLD occur against the background of obesity, dyslipidemia or type 2 diabetes mellitus (T2DM). At the present stage, a persistent pathophysiological interaction between NAFLD and T2DM has been demonstrated. Insulin resistance is one of the main pathogenetic causes of the development of T2DM and NAFLD. At the same time, it is necessary to highlight the role of the intestinal microbiota and epigenome in the manifestation and progression of NAFLD. Therefore, treatment approaches should be comprehensive. Diet therapy should be aimed at calorie restriction. However, in real clinical practice, phisicians face a low commitment to appropriate and long-term dietary recommendations necessary for weight loss. At the same time, use of dietary fibers, which are part of the preparation Mucofalk, helps to slow down the passage of food through the digestive tract, increase the saturation period. Use of a low-calorie diet with a significant fat restriction may increase the risk of gallstones. Ursodeoxycholic acid preparations (Ursofalk) can be recommended for the prevention of cholelithiasis. Considering the role of intestinal microflora in the pathogenesis of NAFLD, it is necessary to correct dysbiotic changes as well as basic pharmacotherapy. Thus, a comprehensive approach to the management of patients with NAFLD and T2DM should be aimed not only at therapy, but also at the prevention of associated metabolic disorders.

Background: Currently, there is an increase in cancer among the elderly. Despite the obvious advances in the healthcare related to the diagnosis of the disease and its treatment, oncopathology occupies a high position in the structure of the overall morbidity. Clinical case description: Patient T., 62 years old, came to an internist with the complaints of constant pulling pains in the lower abdomen, a stool disorder in the form of alternating constipation and diarrhea, presence of blood in the stool over the past 6 months, a weight loss of 8 kg over the past 4 months. She was examined independently two years ago, when the disorders of the gastrointestinal tract appeared for the first time, which she associated with constant stressful situations at work. According to the study results, no significant deviations were found. The patient also underwent 16s-RNA sequencing of the intestinal microbiome, which revealed significant changes in many clusters of bacteria (a decrease in the quantitative composition of Lactobacterium, Bifidobacterium, Akkermansia, Faecalibacterium, which is the main representative of the normal intestinal flora, that may indicate a decrease in the protective barrier function of the colonic mucosa, an increase in Fusobacterium, as well as other representatives of the pathogenic flora). Presently, within the framework of laboratory and instrumental studies, the following diagnosis was established: "Malignant formation of the colon (colorectal cancer). T3M0N1". A repeated study of the intestinal microbiota was carried out, according to the results of which an increase in Fusobacterium up to 7.5% was observed, along with a sharp decrease in the representatives of the normoflora (1%). Conclusion: Changes in various bacterial clusters of the intestinal microbiota can serve as an early marker for the verification of malignant neoplasms of the large intestine. Determining the amount of Fusobacterium in the intestinal microbiome can be an indicator of the first diagnostic line, which helps to identify the pathological process at the stage of precancer, take timely therapeutic measures, improve the quality of life, and increase its longevity.

Introduction: The gut microbiome is an integral part of the body, and the eubiosis conditio significantly influences homeostasis. Small intestinal bacterial overgrowth (SIBO) is connected with an increased numer of bacteria, it causes gastrointestinal symptoms. The main symptoms are abdominal pain, bloating and diarrhea. SIBO correlates with the occurrence of other chronic diseases. The basis of treatment are antibiotics. There are also scientific reports on supplementing pharmacological therapy with dietary management. Objective: The purpose of this paper is to review the current knowledge on the bacterial overgrowth of the small intestine. Particular attention took notice of to the relationship between SIBO and other chronic diseases as well as potential and applied treatments. Material and methods: The review includes publications published in 2020-2023 and certain works published earlier, in the years 2008-2017. Data were collected using PubMed, ScienceDirect i Google Scholar. Results: Small intestinal bacterial overgrowth is heterogeneous disorder. Its symptoms are nonspecific. SIBO is related to several different diseases and corresponds with them. Empirical treatment consists in administration of antibiotics. Supplementing therapy with alternative methods for example probiotic and diet therapy promotes success in treating. Conclusions: The lack of standarized therapeutic menagment and focused on bacterial eradication only approach makes, SIBO is recurrent ailment. More research is needed. The important thing is holistic approach on etiology, pathogenesis and therapy.

Background. According to the World Health Organization, about 50 million people worldwide suffer from epilepsy. Almost 1/3 of patients are diagnosed with drug-resistant epilepsy (DRE). There is a relationship between the intestinal microbiome (IM) and the central nervous system, which is carried out throughout life through a bidirectional dynamic network. There is evidence that IM changes in patients with DRE.Objective: to summarize the current literature data on the role of the microbiome-gut-brain axis in DRE, as well as to assess the value of changes in the composition of IM as a prognostic marker of the development of DRE.Material and methods. The authors conducted a search for publications in the electronic databases PubMed/MEDLINE and eLibrary, as well as Google Scholar search engine. The evaluation of the articles was carried out in accordance with the PRISMA recommendations. As a result of the search, 4,158 publications from PubMed/MEDLINE database, 173 publications from eLibrary, and 1,100 publications found with Google Scholar were extracted. After the selection procedure, 121 studies were included in the review.Results. The review provides convincing evidence of a correlation between IM and DRE. There were obvious differences in the composition of the intestinal microbiota in patients with epilepsy, depending on sensitivity to drugs. Dysbiosis of the intestinal microbiota can be corrected by exogenous interventions such as ketogenic diet, probiotic treatment and fecal microbiota transplantation, which subsequently leads to changes in neurochemical signaling in the brain and, consequently, to a decrease in epileptic activity.Conclusion. A ketogenic diet, probiotics and antibiotics may have some potential to influence epilepsy through the correction of dysbiosis of the intestinal microbiota, but the studies available to date do not provide an adequate level of evidence. Future clinical multicenter trials should use standardized protocols and a larger sample to provide more reliable evidence.In addition, further fundamental research is needed to elucidate potential mechanisms and therapeutic targets.

Autism spectrum disorders (ASDs) are common neurodevelopmental disorders characterized by heterogeneity and high variability in severity of mental, neurological, and somatic symptoms. Such gastrointestinal malformations as abdominal pain, constipation, diarrhea, gastroesophageal reflux, nutritional disorders, intestinal microbiota disorders are common in autistic children. The association between the severity of gastrointestinal malformations and the severity of behavioral symptoms in ASDs was revealed. Early diagnosis and assessment of gastrointestinal malformations in ASDs is crucial for their further correction to optimize nutrition, to develop individual complex treatment and management with the involvement of multidisciplinary specialists.

Introduction. The results of numerous studies indicating the relationship between the development of reactive arthritis (ReA) and the disturbance of the intestinal microbiocenosis give rise to interest in commensal microorganisms that make up the intestinal microbiota as potential initiators of immune-dependent inflammatory diseases of the joints. In this regard, the question of the expediency of using probiotic preparations for the correction of ReA patients intestinal microflora is of practical interest.The purpose of the study was to evaluate the effectiveness of Lactobacillus rhamnosus LGG (LGG) in the preventive treatment of children with ReA to prevent the development of relapses.Materials and methods. Clinical and microbiological study included 60 patients with ReA from 3 to 17 years old, who were divided into two groups, 30 children each. Patients of the group 1 received courses of treatment with LGG in the inactive phase of the disease. Patients of the group 2 (comparison group) were not treated with probiotic. The criteria for the effectiveness of treatment were the number of relapses of ReA during follow-up observation for 1 year; dynamics of intestinal microbiocenosis condition according to the following parameters: indicator of microbial contamination (IMC) of intestinal microsymbionts; ability to biofilm formation (BF); levels of lactoferrin and lysozyme in coprofiltrates.Results. In patients treated with LGG, relapses of arthritis were significantly less frequent during 12 months of prospective observation relative to the comparison group. Patients of the group 1 showed positive dynamics of the state of intestinal microbiocenosis: a decrease in the severity of dysbiosis, a decrease of lactoferrin and lysozyme level in coprofiltrates, IMC and BF of opportunistic microorganisms against the increase IMC and BF in bifidobacteria and lactobacilli.Conclusions. The use of LGG in the treatment of children with ReA in the inactive phase of the disease contributes to the correction of intestinal microbiocenosis disorders and reduces the number of arthritis relapses.

The review provides the analysis of recent publications covering the biological significance of infant microbiome and showing modern research technologies. Correlations of quantitative and qualitative characteristics of intestinal microbiota with delayed health issues were evaluated. Various concepts of newborn microbiome origin, timing, and stages of bacterial colonization of gastrointestinal tract were considered. Data on the role of delivery method on infant microbiota development is presented (including the significance of contamination with maternal vaginal flora where ontogenetic priority belongs to lactobacilli). It was revealed that Lactobacillus fermentum was the basis microflora providing the conditions for the subsequent successful colonization of the child’s intestines with obligate symbionts. The significance of breastfeeding in adequate microbiota development was confirmed. In case of mandatory formula feeding, it is necessary to enrich infant milk formulas with components that promote the selection of symbiotic microflora such as: long-chain polyunsaturated fatty acids, prebiotics, oligosaccharides, and probiotics of specific action. The innovative formula based on synbiotic/combiotic concept will be able to partially compensate impaired microbiota development in infant on mandatory formula feeding.

The review provides the analysis of modern publications on the topic of correlation between development of intestinal microbiota and maturation of neurophysiological activity patterns (on the example of sleep age structure development). The importance of the stage maturation of intestinal microbiota in the concept of the gut-brain axis is presented. Mechanisms and mediators involved in this axis are described, and its ontogenetic significance is justified. The main stages of sleep function development in a child as an important component of the general mental health maturation in relation to environmental factors and family features are presented. Recommendations on sleep periods duration and estimation of sleep onset and sleep structure are also given. Direct and reverse correlations of quantitative and qualitative microbiota parameters with sleep efficiency are shown. Positive correlation was identified between sleep consolidation, number and diversity of Bacteroidetes species in intestinal microbiota, and composition of bacterial metabolites. The presence of such correlations is theoretical justification for further development of methods of pathogenetic therapy of both microbiota and sleep disorders. Keywords: sleep, diet, nutrition, sleeping schedule, infant, development, intestinal microbiota.

Background. Atopic dermatitis (AD) arouses high research interest these days due to its significant morbidity rate. The most crucial risk factor for its development is the intestinal microbiota composition. The correlation of this factor with the development of AD in children requires further study.Objective. The aim of the study is to perform comparative analysis of the intestinal microbiota in 1–5 years old children with AD and conditionally healthy children via 16S-sequencing of ribosomal RNA (rRNA) of bacterial genes.Methods. We have conducted cross sectional study. 60 children with diagnosed AD and 15 conditionally healthy children aged from 1 to 5 years were surveyed. Intestinal microbiota was examined via 16S-sequencing of rRNA of bacterial genes.Results. The intestinal microbiota in children with AD and conditionally healthy children has statistically significant differences. Despite the absence of significant differences in species richness of compared groups, children with AD had the elevation in the metagenome of Proteobacteria; Bacilli and Gammaproteobacteria classes; Enterococcaceae and Veillonellaceae families; Eggerthella, Dialister and Enterobacter genus; as well as the decrease in the relative value of Actinobacteria, Bacteroidetes, Verrucomicrobia; Bacteroidales and Bifidobacteriales orders; Bifidobacteriaceae, Bacteroidaceae, Erysipelotrichaceae families; Lachnoclostridium, Roseburia, Prevotella, Coprococcus, Ruminococcus, Faecalibacterium, Bifidobacterium, Bacteroides genus; decrease of Bifidobacterium longum, Faecalibacterium prausnitzii, Bacteroides fragilis.Conclusion. It was revealed that the intestinal microbiota of children with AD has significant differences in taxonomic composition with the microbiota of conditionally healthy children. Elevation of Proteobacteria, Bacilli and Gammaproteobacteria classes, Eggerthella, Dialister and Enterobacter genus can be the risk factor for this disease development, whereas decrease of such bacteria as Verrucomicrobia, Bacteroidales and Bifidobacteriales can aggravate atopic symptoms. Thus, the need for further study of intestinal microbiota in children with AD is justified to establish the correlation of these bacteria with the disease course.

The review article analyzes literature data on the issues of immune response dysregulation during aging. It has been shown that impairment of innate and adaptive immune response in elderly and senile people under the conditions of spreading the new coronavirus infection is an aggravating factor in the course of the disease and recovery. Neuro-immuno-endocrine changes occurring in the organs of immune system, immunocompetent cells, molecules and receptor formations involved into the arising immune response have been traced. The imbalance of the brain-intestine-microbiota axis is considered in sufficient details, where a significant role is attributed to the changes occurring in hypothalamic-adrenal system under participation of biogenic neurotransmitters and neuromodulators. It is shown that intestinal microbiota may be involved into the neurodegeneration events, due to toxic effects on the brain via the neuro-immuno-endocrine and metabolic pathways. The data are presented, which show that adrenaline, norepinephrine, dopamine and serotonin are involved in the immune response dysregulation, thus making this process similar to the changes that occur during the general adaptation syndrome and stress response of the body. On the other hand, the review notes that chronic stress during aging not only alters the activity of macrophages, lymphocytes and dendritic cells, but also increases the level of proinflammatory cytokines in blood, thereby affecting permeability of the blood-brain barrier. The article emphasizes that with body aging, a neuroendocrine sensory pathway of immune response dysregulation is gradually formed. In this regard, it is noted that the afferent nerve endings and neurons of the vagus, adrenergic and peptidergic nerves are involved into dysfunction of immune system by affecting the processes occurring not only in thymus, but also in the brain. However, it is obvious that the pathodynamic “dysadapting circuit” formed in the higher compartments of nervous system is also involved in dysregulatory immune responses during aging. Hence, the work concludes that the signaling networks of the body's regulatory systems (nervous, immune and endocrine) are closely interconnected throughout the lifetime, but with aging and penetration of antigens into the body, this interaction is easily disrupted at different levels of organization of living matter, thus leading to dysregulation.

The organized infant’s sleep schedule is the crucial part of normal individual development. On the contrary, restless sleep, nocturnal awakening, long wakefulness can lead to deviations in physical, psychomotor, and cognitive development. Feeding schedule organized according to the time of a day and circadian rhythms (chrono-nutrition concept) can be useful for prevention and correction of such disorders. You are aware of the effect of such factors as feeding before night's sleep, nutrition at dark time of a day, diet enriched with triptophane and nucleotides, on the maturation and consolidation of infants sleep. The correlation between intestinal microbiota and factors affecting the circadian and metabolic activity of the body are presented: day-night cycles, sleep and wake, diet and nutrition. Targeted regulation of the intestinal microbiota through products enriched with functional components (prebiotics) can lead to the development of healthy sleep in infants via axis “brain - intestine - microbiota".

Liver cirrhosis (LC) takes the main place in the structure of the pathology of the digestive system in terms of the frequency of mortality, as well as in the development of fatal and poorly controlled complications, which requires the search for effective methods for preventing the progression of the disease and the development of complications. The article provides updated information on the role of the intestinal microbiota, as well as endotoxemia and increased intestinal permeability syndromes in the pathophysiology of LC and its complications. The results of recent meta-analyses of the impact of dysbiotic disorders on the prognosis of the LC and the options for their correction are presented. Understanding of the significance of involvement of gut microbiota in the pathogenesis of LC has become one of the levers of management of the risks of complications of LC. In this case, the livergut axis can be considered to be the leading link to the formation of most of the main complications of LC.

On the basis of the analysis of foreign and Russian scientific studies the current data on the role of the intestinal microbiota in the formation of immunity and changes in its qualitative composition in the formation of various diseases are presented: For example, a decrease or absence of Helicobacter pylori is associated with bronchial asthma and reflux esophagitis in childhood, a change in Firmicutes/Actinobacteria ratio in psoriasis, and Bacteroidetes/Firmicutes ratio in the gastrointestinal tract in obesity, inflammatory bowel diseases are accompanied by an increase in Enterobacteriaceae, functional disorders of the gastrointestinal tract by a growth of Veillonella bacteria. The article shows the mechanisms of influence of the microbiota of the gastrointestinal and respiratory tracts on reducing the frequency of repeated infections by induction of antiviral defense genes, which in studies of probiotic therapy is confirmed by significant clinical effects. A discussion of the benefits of multistrain probiotics with comprehensive effects on the intestinal microbiota is provided. The importance of including probiotic strains in the complex therapy of acute respiratory infections is confirmed by the studies proving their positive effect on the child’s immunity, reducing the severity of the disease and the frequency of complications and relapses. The results of modern scientific research prove the importance of the optimal ratio of probiotic strains in the combination of lactoand bifidobacteria, as well as their strain specificity. The article presents information on a synbiotic created using an innovative protective technology of each sachet microgranule including a combination of 9 probiotic strains of lactoand bifidobacteria. The presence of fructooligosaccharide in the prebiotic component enhances the effect of the probiotic component.

Aim. To determine the role of the acetate in the persistence of indigenous bifidobacteria in the colon biotope through the lysozyme resistance in model conditions of the acetylation–deacetylation of peptidoglycan.Materials and methods. The study was performed on 16 strains of the two indigenous bifidobacteria speсies: Bifidobacterium bifidum и Bifidobacterium longum subsp. longum. Bifidobacteria was cultivated in the 0.6% O2 and 9% CO2 atmosphere at the temperature 37ºС in CO2 incubator for 48 hours. The production of the acetate by the bifidobacteria was determined by gas chromatography. The effect of the acetate on the lysozyme resistance of non-indigenous gram-positive bacteria was determined on the Listeria monocytogenes ICIS-280 model strain by the cultivation in LB-Lennox broth with ammonium acetate added in the concentration range matching the concentrations produced by the studied bifidobacteria, in lysozyme serial dilutions at final concentrations 5 μg/ml to 40 μg/ml within 24 hours.Results. It was found that the acetate release of Bifidobacterium longum subsp. longum was on average two times higher that of Bifidobacterium bifidum (27.0 and 14.7 mmol/liter, respectively) and was quite consistent with the concentrations of acetic acid determined in the intestinal contents (up to 50 mmol/liter). Cultivation of bifidobacteria in a medium with lysozyme, ammonium acetate and their combination did not have a significant impact on their growth parameters at the maximum used concentrations of these substances. In the test strain, the addition of ammonium acetate in the range created by bifidobacteria caused a decrease in the minimum inhibitory concentration of lysozyme by more than two times — from 40 μg/ml to less than 20 μg/ml. In the control medium without lysozyme, no inhibition of the growth of the indicator culture was observed up to the maximum concentrations of ammonium acetate.Conclusion. The mechanism of persistence (survival) of indigenous bifidobacteria in the human intestinal biotope has been identified, which is associated with the production of acetic acid at a level that selectively suppresses lysozyme resistance of non-indigenous gram-positive microbiota viareversible deacetylation of peptidoglycan. This allows indigenous bifidobacteria to maintain a stable dominant position in the biotope.

Background. The incidence of colon cancer over the past decade has been growing markedly in the Russian Federation, with about 50 % cases detected at stagesIII–IV of the disease, when a clear clinical picture of the disease appears. In this regard, the search for new methods for early diagnosis of RTK is undoubtedly relevant.Objective. To determine the standard composition of the aerobic parietal colon microbiota and the level of cytokines (chemokines and growth factors) in patients with cancer of the left half of the colon and to assess the possibility of using these data in the diagnosis of the tumor process.Materials and methods. Blood tests were performed on the day of the study using two test systems (BioLegend): multiplex kit for determining growth factors, chemokine multiplex kit. The composition of the intestinal microbiota was determined in colon biopsy specimens by the bacteriological method using the standard test systems StaphyTest, StreptoTest, and EnteroTest.Results. There is an increase in the number of Clostridiumspp. and a decrease in Bifidobacteriumspp., E. coli in the colon during the transformation of a healthy person’s mucosa into a malignant tumor (p < 0.05); a clear tendency was revealed for both an increase (EGF, HGF, M-CSF, PDGF-AA, PDGF-BB, IP-10) and a decrease (MCP-1, RANTES) of the level of chemokines and growth factors under colon cancer conditions. In addition to general quantitative changes in the intestinal microbiota, the level of the investigated substances, a statistically significant dependence was established on the sex, age of the patient, as well as the degree of differentiation and form of tumor growth.Conclusion. It was established that changes in the quantitative composition of the intestinal microbiota, the level of some biologically active substances that occur precisely in the conditions of colon cancer, can be interconnected and interdependent, and also serve as an additional diagnostic marker in the detection of a malignant tumor.

Introduction. Colon cancer (RCC) clinically manifests itself in the late stages, therefore, early diagnosis presents significant difficulties. There are many types of microorganisms in the human colon that form symbiosis with intestinal cells to maintain normal function. Аim of the study was to determine the composition of the parietal microflora of the colon under conditions of a tumor process and to assess the possibility of using these data in the diagnosis of colon cancer. Material and methods. The main group included 63 patients operated on for cancer (adenocarcinoma) of the left half of the colon (descending, sigmoid, rectosigmoid regions) with I T1-2N0M0, II T3-4aN0M0, III T1-2N1M0 stages of the tumor process. Among them are 32 men and 31 women aged 20 to 75 years (57.7 ± 3.8 years). In all patients, before hospitalization, the tumor was confirmed by colonoscopy followed by histological examination. The group of clinical comparison in the amount of 25 people consisted of patients with chronic hemorrhoids without exacerbation, who underwent colonoscopy. Material from the main group, biopsies of tumor tissue and visually unchanged colon mucosa, were taken intraoperatively during tumor removal. In patients of the clinical comparison group, the material was taken during the colonoscopy process. The composition of the intestinal microbiota was determined by a bacteriological method. Results and discussion. As a result of comparing the colon microbiota of cancer patients and the clinical comparison group, statistically significant differences in the quantitative composition of Lactobacillus spp., Bifidobacterium spp., Bacteroides spp., Clostridium spp., Enterococcus spp., Escherichia coli (typical), Escherichia coli (lactose-negative), Enterobacteriaceae, Staphylococcus spp. (CNS), Candida spp. It was established for the first time that Bifidobacterium spp., Enterococcus spp. and the age of the patient can be further used in the diagnosis of a malignant process. Conclusion. The created additive model can be used as an additional screening criterion in the early diagnosis of colon cancer.

Obesity is a global problem of modern healthcare. In 2016, the World Health Organization estimated that 39% of people over 18 were overweight, and the number of obese people worldwide almost tripled over the period from 1975 to 2016. The number of overweight and obese children is growing at an alarming rate, with the World Health Organization estimating that in 2016 the number of overweight children under the age of 5 will exceed 41 million. Scientific evidence supports the hypothesis that the development of obesity is closely related to changes in both the function and composition of the intestinal microbiota, which plays a significant role in controlling energy metabolism and changes in body mass index. The main therapy for obesity and associated metabolic disorders to date has been a corrected diet combined with physical activity. The new therapeutic strategy for the treatment and prevention of obesity is based on changing the metabolic activity of the intestinal microbiota using probiotics. Studies on changes in metabolic activity and obesity in rodents have shown encouraging results. The beneficial effects of probiotics on human health today no longer require proof. Probiotics have an integrated effect on the physical, biochemical and metabolic parameters associated with obesity, combined with adequate nutrition and lifestyle correction. Probiotics in the presence of prebiotics have more pronounced metabolic functions, help stabilize the intestinal microbiota, maintain a healthy body weight and control factors associated with fat accumulation and chronic inflammation.

The increase in allergic diseases over the past several decades is correlated with changes in the composition and diversity of the intestinal microbiota, which plays a significant role in the development of the immune system of the child. There are presented data on the role of the intestinal microbiota, the organization and the factors influencing the development of immunity. It is shown that microbial colonization in the early stages of life is influenced by various factors. Early postnatal life is a key time for the development of the immune system and the colonization of the host microbiota. Microbial deprivation is the cause of allergic diseases. The ability of intestine microbiota to influence immune response resulted in novel approaches in therapy that use these differences in microbiota for therapy and prevention in allergy patients. And therefore on the basis of «hygiene hypothesis» of allergy emergence, a consideration is expressed that early manipulation with intestinal microbial communities may offer a new strategy of allergic sensibilization prevention.

Ninety four infants were observed as inpatients. Thirty nine of them were mature neonates and 55 were premature infants with a very low body weight. The majority of the patients were treated with antibiotics. The mature infants were treated with penicillins, aminoglycosides, cephalosporins and the premature neonates were treated in addition with carbapenems, fluoroquinolones, glycopeptides. The mature infants were randomized into 2 groups: the control group (n=18) received the standard therapy and the main group (n=21) in addition received 1 ml of liquid probiotic Enterococcus faecium L3 (with a titer of 5X108 CFU/ml) 2 times a day for 10 days. The premature newborn infants were also randomized into 2 groups. The control group (n=26) received the standard therapy. The main group (n=29) additionally received 1 ml of liquid probiotic E.faecium L3 2 times a day for 10 days. The effectiveness of the therapy in the mature neonates was evaluated by the frequency of dyspeptic disorders and in the premature infants by the frequency of infectious complications and the episodes of food intolerance. The intestinal microbiota of the infants was investigated by the real-time PCR and bacteriological analyses of the feces: in the mature infants on admission to the hospital and 10 days after the treatment (periods 1-2), in the premature infants on admission to the hospital and then twice with an interval of 14 days (periods 1-2-3). It was shown that the use of the probiotic strain E.faecium L3 during the antibiotic therapy in the premature infants promoted significant reduction in the frequency of infectious complications. In the mature neonates the probiotic therapy reduced the risk of dyspeptic disorders. The studies showed reduction in persistence of Clostridium difficile in the intestinal microbiota of the newborn infants receiving the antibiotic therapy in combination with probiotic E.faecium L3, that was accompanied by preserving and growth of bifidobacteria and lactobacilli and reduction of the number of opportunistic microorganisms.

Aim. To study the composition of the intestinal microbiota in patients with chronic heart failure (CHF), as well as a relationship between the features of the CHF clinical course and changes in the microbial composition of the colon.Materials and methods. The study included 60 heart failure patients with systolic dysfunction diagnosed according to the results of echocardiographic examination. The control group consisted of 20 patients comparable to the main group by gender, age and underlying diseases in the absence of CHF. In all patients, the severity of CHF symptoms was assessed using a clinical assessment scale. The levels of the N-terminal fragment of the cerebral natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) were determined. Echocardiographic examination and, if indicated, Holter ECG monitoring were performed. The intestinal microbiota in stool samples was studied by sequencing the 16S gene of ribosomal RNA (rRNA).Results. In comparison with the control group, CHF patients showed a decrease in the relative content of Tenericutes (p = 0.02, Mann—Whitney test) and an increase in the proportion of Euryarchaeota (p = 0.02) and Firmicutes (p = 0.03). At the family level, an increase in the proportion of Methanobacteriaceae (p = 0.03) and a decrease in the proportion of Pseudomonadaceae (p = 0.01) and Moraxellaceae (p = 0.01) were noted. No dependence of the intestinal microflora composition on the functional class of heart failure was observed. However, a correlation was revealed between the relative number of certain bacterial families and the severity of impaired contractile function, the level of the inflammatory marker and the biochemical marker of heart failure.Conclusions. The obtained data indicate differences in the intestinal microbiota composition in patients with and without heart failure. A correlation between the number of some bacterial families and various laboratory and instrumental indicators assessed in heart failure patients was revealed. Further research into the effect of intestinal microbiota on the course of heart failure appears to be promising for improving treatment methods.

Recent studies have shown the correlation between stress, immunity and intestinal microbiota. Chronic stress is associated with high production of inflammation mediators and risk of infection development, chronic systemic inflammation and inflammatory diseases development, as well as depressive disorders. Intestinal microbiota produces a wide range of compounds important for the organism: all major neurotransmitters, including serotonin, cytokines, tryptophan and short-chain fatty acids. Serotonin deficiency is considered as significant cause factor for development of anxiety, aggression, affective disorders and stress. Tryptophan is the serotonin precursor. Tryptophan is produced by intestinal microbiota or derived from food can be metabolized into kinurenine. Proinflammatory cytokines activate hypothalamus-pituitary-adrenal axis that increases of the level of circulating kinurenine and reduces the serotonin synthesis. Besides that, more kinurenine enters the brain during the inflammation process, and the neurotoxic pathway of kinurenine metabolism overwhelm the neuroprotective one. The less various microbiota microbiota is associated with increased response of the hypothalamus-pituitary-adrenal system, increase of pro-inflammatory cytokines, reduction of stress resistance, and depression. Enrichment of the diet with prebiotic components increases the diversity of the intestinal microbiota. Dietary interventions for intestinal microbiome also include probiotics promoting increased body resistance and cause less exposure to depression.

Aim.To study the intestinal microbiota changes in patients with bronchial asthma (BA). Materials and methods.40 patients and 15 healthy individuals were included for the study. The microbiota study in feces samples was performed by sequencing the 16SpRNA gene. Results.It was noted an increasing of theProteobacteriaproportion in the patients with BA. The fractions ofBetaproteobacteriaиGammaproteobacteriawere increased in the patients with allergic BA and at the same time, only theGammaproteobacteriapart was increased in patients with non-allergic form of BA. It was found an increase inBacilliand a decrease in the proportion bacteria forming butyrate (Anaerostipes, Faecalibacterium) and acetate (Alistipes), which was corresponded to a decrease in the proportion of strict anaerobic symbionts and an increase in the proportion of opportunistic facultative anaerobes. The relative bacteria amount was reduced for theNegativicutes Erysipelotrichia, Bacteroidia classes, theErysipelotrichaceae,Pseudomonadaceae, Rhodospirillaceae, Bacillaceae familiesand for the kinds ofBarnesiella, Paraprevotella, Pyrolobus, Bifidobacterium, Pseudomonas, Coprobacter, Bacillusin the allergic asthma patients with syndrome of intensive bacterial overgrowth (SIBO) cases. In the non-allergic asthma case, the presence of SIBO was accompanied by the relative bacteria amount increasing of theBacteroidaceaeand theParaprevotellafamilies and theOdoribacter,Bacteroides, Butyricicoccus, Parasutterellagenera. The bacterial spectrum changes correlated with the main clinical and laboratory manifestations of BA in the patients. Conclusion.The results have indicated the differences in the intestinal microflora composition of healthy volunteers and patients with bronchial asthma in including the SIBO presence. It is necessary more detail study of the bacterial composition changes in the intestine for the bronchopulmonary pathology case.

At present, the role of intestinal microbiota in diverse diseases of the central nervous system, including of multiple sclerosis (MS) has been extensively investigated. Self-reactive CD4+ Th1 and Th17 cells specific to myelin-derived antigens play a key role in the MS pathogenesis. Taking into consideration pathogenetic features related to MS development, we examined a relation between intestinal microbiocenosis and abundance of various peripheral blood helper T (Th) cell subsets in MS patients. Objective of the study: to assess prevalence of individual members of the intestinal microbiota in MS patients and analyze a relation with peripheral blood Th cell subsets. Prevalence of symbiotic and opportunistic microbial species was estimated by bacteriological method and real time PCR in 112 MS patients (72 females, 40 males) of varying severity and duration. Th cell subsets (Th1, Th2, Th17, Th1/Th17, Th17/Th22, DP Th17) were analyzed by using multi-color flow cytometry based on Th cell subset-specific surface expression of chemokine receptors. A relationship between individual intestinal microbiota species and severity, duration and rate of MS progression, as well as with the phenotype of immune cells was assessed. It was found that the most significant correlation between percentage of peripheral blood Th cell subsets was observed with prevalence of Lactobacillus spp., Enterococcus spp. and Enterobacter spp. Moreover, prevalence of Enterococcus spp. Th cell composition influenced synergistically or antagonistically together with Enterobacter spp. or Lactobacillus spp., respectively. It is suggested that direct and indirect impact of intestinal microbiota composition on human immune system might contribute to developing novel strategies for treating MS.

Purpose of this article is to clarify the role of intestinal microbiota changes in cardiovascular diseases pathogenesis. In the analysis of intestinal microbiota changes in patients with cardiac pathology, a diversity and lack of research on this issue are notable. Intestinal microflora performs immune, metabolic, synthetic, enzymatic, antitoxic and other functions, providing intestinal colonization resistance. The intestinal microbiota effects on the human body are primarily due to toxic metabolites which can be provisionally divided into five groups: trimethylamine and its derivatives, short-chain fatty acids, endotoxin and bacterial wall products, bile acids and uremic toxins. It is interesting to further study their role in the pathogenesis of heart diseases. For example, bacterial role in trimethylamine, choline metabolism and their effects on the pathogenesis of atherosclerosis. The possibilities of their use as diagnostic markers are studied. However, studies of trimethylamines are usually associated with difficulties, due to their strong dependence on the patient's diet. Trimethylamines are the most studied group of intestinal metabolites, although there are still no reliable ways to correct them. Analysis of short-chain fatty acids requires the identification of each fatty acid individual role, and comparing their content in peripheral blood and stool. Endotoxin is a marker of microbial activity in the intestine. It is an important component of the bacterial cell wall. A study of bile acids metabolism changes influenced by intestinal microbiota also can help to understand disorders of lipid metabolism. An increase in the intestinal microflora uremic toxins (p-cresol, indoxyl sulfate) synthesis is associated with chronic kidney disease. It is promising to develop further ways for correction of the intestinal microbiota composition, which requires a better understanding of cardio-vascular pathology pathogenetic mechanisms. Conclusions. The study of intestinal microbiota composition is appropriate taking into account synthetic activity of various bacteria. Reviewing the effect of microbial metabolites on the human body and studying the mechanisms of their synthesis, it is possible to understand their role as diagnostic markers and suggest ways of correction.

The probiotic properties of the Bacillus subtilis GM2 and GM5 strains were studied on 90 Cobb 500 broiler chickens aged one day that were randomly divided into three groups: the control group with the standard diet and two experimental groups (30 chickens per group) with the diet supplemented with B. subtilis GM2 (group 1) and GM5 (group 2) spores. The addition of B. subtilis GM2 and GM5 spores at a concentration of 1·107 CFU/g to the ration of broiler chickens improved their growth rate, as well as increased the digestibility of nutrients and modulated the intestinal microflora in them. The use of probiotics stimulated an increase in the live weight of chickens by 6.30% and 13.78% (p = 0.05) as compared with the control group. The average daily weight gain in experimental groups 1 and 2 amounted to 52.82 ± 0.36 g and 56.54 ± 0.47 g per chicken, which is more than in the control group (49.69 ± 0.40 g) – by 6.30% and 13.79% (p = 0.05), respectively. The administration of probiotics by feeding favored an increase in the population of lactic acid bacteria in the small and large (to a lesser extent) intestine – bacteria belonging to the Enterobacteriaceae, Lactobacillaceae, and Clostridiaceae families were isolated from the intestinal contents and identified. The veterinary-sanitary examination found that the meat of broiler chickens from the experimental groups meets all the GOST requirements for organoleptic, physico-chemical, and bacterioscopic characteristics. Thus, probiotics based on the B. subtilis GM2 and GM5 strains have a positive effect on the growth and fodder digestibility of broiler chickens.

Aim. This review aims to describe the nature of changes in the intestinal microbiota in irritable bowel syndrome (IBS) and provide a pathogenetic justification of the feasibility of a therapeutic impact on microbiota. General findings. An important aspect of the interaction of intestinal bacteria with the “host” cells is their contact with pattern recognition receptors of enterocytes, dendritic cell receptors, as well as a transcellular transport of antigens in the region of Peyer’s patches. The area of interaction of intestinal bacteria and the human body is not limited to the intestines. Intestinal bacteria demonstrate a significant humoral effect due to signalling molecules, some of which exhibit neurotransmitter properties. The study of the bacterial cross-feeding for various species, i.e. mutual use of nutrient substrates produced by bacteria of various species, is of a great interest. The development of a lowactivity inflammation in IBS can partly be explained by the increased interaction of flagellin with the corresponding receptor, as well as the influx of excess bacteria from the small intestine. The majority of studies on IBS have demonstrated the predominance of intestinal bacteria with pro-inflammatory potential (Enterobacteriaceae) and the lack of bacteria with a pronounced anti-inflammatory, antimicrobial and enzymatic action (Lactobacillus and Bifidobacterium), as well as increased mucus degradation. Similar changes are observed in inflammatory bowel diseases. Reduced microbial diversity increases susceptibility to intestinal infections and parasitoses, including those caused by protozoa conditionally pathogenic for adults, such as Blastocystis hominis hominis, Dientamoeba fragilis, Giardia lamblia. With the help of nutrition correction, the use of probiotics and functional foods containing certain probiotic strains, plant fibres (primarily psyllium) and, in some cases, nonabsorbable antibiotics, a positive effect can be achieved in a significant number of IBS patients. Recent works have shown that clinical improvement is accompanied by a change in the composition of the intestinal microbiota.Conclusion. For the pathogenetic treatment of irritable bowel syndrome, the use of non-drug treatment is justified, such as diet optimization and prescription of plant fibres and probiotic bacterial strains. The positive effect of such an approach is largely determined by modification of the intestinal microbiota composition. This opens up prospects for a further, more targeted impact on the intestinal microbiome.

Microbiome is a key element in maintaining health, forming all saprophytic, commensal and parasitic microorganisms that invade the human body. The development of microbiota begins already in the prenatal period, providing the way for further studies on the influence of the course and duration of pregnancy, delivery mode, feeding, exposure to environmental factors and gestational age. Colonization of the gastrointestinal tract of infants is an important aspect of later health. Probiotics and prebiotics can regulate the composition of bacterial flora of the gastrointestinal tract and thus influence the homeostasis of human body.

The article describes the modern views on the relationship between altered development of gut microbiota in infants and the risk of developing atopic diseases (atopic dermatitis and bronchial asthma). The studies of genetic susceptibility to atopy and the influence of epigenetic mechanisms involved in the regulation of gene expression responsible for the hyperproduction of immunoglobulin E are discussed. The characteristics of the microbiota of infants with already developed atopic diseases and children at risk of atopy are analyzed. In infants who subsequently developed atopy, the composition of gut microbiota at the birth is characterized by a reduced abundance of bifidobacteria and high content of potentially pathogenic microorganisms. The triggering role of active metabolites of altered microbiota on the differentiation of T-regulatory cells has been established. A preventive effect of optimal breastfeeding has been confirmed: meta-analyzes of recent studies indicate a link between the duration of breastfeeding and a decrease in the frequency of bronchial asthma. The microbiota of breast milk contributes to the proper development of the infant’s microbiota, determines its diversity and immunomodulating action. On the basis of the conducted research, methods of targeted correction of the intestinal microbiota in children with risk of atopy can be developed.

Aim: to review available data confirming the pathogenetic role of the intestinal microbiota in the formation of irritable bowel syndrome (IBS).Key findings. Changes in the intestinal biotope cause the development of visceral hypersensitivity and impaired intestinal motor activity, as well as neuroimmune transmission. This article discusses the main aspects of the biological properties of probiotic bacteria in terms of their action within the “brain — intestine — microbiota” chain. The results of experimental and clinical studies elucidating the mechanisms of action of probiotic cultures have been generalized. The understanding of these mechanisms allows practitioners to make informed decisions in prescribing probiotics to IBS patients. Key concepts concerning fecal microbiota transplantation, as well as the prospects and difficulties of implementing this approach are considered.Conclusions. The term “microbiota — intestine — brain” clearly demonstrates the correlation between the main functional components of IBS. Meta-analyses and systematic reviews confirm the efficacy of probiotics in IBS. However, further research into probiotic therapy options is needed to identify specific bacterial strains with proven clinical efficacy. The fecal microbiota transplantation method also requires further research, since many issues associated with this approach remain unclear.

The presented review of the special literature data (on MEDLINE and eLIBRARY.RU databases) makes it possible to determine a number of topical issues for preventing child disability as well as trends of scientific research in this area, taking into account the causes of disability and its structure by the underlying disease. The World Health Organization has established a relentless focus on the problem of disability, including that of children, which is reflected in the continuous improvement of methods for assessing and classifying persistent disabilities. It has been shown that the prevention of disability in children and the support of families raising handicapped children and children with disabilities are among the main priorities of the state social policy of the Russian Federation. The data on modern technologies for reducing the genetic burden in the population from the perspective of prevention of hereditary and congenital diseases, including orphan ones, has been presented. The results of studies indicating the increasing role of the intestinal microbiota in the development and prevention of a number of diseases affecting the formation of disability in children have been presented. The problem of combating antibiotic resistance is considered from a preventive perspective. A number of scientific studies is devoted to non-infectious pathology, which is becoming increasingly important in the formation of disability in children of different age groups, starting from the neonatal period. The actual data on the role of obesity in the formation of serious health disorders has been given. The opinion is expressed on the need to create a system of hygienic and medico-psychological safety of children's life in conditions of hyperinformatisation and the modern environmental situation. It is assumed that the implementation of the results of the proposed research into health care practice will make it possible to influence the processes of disability in a child on a deeper pathogenetic level as well as to improve the arrangement of preventive activities in this direction.

The article discusses the possible relationship between breast milk oligosaccharides, the composition of the intestinal microbiota of an infant and his behaviour shaping. The data of research studies performed both on the model of laboratory animals and among children, devoted to the study of the effect of intestinal microbiota on shaping behavioural features and cognitive functions is presented.

The aim of the study is to analyze current views concerning interrelations between the state of intestinal microbiota and the course of ischemic-reperfusion brain injury. Conclusion. Literary data are indicative of disputable scientific opinions existing nowadays concerning the role of dysbacteriosis (neuroprotective or neurodegenerative) in the course of ischemic brain injuries. Meanwhile, the studies are in common concerning the evidenced role of the intestinal microbiota in disturbances of T-cell homeostasis, ratio changes of their Treg-Th17 subpopulations, and migration of intestinal lymphocytes to the ischemic brain.

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