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Tom 15, Nr 1 (2021)
Inne materiały uzgodnione z Redakcją
Opublikowany online: 2021-02-15

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Eksport do Mediów Społecznościowych

Eksport do Mediów Społecznościowych

Probiotykoterapia w zespole metabolicznym

Małgorzata Moszak1, Paweł Bogdański1
Forum Medycyny Rodzinnej 2021;15(1):14-33.

Streszczenie

Mikrobiota jelitowa (GM) pełni w organizmie liczne funkcje warunkujące homeostazę metaboliczną — między innymi uczestniczy w syntezie witamin K, B1 , B6, B12 oraz kwasu foliowego, trawieniu i wchłanianiu składników odżywczych, przemianach cholesterolu i kwasów żółciowych oraz stymulacji układu odpornościowego. Ostatnie dwudziestolecie jest okresem intensywnych badań nad florą bakteryjną oraz zależnościami między jej ilościowymi i jakościowymi zabur zeniami a chorobami metabolicznymi, takimi jak otyłość, cukr zyca typu 2, osteoporoza, hipercholesterolemia oraz stłuszczenie wątroby. Wśród mechanizmów łączących zaburzenia składu i aktywności GM z rozwojem chorób metabolicznych wymienia deregulację przemian energetycznych, utratę integralności błony śluzowej jelit prowadzącą do endotoksemii i stanu zapalnego, zmianę metabolizmu kwasów żółciowych i sygnalizacji receptora farnezoidowego X oraz wpływ metabolitów bakteryjnych (SCFA, TMAO, LPS) na regulacjękluczowych szlaków metabolicznych. Pozytywny wpływ probiotyków na przebieg leczenia otyłości i zabur zeń metabolicznych związanych z nadmierną masą ciała wynika z ich zdolności kształtowania ekosystemu bakterii jelitowych. Zaprezentowane w opracowaniu dane pochodzące z licznych metaanaliz oraz badań klinicznych dostarczają dowodów na istotny potencjał probiotyków w poprawie wykładników gospoda rki węglowodanowej, lipidowej oraz ciśnienia tętniczego, a także prawdopodobny wpływ na redukcję masy ciała i zmianę jego składu. Naukowcy podkreślają jednak, że racjonalizacja użycia drobnoustrojów probiotycznych w leczeniu zespołu metabolicznego wymaga zastosowania probiotykoterapii o przemyślanej specyfice szczepów bakterii lub/i ich połączeń, dawce, czasie trwania i formie. Określenie tych elementów wydaje się kluczowym zadaniem przyszłych badań.

Słowa kluczowe: probiotykimikrobiota jelitowazespół metabolicznynadwagaotyłośćcukrzycahiperlipidemianadciśnienie tętnicze

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