rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2016-199-205rsp-2217Research ArticleПРОГРЕСС В РЕВМАТОЛОГИИ В XXI ВЕКЕPROGRESS IN RHEUMATOLOGY IN THE XXI CENTURYКонцепция «болезни барьерного органа» в патогенезе спондилоартритовTHE CONCEPT OF BARRIER ORGAN DISEASE IN THE PATHOGENESIS OF SPONDYLOARTHRITISГалушкоЕ. А.GalushkoE. A.

учебно-методический отдел с центром информационных технологий

заведующая отделом, докт. мед. наук

34A, Kashirskoe Shosse, Moscow 115522 

egalushko@mail.ruГордеевА. В.GordeevA. V.

лаборатория микроциркуляции и воспаления

ведущий научный сотрудник лаборатории, докт. мед. наук

34A, Kashirskoe Shosse, Moscow 115522 

ФГБНУ Научно- исследовательский институт ревматологии им. В.А. Насоновой, МоскваРоссияV.A. Nasonova Research Institute of Rheumatology, MoscowRussian Federation201619072016542199205Copyright © Галушко Е.А., Гордеев А.В., 20162016Галушко Е.А., Гордеев А.В.Galushko E.A., Gordeev A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2217

В настоящее время созданы предпосылки для изменения научного взгляда на этиологию и патогенез спондилоартритов (СпА). Важная роль отводится нарушению функционирования и целостности так называемых барьерных органов, выстраивающих защиту человека между его внутренней и внешней средой. Современные данные о клеточно-молекулярных механизмах патогенеза СпА позволяют ревматологам выдвинуть гипотезу о концепции «болезни барьерного органа» как доклинической стадии развития заболеваний, входящих в группу СпА. Существуют основания предполагать, что в этом процессе задействованы индивидуальные генетические и иммунные факторы, приводящие к повреждению поверхностного эпителия слизистых оболочек и эпидермиса, который служит первым защитным барьером врожденного иммунитета и находится в контакте с чрезвычайно большим количеством микроорганизмов (микробиомом) и с патоген-ассоциированными молекулярными структурами. Микробиом может оказывать влияние на доклиническую фазу болезни несколькими способами, в том числе путем изменений состава микрофлоры (дисбиоз), а также действуя в качестве мишеней иммунологической дисрегуляции. 

There have been now prerequisites for changing the scientific view of the etiology and pathogenesis of spondyloarthritis (SpA). An important role is assigned to the dysfunction and disintegration of the so-called barrier organs that make protection of man between his internal milieu and the environment. An update on cellular and molecular mechanisms in the pathogenesis of SpA permits rheumatologists to offer a hypothesis of the concept of barrier organ disease as a preclinical stage of the diseases included in the SpA group. There is reason to think that this process involves individual genetic and immune factors leading to damage of the superficial epithelium of the mucosal membranes and epidermis that serves as the first protective barrier for innate immunity and is in contact with huge numbers of microorganisms (a microbiome) and with the pathogen-associated molecular patterns. The microbiome may affect the preclinical phase of the disease in several ways, including those to change the composition of the microflora (dysbiosis) and to act as targets for immunological dysregulation. 

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The authors declare that there are no conflicts of interest present.