[TROPHOLOGY ASPECTS OF NOOCPHEROGENESIS. On the 90th anniversary of A M Ugolev].

This paper presents an analytical review of A. Ugolev's scientific heritage (the theory of adequate nutrition, all-purpose functional blocks, the unity of natural and artificial technologies, the discovery of membrane digestion, new doctrine--trophology) to explain trophological aspects of noospherogenesis. The authors have presented their specific views for the development of these ideas; the theory of therapeutic infections, the holistic theory of nutrition, the endoecological deficiency syndrome, the activation of all-purpose functional blocks, evasion receptors, new principles of treatment with the effects on microbiota, combining the essence of the diseases and their treatment.

FUNCTIONAL FOODS ARE CRITICAL COMPONENTS OF TREATMENT OF METABOLIC DISORDERS IN CELIAC DISEASE.

AIM: To evaluate the effectiveness of Native-complex functional food to correct nutritional disorders and to normalize gastrointestinal motor activity in celiac disease (CD). METHODS: 20 CD patients with constipation and metabolic disorders were included in the study (age 31.8?9.5 years, male to female ratio 1:5.3). The diagnosis of CD was confirmed by clinical and anamnestic data, endoscopy, histopathology of duodenal biopsy specimens, HLA-DQ2 and HLA-DQS typing. All patients received Native-complex Fucus jelly (Kelp jelly) within 2 months. RESULTS: At the beginning of the study45% of patients had stools corresponding to the Bristol Stool Form ScaleType 1,40% of patients had Type 2 stools and 15% of patient had Type 3 stools. 15 patients (75%) showed a decrease in fat mass and 13 patients (65%) showed a decrease in fat-free mass indicated by bloimpedance measurement. All patients had low values of total bacterial counts and increased abundance of pathobionts including fungi and viruses in fecal microbiota. Supple- mentary nutrition significantly improved symptoms, intestinal circadian rhythms and stool consistency in CD patients. At the end of the study 70% of patients had daily bowel movements, 30% of patients had stools every other day. The average stool frequency was 5,95 ? 1,80 per week. 80% of patients had Type 4 or Type 5 stools,20% of patients had Type 3 stools according to the Bristol Scale. Supplementary nutrition significantly improved gut microbiota profile. CONCLUSION: Long-term gluten-free diet in celiac disease leads to a decrease in dietary fiber and polysaccharides consumption and promotes intestinal dysbiosis. Functional foods improve symptoms; stool consistency and gut microbiota profile in adult celiac patients on gluten-free diet.

THE PSYCHO-PHYSIOLOGICAL STATUS IN CELIAC DISEASE.

Based on the results of a comprehensive study of 35 people aged from 19 to 52 years, among them 20 women and 15 men with celiac disease features of their physiological status were studied, reflecting the severity of the disease and quality of life. The diagnosis was based on the clinical and anamnestic data, endoscopy, histomorphological, immunological and genetic exams. Psychophysiological analysis showed that in celiac disease is characterized by the formation reactions with anxiety, anxiety-phobic, neurotic, affective, and hypochondriacal symptoms. The results of the study emphasized the importance of adaptive physiological capacity of the body to build tolerance to the development of psycho-vegetative, hypochondriacaldepressive and other disorders.

[Connective tissue dysplasia in patients with celiac desease as a problem of violation of adaptation reserve islands of the body].

Clinically significant dysplasia of connective tissue in patients with celiac disease is often responsible for various visceral disorders. Different disturbances of motor and evacuation functions are often determined in this patients (gastroesophageal reflux, duodenogastral reflux, spastic and hyperkinetic dyskinesia). The clinical course of the celiac disease, associated with connective tissue dysplasia, is characterized by asthenovegetative syndrome, reduced tolerance to physical activity, general weakness, fatigue and emotional instability. These data should be considered in choosing a treatment.

[FEATURES OF FUNCTIONAL DISORDERS GASTRODUODENOBILIARY SYSTEM IN PATIENTS WITH CELIAC DISEASE].

The disturbances in synchronous functioning of gastroduodenal and biliary system and in their consequent interaction underlies functional disorders of the digestive tract. Motor and evacuation functioning of the gastrointestinal tract depends on the bile flow to the duodenum, which influences on digestive processes. Functional disorders of the biliary tract, contributing disturbances of the gastrointestinal motor activity, cause gastrointestinal symptoms. The cause of biliary dysfunctions often are gallbladder anomalies, which are accompanied by disturbances in drainage system of bile flow, development of the pathological refluxes, inflammation and formation of the biliary sludge. The progression of the biliary system deflux dysfunction leads to motor and evacuation dysfunction of the gut. According to the numerous data, gall bladder anomalies, which underlies functional disorders in bile deflux, are common in patients with coeliac disease. The results, obtained in the conducted research, revealed hypertonic hyperkinetic motor disorders of the upper part of the gastrointestinal tract and inflammation changes of the gastroduodenal zone in patients with coeliac disease with fixed bend in the gallbladder neck, necking and different deformation of the gallbladder, which are the visceral signs of undifferentiated connective tissue dysplasia. Disorders in every component of the digestive tract upper part motor activity lead to the corresponding clinical manifestations.

[NONALCOHOLIC FATTY LIVER DISEASE: DIAGNOSTIC, SYMPTOMS, TREATMENT. GUIDELINES WERE APPROVED BY THE XV GASTROENTEROLOGICAL SCIENTIFIC SOCIETY OF RUSSIA IN 2015].

According to the World Health Organization, it is recorded steady growth of the number of chronic liver diseases, including nonalcoholic fatty liver disease (NAFLD), in recent years. As an independent nosological entity, NAFLD is one of the risk factors for cardiovascular diseases, associated with abdominal-visceral obesity, peripheral insulin resistance (IR), and is regarded as the hepatic component of Metabolic syndrome (MS). Nowadays there are no generally accepted national standards for diagnosis and treatment of NAFLD for physicians, gen- eral practitioners, gastroenterologists in Russia. This was the essential reason in their development. The main reason of The guidelines development is the absence of generally accepted national standards for diagnosis and treatment of NAFLD for physicians, general practitioners, gastroenterologists in Russia. These guidelines are based on the global and local data of treatment experience of NAFLD, recently published in reviews, analytical studies in the literature. Guidelines are intended for physicians, general practitioners, gastroenterologists and contain the description of the preferred approaches to the provision of diagnostic, curative and preventive care of patients NAFLD. The quality of recommendations was grading according to the GRADE approach.

[Serum metabolome by gas chromatography-mass spectrometry (GC-MS) in patients with ulcerative colitis and celiac disease].

Metabolomics is the emerging science of measurement and analysis of metabolome--the complete set of low molecular weight compounds in a cell, tissue, organ or whole organism. One of the aims of metabolomics is to research the response of an organism to a pathophysiological insult by measuring the concentrations of small molecule metabolites in biofluids and tissues and its dynamics. Intestinal microbiota is most probably involved in the development and maintenance of autoimmune inflammation in ulcerative colitis and celiac disease. Gas chromatography-mass spectrometry (GC - MS) of serum generates comprehensive metabolic profiles, reflecting integrated human (systemic) and gut microbial metabolism which may be altered in disease states. The aim of this study was to investigate GC - MS-based serum metabolomic profiles in UC and CD patients. Serum metabolic profiles were collected from 75 individuals: 20 patients with mild-moderate active UC, 35 CD patients, and 20 healthy controls (HC). We characterized 84 serum metabolites by use GC-MS. 18 metabolites at least have a combined (human + microbial) origin. In serum of UC patients, phenylacetic acid (PAA), 4-hydroxyphenylacetic acid (4-HPAA), 3-indolylacetic acid (IAA), succinic acid (SA) and fumaric acid (FA) were the metabolites most prominently increased, whereas 3-phenylpropionic acid (PPA) was significantly decreased. Serum of CD patients showed significant increases in IAA, 3-indolepropionic acid (IPA), SA and FA. Increased serum levels of succinic acid suggest its possible damaging effect on intestinal mucosa especially in ulcerative colitis. Orally administered butyrate + inulin as supplement to mesalazine in UC or gluten free diet in CD was effective in reducing disease activity with a marked improvement of serum metabolomic profiles (including SA reduction) and gut microbiota in both diseases. There were no any adverse events.

[Late diagnosis of celiac disease].

A 45 year-old woman presented with late-diagnosed celiac disease, marked disorders of calcium and bone metabolism, and severe osteoporosis. Weak enteral symptoms delayed diagnosis. High efficiency of agluten and vitamin D therapy was documented.

[Administration of afobasol for correction of mental disorders in celiac disease patients].

AIM: To study afobasol efficacy in anxiety and neurotization correction in patients with celiac disease (CD). MATERIAL AND METHODS: We examined 17 CD patients with mental diseases (anxiety, anxiophobic and neurotic disorders) aged 35.3 +/- 3.5 years. Personal and situational anxiety levels were assessed with multivariate questionnaire of the integrative anxiety test, neurotization--with Wasserman's questionnaire. Mental diseases were treated for 4 weeks with afobasol in a daily dose 30 mg. RESULTS: An initial level of personal anxiety was elevated in 100% patients, of situational anxiety--in 66.7%. These kinds of anxiety (most of all general, emotional discomfort, asthenic and phobic components) were treated with a positive effect. Neurotization was high in 11 patients. The treatment was effective in 6 of them. Side effects were not noted. The highest reduction was seen in emotional discomfort, asthenic component and anxiety. CONCLUSION: Afobasol is effective in management of mental diseases in patients with celiac disease.

[Endocrine cells of rectal epithelium in health, in nonspecific ulcerative colitis and irritable colon syndrome in the treatment with prednisolone and salofalk and in the absence of treatment]. / Endokrinnye kletki épiteliia priamoi kishki v norme, pri nespetsificheskom iazvennom kolite i sindrome razdrazhennoi kishki bez lecheniia i pri lechenii prednizolonom i salofal'kom.

The arrangement and ultrastructure of rectal intraepithelial endocrine cells in health, in nonspecific ulcerative colitis (NSUC) and in irritable colon syndrome (ICS) were studied with light and electron microscopy. An increase of the amount of these cells was registered at the initial stages of inflammation, whereas chronic and destructive states were accompanied by the cells decrease. A decrease of endocrine cells number in (NSUC) was pronounced more than in ICS. Compared to prednisolone, the treatment with salofalk produced a more positive effect on endocrine cells reproduction within the rectal lining. The endocrine cells ultrastructural changes found by the authors in ulcerative colitis and irritable colon showed similarity to those in other colon diseases.