medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2026-9-82-88medalphabet-5062Research ArticleСтатьиПищевая аллергия и особенности нутритивного статуса как проявление дисфункции эпителиального барьера у детей с врожденным ихтиозомFood allergy and features of nutritional status as a manifestation of epithelial barrier dysfunction in children with congenital ichthyosishttps://orcid.org/0009-0007-2418-4069МустафаеваД. И.MustafaevaD. I.

Мустафаева Динара Илгар кызы, аспирант 2-го года, врач-педиатр

Москва

Mustafaeva Dinara Ilgar kyzy, 2nd year graduate student, pediatricianNational Medical Research Center for Children’s Healt»

Moscow

mustafaeva-dinara@mail.ruФГАУ «Национальный медицинский исследовательский центр здоровья детей»РоссияNational Medical Research Center for Children’s Healt»Russian Federation20260106202609Диетология и нутрициология8288Copyright © Мустафаева Д.И., 20262026Мустафаева Д.И.Mustafaeva D.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/5062

Врожденный ихтиоз – группа редких генетических заболеваний, характеризующихся нарушением кератинизации и дисфункцией кожного барьера. Общим патогенетическим звеном для различных форм ихтиоза является структурное повреждение эпидермиса, приводящее к повышенной трансэпидермальной потере воды и снижению его защитной функции, что создает условия для транскутанной сенсибилизации пищевыми аллергенами. Особенно хорошо описан данный механизм при синдроме Нетертона, связанном с мутацией гена SPINK5, и вульгарном ихтиозе, ассоциированном с мутациями гена филаггрина. Проникновение пищевых аллергенов через нарушенный кожный барьер запускает каскад иммунных реакций, способствующих активации Th2-иммунного ответа и выработке специфического IgE, с высокой частотой, приводя к пищевой сенсибилизации и пищевой аллергии. Развитие пищевой аллергии на фоне врожденного ихтиоза усугубляет течение основного заболевания и способствует формированию нарушения нутритивного статуса и задержки роста вследствие как ограничительных диет без адекватного диетологического сопровождения, так и дефицита нутриентов и микроэлементов. Настоящий обзор фокусируется на роли дисфункции эпидермального барьера как ключевого связующего звена в развитии коморбидной пищевой аллергии у пациентов с врожденным ихтиозом и подчеркивает необходимость междисциплинарного подхода для данной категории пациентов.

Congenital ichthyosis is a group of rare genetic disorders characterized by impaired keratinization and skin barrier dysfunction. The common pathogenetic link for various forms of ichthyosis is structural damage to the epidermis, leading to increased transepidermal water loss and reduced protective function, which creates conditions for transcutaneous sensitization to food allergens. This mechanism is particularly well described in Netherton syndrome, associated with a mutation in the SPINK5 gene, and vulgar ichthyosis, associated with mutations in the filaggrin gene. However, in other forms of congenital ichthyosis, the characteristics of food sensitization and manifestations of food allergy have not been studied. The penetration of food allergens through the damaged skin barrier triggers a cascade of immune reactions that contribute to the activation of the Th2 immune response and the production of specific IgE, often leading to food sensitization and food allergy. The development of food allergies in the context of congenital ichthyosis exacerbates the course of the underlying disease and contributes to the formation of nutritional status disorders and growth retardation due to both restrictive diets without adequate nutritional support and a deficiency of nutrients and trace elements. This review focuses on the role of epidermal barrier dysfunction as a key link in the development of comorbid food allergies in patients with congenital ichthyosis and emphasizes the need for an interdisciplinary approach for this category of patients.

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