Микробиота полости рта и гастроэнтерологические заболевания

Заболевания пародонта относятся к числу наиболее распространенных заболеваний человека. В начале XXI века сформировалась концепция «пародонтальной медицины», рассматривающая взаимосвязи патологии пародонта с другими заболеваниями организма. На сегодняшний день с патологией пародонта связано более 50 различных соматических заболеваний. Патология пародонта тесно связана с пародонтальной микробиотой. Нами проведен поиск в информационной базе Pubmed источников, опубликованных до 25.01.2026, в которых рассматривалась взаимосвязь пародонтальных бактерий с развитием гастроэнтерологических заболеваний. В представленном обзоре мы рассмотрим взаимосвязь пародонтальной микробиоты с двумя актуальными на сегодняшний день гастроэнтерологическими заболеваниями: с неалкогольной жировой болезнью печени (55 источников) и с воспалительными заболеваниями кишечника (153 источника). Приведенные в обзоре данные демонстрируют, что при неалкогольной жировой болезни печени ведущий представитель микробиоты полости рта Porphyromonas gingivalis (P. gingivalis) обнаружен непосредственно в ткани печени, кроме того, формируется связывающая ось «рот–кишечник–печень» и приобретает значение бактериальная транслокация пародонтальных бактерий в системный кровоток, сопровождающаяся циркуляцией медиаторов воспаления и иммунных комплексов, нарушением метаболического, воспалительного и иммунологического гомеостаза. Микробиота полости рта участвует в развитии и прогрессировании воспалительных заболеваний кишечника посредством изменения микробиоты кишечника по оси «рот–кишечник», нарушения кишечного барьера и проницаемости, высвобождения медиаторов воспаления и нарушения иммунного ответа. Заболевания пародонта можно предотвратить и контролировать, микробиоту полости рта следует рассматривать как модифицируемый фактор заболеваний. Контроль микробиоты полости рта, в особенности ее агрессивных представителей, таких как P. gingivalis, следует рассматривать как возможную стратегию профилактики лечения заболеваний, связанных с патологией пародонта и пародонтальной микробиотой.

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