Возможности использования бактериоцинов лактобактерий в клинической практике (систематический обзор предметного поля)

Введение. В пищевой и фармацевтической промышленности активно применяют молочнокислые бактерии в связи с их способностью к продуцированию технологически ценных веществ, имеющих важное значение для производства продуктов питания. Также некоторые молочнокислые бактерии используют для профилактики и лечения различных заболеваний за счет наличия у них пробиотических свойств. Интерес к родам Lactiplantibacillus и Lactobacillus обуславливается их способностью к синтезу бактериоцинов, которые обладают антимикробной активностью, что приводит к подавлению роста посторонней микрофлоры. Обсуждается возможность применения бактериоцинов в качестве альтернативы антибиотикам в борьбе с патогенной микрофлорой, в том числе в составе пищевых продуктов. Однако лабильность бактериоцинов ограничивает их широкомасштабное использование.

Цель исследования — проведение критического анализа актуальных литературных данных для      выявления основных механизмов действия бактериоцинов, определения направлений их использования в клинической практике и в лечебном питании (с учетом конкретных примеров), а также оценки возможных источников выделения новых высокоактивных штаммов-продуцентов бактериоцинов.

Методы. В рамках исследования был проведен систематический анализ научной литературы за период с 2014 по 2024 г. в соответствии с руководством PRISMA. Первоначальный поиск по заданным ключевым словам выявил 127 научных публикаций. В результате двухэтапного скрининга, включавшего применение критериев включения и исключения, а также удаление дубликатов, для углубленного критического анализа было отобрано 89 статей, которые составили основу данного систематического обзора. Поиск релевантных материалов осуществлялся в базах данных PubMed, Российский индекс научного цитирования (РИНЦ) и других.

Результаты и обсуждение. Проведен критический анализ 89 научных статей. Определены потенциальные направления применения бактериоцинов лактобактерий в клинической практике и лечебном питании: борьба с инфекциями желудочно-кишечного тракта; использование бактериоцинов в качестве замены антибиотикам, а также как антибиопленочное средство. Наиболее известным бактериоцином является низин, который синтезируется Lactococcus lactis и широко применяется в качестве консерванта в пищевой промышленности. Однако такие бактерии, как Lactiplantibacillus plantarum, Lactobacillus gasseri, Lactobacillus crispatus, Latilactobacillus sakei являются бактериоциногенными и могут также успешно применяться. Систематизированы актуальные данные по характеристике и механизму действия бактериоцинов. Показана корреляция между течением соответствующих воспалительных заболеваний желудочно-кишечного тракта, дозой применяемых антибиотиков и приемом очищенных бактериоцинов или пробиотических микроорганизмов, продуцирующих бактериоцины in situ. Рассмотрены существующие препятствия для быстрого внедрения бактериоцинов в клиническую практику, что является актуальным вопросом в связи с нарастающим количеством антибиотикорезистентных штаммов условно-патогенных и патогенных инфекционных агентов. Доказана возможность использования бактериоцинов в качестве альтернатив антибиотикам и/или средств, уменьшающих дозу применяемых антибиотиков, и/или средств лечения и профилактики заболеваний желудочно-кишечного тракта. Определены основные перспективные источники выделения высокоактивных штаммов-продуцентов бактериоцинов. Дальнейшие направления исследований включают целенаправленный скрининг высокоактивных бактериоцин-продуцирующих штаммов лактобактерий с пробиотическими свойствами, разработку схемы снижения дозы антибиотиков за счет использования полученных бактериоцинов.

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