N.N. Priorov Journal of Traumatology and OrthopedicsN.N. Priorov Journal of Traumatology and OrthopedicsВестник травматологии и ортопедии им. Н.Н. Приорова0869-86782658-6738Eco-Vector63192410.17816/vto631924ReviewsОбзорыReview ArticleNew trends in non-surgical treatment of osteoarthritis. Short reviewНовые тренды нехирургического лечения остеоартрита. Краткий обзорhttps://orcid.org/0009-0007-5041-19156091-8422MulykAngela S.МулыкАнжела Сергеевна
Russian Federation

MD

md.amulyk@mail.ruhttps://orcid.org/0000-0003-0783-11765507-5060AlekseevDmitry G.АлексеевДмитрий Глебович
Russian Federation

Cand. Sci. (Biology), associate professor

канд. биол. наук, доцент

exappeal@gmail.comhttps://orcid.org/0000-0002-0502-81206975-8820AkulaevAnton A.АкулаевАнтон Андреевич
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

antonakulaev@gmail.comhttps://orcid.org/0000-0003-3234-89362014-6518GubinAlexander V.ГубинАлександр Вадимович
Russian Federation

MD, Dr. Sci. (Medicine), professor

д-р мед. наук, профессор

shugu19@gubin.spb.ruPirogov Clinic of High Medical Technologies at Saint Petersburg State UniversityСанкт-Петербургский государственный университет, Клиника высоких медицинских технологий им. Н.И. ПироговаUniversity of educational medicineУниверситет образовательной медицины25022025150220253213053151305202416072024Copyright ©; 2025, Eco-VectorCopyright ©; 2025, Эко-Вектор2025Eco-VectorЭко-Векторhttps://eco-vector.com/for_authors.php#07https://journals.eco-vector.com/0869-8678/article/view/631924

At least 240 million people worldwide have symptomatic osteoarthritis and its prevalence is increasing. Current protocols for non-surgical treatment are very limited, and the number of surgical interventions on joints is increasing. Given the global prevalence of this disease, an effective disease-modifying strategy is needed to relieve symptoms and slow progression. Search literature using: PubMed, eLIBRARY.RU, CyberLeninka. Search keywords: osteoarthritis, obesity, gut microbiota, dietary, gut-joint axis, inflammation, osteoarthritis, obesity, intestinal microbiota, gut-joint axis, inflammation. The depth of the review was mainly for the last 5 years. Unsaturated fatty acids and n-6 polyunsaturated fatty acids have a more pronounced pro-inflammatory effect, while n-3 polyunsaturated fatty acids have an anti-inflammatory effect. The gut-joint axis hypothesis is based on possible cross-connections between the joint and the gut. To date, there are four mechanisms by which bacteria can influence the development of arthritis. There are studies examining the modulation of gut microbiota through the use of prebiotics and probiotics. Thus new trends in non-surgical treatment of osteoarthritis include: influence on pro-inflammatory and anti-inflammatory factors, modeling nutrition, modification of the microbiota.

Не менее 240 млн человек во всём мире имеют симптоматический остеоартрит, и его распространённость увеличивается. Современные протоколы нехирургического лечения весьма ограниченны, растёт количество оперативных вмешательств на суставах. Ввиду глобальной распространённости данного заболевания необходима эффективная стратегия, модифицирующая болезнь, для облегчения симптомов и замедления её прогрессирования. Поиск литературы производился при помощи баз PubMed, eLIBRARY.RU, КиберЛенинка. Ключевые слова для поиска: «osteoarthritis», «obesity», «gut microbiota», «dietary», «gut-joint axis», «inflammation», «остеоартрит», «ожирение», «кишечная микробиота», «ось «кишечник — сустав», «воспаление». Глубина обзора — преимущественно последние 5 лет. Ненасыщенные жирные кислоты и омега-6-полиненасыщенные жирные кислоты обладают более выраженным провоспалительным эффектом, тогда как омега-3-полиненасыщенные жирные кислоты обладают противовоспалительным действием. Гипотеза оси «кишечник — сустав» строится на возможных перекрёстных связях между суставом и кишечником. На сегодняшний день выделяют четыре механизма, с помощью которых бактерии могут влиять на развитие артрита. Имеются исследования, посвящённые модуляции кишечной микробиоты посредством использования пребиотиков и пробиотиков. Таким образом, к новым трендам нехирургического лечения остеоартрита можно отнести влияние на провоспалительные и противовоспалительные факторы, моделируя питание, модификацию микробиоты.

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