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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">arthyper</journal-id><journal-title-group><journal-title xml:lang="ru">Артериальная гипертензия</journal-title><trans-title-group xml:lang="en"><trans-title>"Arterial’naya Gipertenziya" ("Arterial Hypertension")</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1607-419X</issn><issn pub-type="epub">2411-8524</issn><publisher><publisher-name>Antihypertensive League</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.18705/1607-419X-2024-2443</article-id><article-id custom-type="edn" pub-id-type="custom">UIUCDO</article-id><article-id custom-type="elpub" pub-id-type="custom">arthyper-2443</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Статьи</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>Микробиом и атеросклероз: состояние проблемы</article-title><trans-title-group xml:lang="en"><trans-title>Microbiome and atherosclerosis: state of the problem</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-8673-7198</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Верховская</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Verkhovskaya</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Верховская Екатерина Вадимовна—студентка Института медицинского образования</p><p>ул. Аккуратова, д.2, Санкт-Петербург, 197341</p><p>Тел.: 8 (812) 702–37–56</p></bio><bio xml:lang="en"><p>Ekaterina V. Verkhovskaya, Student, Institute of Medical Education</p><p>2 Akkuratov str., St Petersburg, 197341</p><p>Phone: 8 (812) 702–37–56</p></bio><email xlink:type="simple">verhovskaya_ev@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1073-3844</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Колесова</surname><given-names>Е. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Kolesova</surname><given-names>E. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Колесова Екатерина Павловна — кандидат медицинских наук, ведущий научный сотрудник научно-исследовательской лаборатории популяционной генетики НЦМУ «Центр персонализированной медицины», научный сотрудник  научно- исследовательской лаборатории эпидемиологии неинфекционных заболеваний</p><p>ул. Аккуратова, д.2, Санкт-Петербург, 197341</p><p>Тел.: 8 (812) 702–37–56</p></bio><bio xml:lang="en"><p>Ekaterina P. Kolesova, MD, PhD, Leading Researcher, Research Institute of Population Genetics of World-Class Research Centre for Personalized Medicine “Center for Personalized Medicine”, Researcher, Institute of Epidemiology of Noncommunicable Disease</p><p>2 Akkuratov str., St Petersburg, 197341</p><p>Phone: 8 (812) 702–37–56</p></bio><email xlink:type="simple">kolesova_ep@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8209-9993</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ванюркин</surname><given-names>А. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Vanyurkin</surname><given-names>A. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ванюркин Алмаз Гафурович—младший научный сотрудник научно-исследовательского отдела сосудистой и интервенционной хирургии, врач сердечно-сосудистый хирург</p><p>ул. Аккуратова, д.2, Санкт-Петербург, 197341</p><p>Тел.: 8 (812) 702–37–56</p></bio><bio xml:lang="en"><p>Almaz G. Vanyurkin, MD, Junior Researcher, Research Institute of Vascular and Interventional Surgery, Cardiovascular Surgeon</p><p>2 Akkuratov str., St Petersburg, 197341</p><p>Phone: 8 (812) 702–37–56</p></bio><email xlink:type="simple">almaz.vanyurkin@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0584-2330</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зайкова</surname><given-names>Е. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Zaikova</surname><given-names>E. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зайкова Екатерина Константиновна — младший научный сотрудник научно-исследовательской лаборатории аутоиммунных и аутовоспалительных заболеваний НЦМУ «Центр персонализированной медицины»</p><p>ул. Аккуратова, д.2, Санкт-Петербург, 197341</p><p>Тел.: 8 (812) 702–37–56</p></bio><bio xml:lang="en"><p>Ekaterina K. Zaikova, MD, Junior Researcher, Research Institute of Autoimmune and Autoinflammatory Diseases of World-Class Research Centre for Personalized Medicine “Center for Personalized Medicine”</p><p>2 Akkuratov str., St Petersburg, 197341</p><p>Phone: 8 (812) 702–37–56</p></bio><email xlink:type="simple">zaykova_ek@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1916-5705</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Калинина</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kalinina</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Калинина Ольга Викторовна—доктор биологических наук, профессор кафедры лабораторной медицины и генетики, ведущий научный сотрудник научно-исследовательской лаборатории аутоиммунных и аутовоспалительных заболеваний НЦМУ «Центр персонализированной медицины»</p><p>ул. Аккуратова, д.2, Санкт-Петербург, 197341</p><p>Тел.: 8 (812) 702–37–56</p></bio><bio xml:lang="en"><p>Olga V. Kalinina, Doctor of Biological Sciences, Professor, Department of Laboratory Medicine and Genetics, Leading Researcher, Research Institute of Autoimmune and Autoinflammatory Diseases of World-Class Research Centre for Personalized Medicine “Center for Personalized Medicine”</p><p>2 Akkuratov str., St Petersburg, 197341</p><p>Phone: 8 (812) 702–37–56</p></bio><email xlink:type="simple">kalinina_ov@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1214-0150</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чернявский</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Chernyavsky</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Чернявский Михаил Александрович — доктор медицинских наук, заведующий научно-исследовательским отделом сосудистой и интервенционной хирургии, врач сердечно-сосудистый хирург, доцент кафедры факультетской хирургии с клиникой </p><p>ул. Аккуратова, д.2, Санкт-Петербург, 197341</p><p>Тел.: 8 (812) 702–37–56</p></bio><bio xml:lang="en"><p>Mikhail A. Chernyavsky, MD, PhD, DSc, Head, Research Institute of Vascular and Interventional Surgery, Cardiovascular Surgeon, Associate Professor, Department of Specialized Surgery with the Clinic</p><p>2 Akkuratov str., St Petersburg, 197341</p><p>Phone: 8 (812) 702–37–56</p></bio><email xlink:type="simple">chernyavskiy_ma@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2427-4148</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Маслянский</surname><given-names>А. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Maslyanskiy</surname><given-names>A. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Маслянский Алексей Леонидович—доктор медицинских наук, руководитель научно-исследовательской лаборатории ревматологии и иммунопатологии </p><p>ул. Аккуратова, д.2, Санкт-Петербург, 197341</p><p>Тел.: 8 (812) 702–37–56</p></bio><bio xml:lang="en"><p>Alexey L. Maslyanskiy, MD, PhD, DSc, Head, Scientific Laboratory of Rheumatology and Immunopathology</p><p>2 Akkuratov str., St Petersburg, 197341</p><p>Phone: 8 (812) 702–37–56</p></bio><email xlink:type="simple">maslyanskiy_al@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5656-3978</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Яковлев</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Yakovlev</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Яковлев Алексей Николаевич — кандидат медицинских наук, заведующий научно-исследовательской лабораторией технологий прогнозирования риска развития сердечно-сосудистых осложнений научно-исследовательского отдела генетических рисков и персонифицированной профилактики НЦМУ «Центр персонализированной  медицины», заведующий научно-исследовательской лабораторией острого  коронарного синдрома, доцент кафедры анестезиологии и реаниматологии</p><p>ул. Аккуратова, д.2, Санкт-Петербург, 197341</p><p>Тел.: 8 (812) 702–37–56</p></bio><bio xml:lang="en"><p>Alexei N. Yakovlev, MD, PhD, Head, Research Laboratory of Technologies for Predicting the Risk of Cardiovascular Complications of World-Class Research Centre for Personalized Medicine “Center for Personalized Medicine”, Head, Acute Coronary Syndrome Research Laboratory, Associate Professor, Anesthesiology and Intensive Care Chair</p><p>2 Akkuratov str., St Petersburg, 197341</p><p>Phone: 8 (812) 702–37–56</p></bio><email xlink:type="simple">yakovlev_an@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0559-697X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бабенко</surname><given-names>А. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Babenko</surname><given-names>A. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бабенко Алина Юрьевна — доктор медицинских наук, заведующая научно-исследовательским отделом генетических рисков и персонифицированной профилактики, заведующая научно-исследовательской лабораторией предиабета и метаболических нарушений НЦМУ «Центр персонализированной медицины», заведующая научно-исследовательской лабораторией диабетологии, профессор кафедры внутренних болезней</p><p>ул. Аккуратова, д.2, Санкт-Петербург, 197341</p><p>Тел.: 8 (812) 702–37–56</p></bio><bio xml:lang="en"><p>Alina Yu. Babenko, MD, PhD, DSc, Head, Research Department of Genetic Risks and Personalized Prevention, Head, Research Laboratory of Prediabetes and Metabolic Disorders of World-Class Research Centre for Personalized Medicine “Center for Personalized Medicine”, Head, Research Laboratory of Diabetology, Professor, Department of Internal Diseases</p><p>2 Akkuratov str., St Petersburg, 197341</p><p>Phone: 8 (812) 702–37–56</p></bio><email xlink:type="simple">babenko_ayu@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8169-7812</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Конради</surname><given-names>А. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Konradi</surname><given-names>A. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Конради Александра Олеговна — доктор медицинских наук, профессор, академик РАН, заместитель генерального директора по научной работе, заведующая кафедрой организации, управления и экономики здравоохранения факультета послевузовского и дополнительного образования Института медицинского образования</p><p>ул. Аккуратова, д.2, Санкт-Петербург, 197341</p><p>Тел.: 8 (812) 702–37–56</p></bio><bio xml:lang="en"><p>Aleksandra O. Konradi, MD, PhD, DSc, Professor, Academician of the Russian Academy of Sciences, Deputy Director General for Scientific Work, Head, Department of Organization, Management and Economics of Healthcare, Faculty of Postgraduate and Additional Education, Institute of Medical Education</p><p>2 Akkuratov str., St Petersburg, 197341</p><p>Phone: 8 (812) 702–37–56</p></bio><email xlink:type="simple">konradi@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2929-0980</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шляхто</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Shlyakhto</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шляхто Евгений Владимирович — доктор медицинских наук, профессор, академик РАН, генеральный директор</p><p>ул. Аккуратова, д.2, Санкт-Петербург, 197341</p><p>Тел.: 8 (812) 702–37–56</p></bio><bio xml:lang="en"><p>Evgeny V. Shlyakhto, MD, PhD, DSc, Professor, Academician RAS, Director General</p><p>2 Akkuratov str., St Petersburg, 197341</p><p>Phone: 8 (812) 702–37–56</p></bio><email xlink:type="simple">fmrc@almazovcentre.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В.А.Алмазова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Almazov National Medical Research Centre</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>21</day><month>01</month><year>2025</year></pub-date><volume>30</volume><issue>5</issue><fpage>451</fpage><lpage>466</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Верховская Е.В., Колесова Е.П., Ванюркин А.Г., Зайкова Е.К., Калинина О.В., Чернявский М.А., Маслянский А.Л., Яковлев А.Н., Бабенко А.Ю., Конради А.О., Шляхто Е.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Верховская Е.В., Колесова Е.П., Ванюркин А.Г., Зайкова Е.К., Калинина О.В., Чернявский М.А., Маслянский А.Л., Яковлев А.Н., Бабенко А.Ю., Конради А.О., Шляхто Е.В.</copyright-holder><copyright-holder xml:lang="en">Verkhovskaya E.V., Kolesova E.P., Vanyurkin A.G., Zaikova E.K., Kalinina O.V., Chernyavsky M.A., Maslyanskiy A.L., Yakovlev A.N., Babenko A.Y., Konradi A.O., Shlyakhto E.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://htn.almazovcentre.ru/jour/article/view/2443">https://htn.almazovcentre.ru/jour/article/view/2443</self-uri><abstract><p>Цель исследования — изучение современных представлений о влиянии микробиома кишечника, ротовой полости и атеросклеротической бляшки на развитие и прогрессирование атеросклероза (АС). Материалы и методы. Литературный обзор осуществлен путем анализа научных публикаций в PubMed, метаанализов, рандомизированных клинических исследований, а также рекомендаций и обзорных статей за период с 1997 по 2024 год. В данном обзоре рассмотрены современные представления о вышеупомянутых нетрадиционных факторах риска (ФР) АС. Заключение. АС — заболевание с многофакторным патогенезом. Понимание роли как классических, так и неклассических ФР в развитии атеросклеротического поражения сосудов имеет большое значение для разработки эффективных профилактических и терапевтических мер. Среди неклассических ФР АС можно выделить роль микробиома кишечника и ротовой полости. К основополагающим механизмам влияния микробиоты ротовой полости и кишечника на развитие АС можно отнести следующие: прямое повреждающее действие липополисахаридов и бактериальных токсинов на сосудистую стенку, влияние микробных метаболитов и повышенной проницаемости кишечной стенки на транслокацию бактериальных токсинов в системный кровоток, а также развитие хронического низкоуровневого системного воспаления и эндотелиальной дисфункции. В данном обзоре рассмотрены современные представления о вышеописанных нетрадиционных ФР АС.</p></abstract><trans-abstract xml:lang="en"><p>Objective. To study modern ideas about the influence of the intestinal microbiome, oral cavity and atherosclerotic plaque on the development and progression of atherosclerosis (AS). Design and methods. The literature review was carried out by analyzing scientific publications in PubMed, meta-analyses, randomized clinical trials, as well as guidelines and review articles within the period from 1997 to 2024. This review examines modern ideas about the above-mentioned non-traditional risk factors (RF) for AS. Conclusions. AS is a disease with a multifactorial pathogenesis. Understanding the role of both classical and non-classical RF in the development of atherosclerotic vascular disease is important for the development of effective preventive and therapeutic measures. Among the non-classical RF for AS is the role of the intestinal and oral microbiome. The fundamental mechanisms of the influence of the microbiota of the oral cavity and intestines on the development of AS include the following: the direct damaging effect of lipopolysaccharides and bacterial toxins on the vascular wall, the influence of microbial metabolites and increased permeability of the intestinal wall on the translocation of bacterial toxins into the systemic bloodstream, as well as the development of chronic lowlevel systemic inflammation and endothelial dysfunction. This review examines modern ideas about the abovedescribed non-traditional RF for AS.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>атеросклероз</kwd><kwd>кишечная микробиота</kwd><kwd>триметиламин-N-оксид</kwd><kwd>короткоцепочечные жирные кислоты</kwd><kwd>кальпротектин</kwd><kwd>зонулин</kwd><kwd>пародонтит</kwd></kwd-group><kwd-group xml:lang="en"><kwd>atherosclerosis</kwd><kwd>intestinal microbiota</kwd><kwd>trimethylamine-N-oxide</kwd><kwd>short-chain fatty acids</kwd><kwd>calprotectin</kwd><kwd>zonulin</kwd><kwd>periodontitis</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Министерство науки и высшего образования Российской Федерации (Соглашение № 075-15-2022-301).</funding-statement><funding-statement xml:lang="en">The study was carried out with the support of the Ministry of Science and Higher Education of the Russian Federation (Agreement No. 075-15-2022-301)</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">GBD 2017 Causes of Death Collaborators. 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