CURRENT VIEW OF THE YESTERDAY'S MEDICINE (review)

Authors

  • Abay K ZHANGABYLOV Kazakhstan-Russian Medical University
  • Bakytzhan R BIMBETOV «Hospital of the Medical Center» of the Department of Affairs President of the Republic of Kazakhstan
  • Nurlan T JAINAKBAYEV Kazakhstan-Russian Medical University
  • Каramyat A ZORDINOVA Kazakhstan-Russian Medical University

DOI:

https://doi.org/10.31082/1728-452X-2020-219-2220-9-10-44-51

Keywords:

essentialphospholipids, liver cell membranes, hepaprotectors

Abstract

Phospholipids (PL) – lipids that are not involved in accumulation of fatty deposits play a significant role and serve various functions. Firstly, as a component of cell membranes of all cells in the organism.
In clinical practice, for the past decades, phospholipids were primarily used as hepaprotective substances, going by the name of “essential phospholipids (EPL)”. Becoming a popular, demanded, well-promoted remedy for the treatment of liver diseases.
However, despite the many years of approbation, the existing and sufficientclinicalexperience, discussions regarding their benefits, effectiveness, safety and reliability are still underway and have brought up diametrically opposed views. From complete rejection of EPL as medicinal means, to full recognition of the advertised properties of EPL drugs based on the given manufacturer’s descriptions.
For this reason, to clarify the issuing situation, we have conducted a literature search on the object of investigation.
Purpose of the study. Search and critical analysis of modern literature sources on the topic of work using the principles of evidence-based medicine.
Material and Methods. A critical online review of the literature sources chosen for the research has been carried out in the Web of Science Thompson Reuters, Springer Link and Pubmed databases, as well as in research works and online articles 10 years deep. Inclusion criteria: research papers with a high index of evidence base. Exclusion criteria: literature sources with no evidence, low quality works.
Results and Discussion. The articleoutlines the natural role of proteins, lipids and the function of the cytolemma of intracellularorganoids in the restoration of damaged membranes of hepatocytes - de novo. Substantiating the obvious uselessness of using essential phospholipids in the treatment of liver diseases in general, fatty hepatosis in particular. The inability of penetration into liver cells for phospholipids in their native form and their alignment in thehepacyte membrane is indicated, since they belong to different biological species and have a mutually closed genetic system.
In the literature search undertaken by us on this issue, the analytical and critical review of scientific literature have also shown that when ingested, essential phospholipids have low bioavailability, as the phospholipids in the chylomicrons do not directly enter the liver, but first the lymphatic system through which they are transported to the adipose tissue of the organism, where they are accumulated and metabolized.
With parenteral administration, EPL spreading through the bloodstream can accumulate in other organs, systems, without reaching the liver tissue. For example, the largest amounts of EPL are usually found in the cell membranes of the nervous tissue and the brain.
Conclusion. Essential phospholipids in the form of soy lecithin products cannot replace the endogenous phospholipids of the human body - in principle.

References

Zhangabylov AK. Saumal, kumys – lechebnye svoistva [Saumal, koumiss - medicinal properties]. LAP Lambert academic Publishing RU. – 17 Meldrum Street, Beau Bassin 715046 Mauritius; 2018. 154 p.

Bimbetov B, Zhangabylov A, Аitbaeva С, et al. Mare’s milk: Therapeutic and dietary properies. Bulletin of National Academy of Sciences of the Republic of Kazakhstan. 2019;3(379): 52-58. DOI: 10.32014/2019.2518-1467.68

Kucheryavyy YuA, Morozov SV. Gepatoprotektory: ratsionalnye aspekty primeneniia. Uchebnoe posobie dlia vrachei [Hepatoprotectors: rational aspects of their use. A textbook for doctors]. M.: Forte Print; 2012. 36 p. ISBN 978-5-905757-24-2

Graham DY, Dore MP. Helicobacter pylori therapy: a paradium shift. Expert Rew AntiInfect Ther. 2016;14(6):577-85. DOI:10.1080/14787210.2016.1178065

Nikolsky BP. (ed.) Spravochnik khimika, tom 1, 2-e izd. [The Chemist's Handbook, Vol. 1, 2nd ed.] M.: Chemistry; 1996. 1072 p.

Topchiy NV, Toporkov AA. Diseases of the digestive system. RMZh = RMZh. 2012;35:1710 (In Russ.)

Wikimedia Foundation. Inc. Alpha GPC (gliatilin). Available from: https://ru.wikipedia.org/wiki/Alpha-GPC

Kuznetsov VI, Morrison VV, Lisko OB. Lipids in the structure and functioning of biochemical membranes (review). Caratovskii nauchno-prakticheskii zhurnal = Saratov Scientific and Practical Journal. 2014;10(2): 262-266 (In Russ.)

Davydov AS. Biologiia i kvantovaia mekhanika. Glava III. Belki i ikh biologicheskie funktsii. Glava IV. Kletochnye membrany [Biology and Quantum Mechanics. Chapter III. Proteins and their biological functions. Chapter IV. Cell membranes]. Kiev: Nauk, Dumka; 1979. 296 p.

Antonov VF. Biophysics of membranes. Sorovskii obrazovatelnyi zhurna = Sorovsk Educational Journal . 1996;6: 4-12 (In Russ.)

Troshin AS, Troshina VP. Fiziologiia kletki [Cell Physiology]. M.: "Education"; 1979. 118 p.

Mukhomedzyanova SV, Pivovarov YuI, Bogdanova OV, Dmitrieva LA, Shulunov AA. Biological membrane lipids in norm and pathology (literature review). Acta Biomedica Scientifica. 2017;2(5)1:43-49 (In Russ.) DOI: 10.12737/article_59e8bcd3d6fcb1.49315019

Lombard J, López-Garcίa P, Moreira D. The early evolution of lipid membranes and the three domains of life. Nat Rev Microbiol. 2012 Jun 11;10(7):507-15. DOI:10.1038 / nrmicro2815

Gennis R. Biomembrany: Molekuliarnaia struktura i funktsiia. Per. s angl. [Biomembranes: Molecular structure and function]. M.: World; 1997. 624 p.

Endoplazmaticheskii retikulum (EPR), funktsii. Funktsii agranuliarnogo endoplazmaticheskogo retikuluma. Funktsii granuliarnogo endoplazmaticheskogo retikuluma. [Endoplasmic reticulum (ER), functions. Functions of the agranular endoplasmic reticulum. Functions of the granular endoplasmic reticulum]. Available from: https://ru.wikipedia.org/wiki

Kanyukov VI. Strekalovskaya AD, Saneeva TA. Belki, lipidy: Uchebnoe posobie [Proteins, lipids]. Orenburg: Orenburg State University; 2012. 122 p.

Plant cells. Materials from Wikipedia. Available from: https://ru.wikipedia.org/wiki

18 Zyak GV, Drozdov AL, Shulga SM. Modern understanding of the biological properties of lecithin (lecture for doctors). Lektsii dlia praktikuiushchikh vrachei = Lectures for Practicing Doctors. 2010;15(2):123-135 (In Russ.)

Bilich G.L. Biologiia. V 4 tomakh [Biology. In 4 volumes]. - M.: Oniks Publishing House; 2019. 864 p.

Matveev AV. Gepatoprotektory. Analiz mezhdunarodnykh issledovanii po preparatam gruppy lekarstv dlia pecheni [Hepatoprotectors. Analysis of international studies on drugs in the group of drugs for the liver]. Simferopol, IG "ARIAL"; 2013. 384 с. ISBN 978-617-648-199-7

Gunderman KY. Essential phospholipids - essential therapy for non-alcoholic fatty liver disease. Meditsina (Almaty) = Medicine (Almaty). 2017;10(184):102-104 (In Russ.)

Zimmerman YS, Vologzhanina LG. Patient adherence to adherence to medical recommendations as an effective factor in increasing the effectiveness of treatment. Clinicalmedicine. 2015; 93(3):5-13 (In Russ.)

Nersesov AV, Zhankalova ZM, Raisova AM, et al. Characterization of outpatients suffering from liver conditions (Chronic viral hepatitis, hepatic steatosis, hepatic disease related todiabetesorobesity) managed under real life conditions and receiving a treatment with Essentiale® asanadjunctivetreatment to standard care (the results of multicenter study REPAIR. Meditsina (Almaty) = Medicine (Almaty). 2017; 9(183):12-143 (In Russ.)

Borisova IV, Palgova LK, Tarasova MA. The use of essential phospholipids in the treatment of medicinal liver damage during pregnancy. Zhurnal akusherstva i zhenskikh boleznei = Journal of ObstetricsandWomen'sDiseases. 2017; 66(2):14-23 (In Russ.)

Vasilenko IA, Dolgova GV, Sorokoumova GM, et al. Comparative study of hepatoprotective drugs Essentiale forte N, Phosphogliv, Essliver forte. RMZh = RMJ. 2013;13:681-684 (In Russ.)

Maev IV, Dicheva DT, Lebedeva EG, et al. The role of essential phospholipids in modern treatment regimens for non-alcoholic steatohepatitis. Consilium Medicum( prilozhenie) = Consilium Medicum (appendix). 2011;1:34-37 (In Russ.)

Oparin AG, Lavrova NV, Blagoveshchenskaya AV. Hepatoprotectors: tactics of clinical trials. Skhіdnoєvropeiskii zhurnal vnutrіshnoї ta sіmeinoї meditsini = The East Europe Journal of Internal and Family Medicine. 2016;1:75-81 (In Russ.). DOI: 10.15407/internalmed2016.01.075

Denisenya G. Essliver Forte: careful protection. Novaia apteka = New pharmacy. 2012;5:138–139 (In Russ.)

Ushkalova E.A. The place of essential phospholipids in modern medicine. Farmateka = Farmateka. 2003;10:10-15 (In Russ.)

Mekhtiev SN, Okovityy SV. Principles of choosing hepatoprotectors. Lechashchii vrach = Attending doctor. 2016; 8:31

(In Russ.)

Belovol AN, Knyazkova II. Clinical pharmacology of hepatoprotectors. Liki of Ukraine = Medicine of Ukraine. 2019;5-6(231-232):18-24 (In Russ.)

Mereshinsky MF, Cherkasova LS. Osnovy klinicheskoi biokhimii. [Fundamentals of Clinical Biochemistry]. M.: Medicine; 1965. 360 p.

Wang Z, Klipfell E, Brian JB, et. al. Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease. Nature. 2011; 472(7341): 57-63. DOI: 10.1038/nature09922

Goldacre Ben. Vsia pravda o lekarstvakh. Mirovoi zagovor farmkompanii [The whole truth about drugs. World conspiracy of pharmaceutical companies]. M.: RIPOL classic; 2016. 576 p. ISBN 978-5-519-65221-6

Semenova IV, Ponezheva ZhB. Actual principles of therapy chronic hepatitis of various etiologies. Arkhiv vutrennei meditsiny = Archives of Internal Medicine. 2015;6:34-42 (In Russ.). DOI: 10/20514/2226-6704-2015-0-6-14-20

Busalаeva EI, Tarasova LV, Matveeva TS. Hepatoprotectors in clinical practice. selection algorithm. Zdravookhanenie Chuashii = Healthcare of Chuvashia.2015; 2:18-21 (In Russ.)

Sukhanov DS, Okovityy SV. Hepatoprotectors properties of the problem. Terapevticheskii arkhiv = Therapeutic Archive. 2012; 81(2):62-68 (In Russ.)

Lieber CS, Weiss DG, Groszmannet R, et al. Veterans Affairs Cooperative Study of polyenylphosphatidylcholine in alcoholic liver disease: effects on drinking behavior by nurse/physician teams. Alcohol Clin Exp Res. 2003 Nov;27(11):1757-64. DOI: 10.1097/01.ALC.0000093744.12232.34

Lieber CS, Weiss DG, Groszmann R, et al. II. Veterans Affairs Cooperative Study of polyenylphosphatidylcholine in alcoholic liver disease. Alcohol Clin Exp Res. 2003 Nov; 27(11):1765-72. DOI: 10.1097/01.ALC.0000093743.03049.80

Bimbetov BR, Zhangabylov AK. Aitbaeva SA. The qualitative composition of sublimated mare’s milk. Medicine (Almaty).2019; 6(204):23-28 (In Russ.). DOI: 10.31082/1728-452X-2019-204-6-23-28

Published

2020-10-07

Issue

Section

Articles