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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">avk</journal-id><journal-title-group><journal-title xml:lang="ru">Архивъ внутренней медицины</journal-title><trans-title-group xml:lang="en"><trans-title>The Russian Archives of Internal Medicine</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2226-6704</issn><issn pub-type="epub">2411-6564</issn><publisher><publisher-name>“SINAPS” LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.20514/2226-6704-2025-15-3-165-177</article-id><article-id custom-type="edn" pub-id-type="custom">ACHXWS</article-id><article-id custom-type="elpub" pub-id-type="custom">avk-2002</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>ОБЗОРНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW ARTICLES</subject></subj-group></article-categories><title-group><article-title>Болезнь Альцгеймера: влияние микрофлоры кишечника и половых различий на патогенез и стратегии лечения</article-title><trans-title-group xml:lang="en"><trans-title>Alzheimer’s Disease: The Impact of Gut Microbiota and Sex Differences on Pathogenesis and Treatment Strategies</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9357-4983</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абдель-Сатер</surname><given-names>Х. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Abdel-Sater</surname><given-names>Kh. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Халед А. Абдель-Сатер — д.м.н., профессор кафедры медицинской физиологии стоматологических и медицинских наук</p><p>Карак </p></bio><bio xml:lang="en"><p>Khaled A. Abdel-Sater — MD, prof. of medical physiology, Department of Dental and Medical Sciences</p><p>Karak </p></bio><email xlink:type="simple">Kabdelsater@mutah.edu.jo</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Стоматологический факультет, Университет Мута</institution><country>Иордания</country></aff><aff xml:lang="en"><institution>Faculty of Dentistry, Mutah University</institution><country>Jordan</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>26</day><month>05</month><year>2025</year></pub-date><volume>15</volume><issue>3</issue><fpage>165</fpage><lpage>177</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Абдель-Сатер Х., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Абдель-Сатер Х.</copyright-holder><copyright-holder xml:lang="en">Abdel-Sater K.</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://www.medarhive.ru/jour/article/view/2002">https://www.medarhive.ru/jour/article/view/2002</self-uri><abstract><p>Болезнь Альцгеймера (БА) — глобальное заболевание. Наиболее важным в патогенезе БА является увеличение отложений амилоидного белка бета (Aβ) и патологическое скопление тау-белка. В развитии болезни принимае т участие ряд этиологических факторов, таких как возраст, генетика, образ жизни, факторы окружающей среды и микрофлора кишечника (МК). Нарушение регуляции МК — один из факторов патогенеза БА, который способствует нарушению когнитивной функции, включая скопление Aβ и тау-белка, выработку нейромедиаторов и метаболитов, нарушение иммунной регуляции, нейровоспаление, нарушение гематоэнцефалитического барьера, оксидативный стресс и синдром раздраженного кишечника.Половые различия могут быть важным фактором патогенеза БА. Около 75 % пациентов с БА являются женщинами. Преобладание БА у женщин связано с генетикой, структурой и функцией головного мозга, эстрогеном, образом жизни (например, образование, род деятельности, уровень физической активности и продолжительность сна) и случаями инфекционно-воспалительных заболеваний. Поскольку продолжительность жизни у женщин больше, чем у мужчин, женщины более склонны к БА.В настоящей статье рассматривается роль МК и половые различия при БА. В начале статьи приводится краткое описание характеристик микрофлоры кишечника и половых различий при БА. В работе рассматриваются перспективные терапевтические стратегии при БА, направленные на МК.</p></abstract><trans-abstract xml:lang="en"><p>Alzheimer’s is a global disease (AD). The most important pathogenesis of AD is the increase in the amyloid-β protein (Aβ) deposition, and abnormal phosphorylation aggregation of the microtubule-associated protein tau. Many etiological factors are implicated in the production of AD such as age, genetics, lifestyle, environmental factors, and gut microbiota (GM). Dysregulation of GM contributes to AD pathogenesis and cognitive impairment via several mechanisms, including Aβ and Tau protein aggregation, production of neurotransmitters and metabolites, immune dysregulation, neuroinflammation, blood-brain barrier disruption, oxidative stress, and leaky gut.Sex differences might be an important factor for AD pathogenesis. About 75 % of AD patients are females. The higher prevalence of AD in females is due to their genetics, brain structure, and function, estrogen, lifestyle factors (e.g., education, occupation, exercise, and sleep), and incidences of infection and inflammations. Because women live longer than men do, they are more likely to get AD.This article discusses the role of the GM and sex differences in AD. It begins with an overview of the gut-microbiota axis and sex differences in AD. It discusses promising therapeutic strategies for AD targeting GM.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>болезнь Альцгеймера</kwd><kwd>микрофлора кишечника</kwd><kwd>половые различия</kwd><kwd>амилоидный белок бета</kwd><kwd>тау-белок</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Alzheimer’s disease</kwd><kwd>gut microbiota</kwd><kwd>sex differences</kwd><kwd>amyloid-β protein</kwd><kwd>tau protein</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Meng X, Su J, Li H, et al. Effectiveness of caregiver non-pharmacological interventions for behavioural and psychological symptoms of dementia: An updated meta-analysis. Ageing Res Rev. 2021 Nov: 71: 101448. doi: 10.1016/j.arr.2021.101448. Epub 2021 Aug 17.</mixed-citation><mixed-citation xml:lang="en">Meng X, Su J, Li H, et al. 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