rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2025-28-6-476-482zegziorosped-2006Research ArticleОБЗОРЫREVIEWSРоль полиненасыщенных жирных кислот в развитии аллергических заболеванийThe role of polyunsaturated fatty acids in the development of allergic diseaseshttps://orcid.org/0000-0001-8549-9493МухортыхВалерий АлексеевичMukhortykhValeriy A.

Канд. мед. наук, врач — аллерголог-иммунолог ФГБУ «ФНКЦ детей и подростков» ФМБА России; доцент каф. педиатрии и детской хирургии, ФГБУ «ГНЦ федеральный медицинский биофизический центр им. А.И. Бурназяна» ФМБА России; науч. сотр., отделение аллергологии и диетотерапии, ФГБУН «ФИЦ питания и биотехнологии»

e-mail: valera-89@yandex.ru

Allergist-immunologist, Federal Scientific and Clinical Center for Children and Adolescents of the Federal Medical and Biological Agency; research, Department of allergology and dietary therapy, State Scientific Center of the Russian Federation — A.I. Burnazyan Federal Medical Biophysical Center of the Federal Medical and Biological Agency; associate prof. of pediatrics and pediatric surgery, Federal Research Center for Nutrition, Biotechnology and Food Safety

e-mail: valera-89@yandex.ru

valera-89@yandex.ruhttps://orcid.org/0000-0001-7640-0754ЛарьковаИнна АнатольевнаLarkovaInna A.

Канд. мед. наук, ст. науч. сотр., отделение аллергологии и диетотерапии, ФГБУН «ФИЦ питания и биотехнологии»; ст. науч. сотр., лаб. клинической иммунологии и аллергологии, ФГАУ «НМИЦ здоровья детей» Минздрава России

e-mail: 1inna_larkova@mail.ru

1inna_larkova@mail.ruhttps://orcid.org/0000-0002-5620-2803ТармаеваНаталия АнатольевнаTarmaevaNataliya A.

Мл. науч. сотр., отделение аллергологии и диетотерапии, ФГБУН «ФИЦ питания и биотехнологии»

e-mail: Nataliia_tarm@mail.ru

Nataliia_tarm@mail.ruhttps://orcid.org/0000-0002-1149-7927РевякинаВера АфанасьевнаRevyakinaVera A.

Доктор мед. наук, зав. отделением аллергологии и диетотерапии, ФГБУН «ФИЦ питания и биотехнологии»; гл. науч. сотр. лаб. клинической иммунологии и аллергологии ФГАУ «НМИЦ здоровья детей» Минздрава России

e-mail: 5356797@mail.ru

5356797@mail.ruФГБУ «Федеральный научно-клинический центр детей и подростков» ФМБА России; ФГБУ «ГНЦ федеральный медицинский биофизический центр им. А.И. Бурназяна» ФМБА России; ФГБУН «ФИЦ питания и биотехнологии»Federal Scientific and Clinical Center for Children and Adolescents of the Federal Medical and Biological Agency; State Scientific Center of the Russian Federation — A.I. Burnazyan Federal Medical Biophysical Center of the Federal Medical and Biological Agency; Federal Research Center for Nutrition, Biotechnology and Food SafetyФГБУН «ФИЦ питания и биотехнологии»; ФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава РоссииFederal Research Center for Nutrition, Biotechnology and Food Safety; National Medical Research Center for Children’s HealthФГБУН «ФИЦ питания и биотехнологии»Federal Research Center for Nutrition, Biotechnology and Food Safety202515012026286476482Copyright © Мухортых В.А., Ларькова И.А., Тармаева Н.А., Ревякина В.А., 20262026Мухортых В.А., Ларькова И.А., Тармаева Н.А., Ревякина В.А.Mukhortykh V.A., Larkova I.A., Tarmaeva N.A., Revyakina V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rosped.ru/jour/article/view/2006Введение

Введение. Неуклонный рост распространённости и тяжести аллергических болезней определяет необходимость поиска новых противоаллергических средств и превентивных стратегий. Наряду с генетической предрасположенностью, значимое влияние на формирование иммунного ответа и риск развития атопии оказывают факторы окружающей среды, в особенности характер питания в критические периоды раннего онтогенеза. Центральное место в этом процессе занимают полиненасыщенные жирные кислоты (ПНЖК), дисбаланс между потреблением провоспалительных ω-6 и противовоспалительных ω-3 ПНЖК рассматривается как один из ключевых факторов, влияющих на эпидемиологию аллергических болезней. Цель: определить влияние ПНЖК на развитие и течение аллергических болезней и оценить потенциальные возможности их применения для профилактики и терапии аллергии.

Материалы и методы

Материалы и методы. Проведён анализ изменений уровней ПНЖК во время беременности, лактации, у детей раннего возраста в связи с маркерами иммунного ответа и исходами аллергических болезней. Особое внимание уделено роли полиморфизмов генов кластера FADS (FADS1, FADS2), кодирующих ферменты десатуразы, в модуляции эффектов ПНЖК.

Результаты

Результаты. Биологические эффекты ω-6 (арахидоновая кислота) и ω-3 (эйкозапентаеновая и докозагексаеновая кислоты) ПНЖК противоположны. Метаболиты арахидоновой кислоты (простаноиды и лейкотриены) поддерживают аллергическое воспаление, способствуют поляризации иммунного ответа по Th2-типу и синтезу IgE. Напротив, ω-3 ПНЖК конкурируют с арахидоновой кислотой за ферменты, подавляя синтез провоспалительных эйкозаноидов и способствуя образованию специализированных медиаторов, которые разрешают воспаление и способствуют формированию иммунной толерантности. Показано, что приём добавок ω-3 ПНЖК во время беременности и лактации ассоциирован со снижением риска развития атопического дерматита, сенсибилизации к пищевым аллергенам (особенно к яичному белку) и бронхиальной астмы у детей, причём эффекты могут сохраняться в течение многих лет. Обогащение детских молочных смесей ПНЖК приближает их иммуномодулирующие свойства к таковым у грудного молока. Эффективность вмешательств с применением ПНЖК существенно зависит от генетического профиля. Взаимодействие генотип–диета является критическим фактором: диетические вмешательства (например, грудное вскармливание, повышенное потребление рыбы) демонстрируют выраженный защитный эффект именно у носителей определённых генотипов.

Заключение

Заключение. ПНЖК играют значимую роль в модуляции иммунных процессов, лежащих в основе патогенеза аллергических болезней. Добавки ω-3 ПНЖК в перинатальном периоде определяют значительный потенциал для первичной профилактики атопии.

Участие авторов

Участие авторов: Мухортых В.А., Ларькова И.А. — концепция и дизайн исследования; Мухортых В.А., Ларькова И.А., Тармаева Н.А. — анализ и обобщение полученных данных, написание текста рукописи; Ревякина В.А. — редактирование. Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Научно-исследовательская работа проведена за счёт средств субсидии на выполнение государственного задания в рамках Программы фундаментальных научных исследований (FGMF-2025-0003).

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила 06

Поступила 06.11.2025Принята к печати 27.11.2025Опубликована 25.12.2025

Introduction

Introduction. The steady increase in the prevalence and severity of allergic diseases worldwide necessitates the search for new pathogenetic mechanisms and preventive strategies. In addition to genetic predisposition, environmental factors, particularly the nature of nutrition during critical periods of early ontogenesis, have a significant impact on the development of the immune response and the risk for atopy. Polyunsaturated fatty acids (PUFAs) play a central role in this process, and the imbalance between the consumption of pro-inflammatory omega-6 and anti-inflammatory ω-3 PUFAs is considered a key factor in the epidemiology of allergic diseases. The aim. To systematize current data on the role and mechanisms of the effect of long-chain PUFA on the risk of development and course of allergic diseases, as well as to assess the potential for their use in prevention and therapy, taking into account genetic features of metabolism.

Materials and methods

Materials and methods. The analysis of data from epidemiological, observational, and intervention studies, as well as systematic reviews, devoted to the study of the relationship between the consumption of PUFAs (both with food and in the form of supplements) during pregnancy, lactation, and early childhood with markers of immune response and clinical outcomes of allergic diseases. Special attention is paid to the role of polymorphisms of genes of the FADS cluster (FADS1, FADS2), encoding desaturase enzymes, in the modulation of the effects of PUFAs.

Results

Results. The biological effects of ω-6 (arachidonic acid, ArA) and ω-3 (eicosapentaenoic acid, EPA and docosahexaenoic acid, DHA) PUFA were established to be opposite. ARA metabolites (prostaglandins, leukotrienes) provoke and support allergic inflammation, promote the polarization of the Th2-type immune response and IgE synthesis. On the contrary, ω-3 PUFAs compete with arcs for enzymes, suppressing the synthesis of pro-inflammatory eicosanoids and promoting the formation of specialized resolving mediators (SRM) that resolve inflammation and promote the formation of immune tolerance. Taking ω-3 PUFA supplements during pregnancy and lactation has been shown to be associated with a reduced risk of atopic dermatitis, sensitization to food allergens (especially egg white) and bronchial asthma in children, and the effects can persist for many years. The enrichment of infant formula with PUFA brings their immunomodulatory properties closer to those of breast milk. The effectiveness of PUFA interventions significantly depends on the genetic profile. Carriers of minor alleles of polymorphisms of the FADS genes are characterized by reduced desaturase activity, which leads to lower baseline concentrations of PUFA (especially ARA) and, as a result, to a greater susceptibility to the positive effects of supplementation of ω-3 PUFA and to a potentially lower risk of developing allergies mediated by reduced synthesis of proinflammatory mediators. The “genotype-diet” interaction is a critical factor: dietary interventions (for example, breastfeeding, increased consumption of fish) demonstrate the most pronounced protective effect in carriers of certain genotypes. At the same time, the data from individual studies are contradictory, which may be due to differences in research design, dosages, initial nutritional status of participants and their genetic background.

Conclusion

Conclusion. Long-chain PUFA play a fundamental role in the modulation of immune processes underlying the pathogenesis of allergic diseases. ω-3 PUFA supplementation during the perinatal period and early childhood demonstrates significant potential for the primary prevention of atopy. However, further large-scale prospective studies are required to develop personalized recommendations, taking into account the genetic characteristics of PUFA metabolism (primarily, the FADS cluster polymorphisms), which will allow identifying target populations, optimal doses, timing, and duration of interventions to maximize their clinical effectiveness.

Contribution

Contribution: Mukhortykh V.A., Larkova I.A. — creation of the concept, construction of sections of the work; Mukhortykh V.A., Larkova I.A., Tarmaeva N.A. — work with literature sources, analysis and generalization of the data obtained, writing the text; Revyakina V.A. — editing the text. All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment

Acknowledgment. The research work on the preparation of the manuscript was carried out using funds from a subsidy for the implementation of a state assignment within the framework of the Fundamental Scientific Research Program (FGMF-2025-0003).

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: November 06, 2025Accepted: November 27, 2025Published: December 25, 2025

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The authors declare that there are no conflicts of interest present.