Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC1299610.15690/vramn12996PEDIATRICS: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ ПЕДИАТРИИResearch ArticleParadigm Shift: New Approaches to Understanding Autism Spectrum DisordersСмена парадигмы: новые подходы к пониманию расстройств аутистического спектраhttps://orcid.org/0000-0002-3167-082XUstinovaNatalia V.УстиноваНаталия Вячеславовна
Russian Federation

MD, PhD

д.м.н.

ust-doctor@mail.ruhttps://orcid.org/0000-0002-2209-7531Namazova-BaranovaLeyla S.Намазова-БарановаЛейла Сеймуровна
Russian Federation

MD, PhD, Professor, Academician of the RAS

д.м.н., профессор, академик РАН

orgkomitet@pediatr-russia.ruhttps://orcid.org/0000-0003-3987-8112BaranovAlexandr A.БарановАлександр Александрович
Russian Federation

MD, PhD, Professor, Academician of the RAS

д.м.н., профессор, академик РАН

baranov@pediatr-russia.ruhttps://orcid.org/0000-0001-7398-0562VishnevaElena A.ВишневаЕлена Александровна
Russian Federation

MD, PhD, Professor of the RAS

д.м.н., профессор РАН

vishneva.e@yandex.ruhttps://orcid.org/0000-0002-8936-3590KaitukovaElena V.КайтуковаЕлена Владимировна
Russian Federation

MD, PhD

к.м.н.

sunrise_ok@mail.ruhttps://orcid.org/0000-0002-4955-0121TurtiTatiana V.ТуртиТатьяна Владимировна
Russian Federation

MD, PhD

д.м.н.

turti@mail.ruhttps://orcid.org/0000-0003-4314-8366AlbitskiyValeriy Yu.АльбицкийВалерий Юрьевич
Russian Federation

MD, PhD, Professor

д.м.н., профессор

albicky1941@yandex.ruhttps://orcid.org/0000-0002-3678-7939SelimzianovaLilia R.СелимзяноваЛилия Робертовна
Russian Federation

MD, PhD

к.м.н.

lilysir@mail.ruhttps://orcid.org/0009-0001-0440-2715GorbunovaElena A.ГорбуноваЕлена Алексеевна
Russian Federation

MD, PhD

к.м.н.

lema020817@gmail.ruhttps://orcid.org/0000-0003-0317-2425EfendievaKamilla E.ЭфендиеваКамилла Евгеньевна
Russian Federation

MD, PhD

к.м.н.

kamillaef@inbox.ruResearch Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of SurgeryНИИ педиатрии и охраны здоровья детей НКЦ № 2 «РНЦХ им. акад. Б.В. Петровского»Scientific and Practical Center for Mental Health of Children and Adolescents Named after G.E. SukharevaНаучно-практический центр психического здоровья детей и подростков им. Г.Е. СухаревойPirogov Russian National Research Medical UniversityРоссийский национальный исследовательский медицинский университет имени Н.И. Пирогова231220237865896000506202301122023Copyright ©; 2023, "Paediatrician" Publishers LLCCopyright ©; 2023, Издательство "Педиатръ"2023"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/about/submissionshttps://vestnikramn.spr-journal.ru/jour/article/view/12996

A significant increase in the prevalence of autism spectrum disorders (ASD), both worldwide and in our country, dictates the need to search for modern and effective methods of prevention, diagnosis and medical care for such patients. At the same time, the results of numerous biomedical research in the field of autism are not reflected in practical healthcare. Aims of this work — substantiation of new approaches to the organization of medical care for people with ASD. The results of promising areas of autism research in the field of genetics, epigenetics, metabolomics, microbiome and multimorbidity, which marked a paradigm shift in the understanding of autism spectrum disorders, and requiring implementation in practice, are analyzed. Based on the concept of 7-p pediatrics (programming child development and health, preventive, predictive, personalized, participatory, multiprofessional, progressive), the necessity and possibility of implementing the results of scientific research into real clinical practice of managing children with autism are substantiated. The results of fundamental scientific research in the field of ASD, revealing their complex and multifaceted nature, allow us to talk about a paradigm shift in understanding this disorder Based on a new concept of medical care — 7P-pediatrics — the results of scientific research can be translated into real clinical practice, including diagnostic, therapeutic, preventive and rehabilitative effects on autism, as well ase programming of the optimal trajectory of the cognitive-behavioral phenotype of children with neurodevelopmental features, including ASD.

Значительный рост распространенности расстройств аутистического спектра (РАС) как во всем мире, так и в нашей стране диктует необходимость поиска современных и эффективных методов профилактики, диагностики и оказания медицинской помощи таким пациентам. При этом результаты многочисленных медико-биологических исследований в области аутизма не находят отражения в практическом здравоохранении. Цель работы — обоснование новых подходов к организации медицинской помощи людям с РАС. Методы. Проанализированы результаты перспективных направлений исследований аутизма в области генетики, эпигенетики, метаболомики, микробиома и мультиморбидности, ознаменовавшие смену парадигмы в понимании расстройств аутистического спектра и требующие имплементации в практическую деятельность. На базе концепции 7П- педиатрии (программирующая развитие и здоровье ребенка, профилактическая, предиктивная, персонализированная, партисипативная, полипрофессиональная, прогрессивная) обоснованы необходимость и возможность имплементации результатов научных исследований в реальную клиническую практику ведения детей с аутизмом. Результаты фундаментальных научных исследований в области РАС, раскрывающие их сложную и многогранную природу, позволяют говорить о смене парадигмы в понимании этого расстройства. На основе новой концепции медицинской помощи — 7П-педиатрии — результаты научных исследований могут транслироваться в реальную клиническую практику, включая диагностические, терапевтические, профилактические и реабилитационные воздействия в отношении аутизма, а также программирование оптимальной траектории когнитивно-поведенческого фенотипа детей с особенностями нейроразвития, включая РАС.

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