Журнал «Боль. Суставы. Позвоночник» Том 15, №4, 2025

Актуальність. Хронічне низькоінтенсивне запалення (ХНІЗ) є ключовим патофізіологічним механізмом, який лежить в основі широкого спектра сучасних мультифакторних захворювань, включаючи депресію, тривожні розлади, метаболічний синдром, остеоартрит і хронічний біль. Актуальність пошуку нових інструментів для метаболічної регуляції запалення, нейроімунної взаємодії та зменшення больового навантаження постійно зростає. Мета: оцінити патогенетичну роль незамінних амінокислот (НАК) у механізмах ХНІЗ, стресових і больових розладів, а також обґрунтувати ефективність їх інтегративного нутрицевтичного застосування у складі комплексної терапії. Матеріали та методи. Виконано систематичний аналіз наукових публікацій, включаючи експериментальні та клінічні дослідження, огляди, метааналізи та довідкові джерела з баз даних PubMed, Scopus, Web of Science та Cochrane Library за 2010–2025 роки. Результати. L-триптофан, метіонін, розгалужені амінокислоти, лізин, фенілаланін і треонін багатовекторно впливають на регуляцію імунної відповіді, епігенетичні механізми, нейромедіаторний баланс і оксидативний гомеостаз. Поєднання НАК може вважатися патогенетично обґрунтованим підходом у комплексній нутрицевтичній терапії станів, що супроводжуються ХНІЗ, нейроендокринною дизрегуляцією та больовими синдромами. Біохімічна комплементарність і функціональна взаємодія цих амінокислот забезпечує багатовекторний вплив на провідні механізми цих патологічних процесів. Висновки. НАК відіграють важливу роль у регуляції ХНІЗ, стресових розладів та хронічного болю завдяки своїм метаболічним, нейромодуляторним і імунорегуляторним властивостям. Синергія НАК в одному нутрицевтичному комплексі забезпечує багатовекторну дію — від модуляції серотонінового та кінуренінового метаболізму до регуляції епігенетичних процесів, антиоксидантного захисту, функції кишкового бар’єра та енергетичного обміну, що є особливо цінним при мультифакторних патологічних станах. Інтегративна нутрицевтична стратегія із застосуванням НАК у поєднанні з вітамінними кофакторами має перспективи клінічного впровадження як допоміжний підхід до корекції запальних, психоемоційних і метаболічних розладів, особливо в умовах нутрієнтного дефіциту, мультиморбідності та стрес-індукованої дизрегуляції.

Background. Chronic low-grade inflammation (CLGI) represents a key pathophysiological mechanism underlying a broad spectrum of contemporary multifactorial disorders, including depression, anxiety disorders, metabolic syndrome, osteoarthritis, and chronic pain. The demand for novel tools for metabolic regulation of inflammation, neuroimmune interaction, and reduction of pain burden is steadily increasing. This study purpose was to evaluate the pathogenetic role of essential amino acids (EAAs) in the mecha­nisms of CLGI, stress-related, and pain disorders, and to substantiate the efficacy of their integrative nutraceutical use within comprehensive therapeutic strategies. Materials and methods. A systema­tized analysis of scientific literature was performed, including experimental and clinical studies, reviews, meta-analyses, and refe­rence sour­ces from the PubMed, Scopus, Web of Science, and Cochrane Library databases, covering the period from 2010 to 2025. Results. L-tryptophan, methionine, branched-chain amino acids, lysine, phenylalanine, and threonine exert multifaceted effects on immune response regulation, epigenetic mechanisms, neurotransmitter ba­lance, and oxidative homeostasis. The combined use of EAAs can be considered a pathogenetically justified approach in the comprehensive nutraceutical therapy of conditions associated with chro­nic low-grade inflammation, neuroendocrine dysregulation, and pain syndromes. The biochemical complementarity and functional interaction of these amino acids provide a multidirectional impact on the key mechanisms underlying these pathological processes. ­Conclusion. EAAs play an important role in the regulation of CLGI, stress disorders, and chronic pain due to their metabolic, neuromo­dulatory, and immunoregulatory properties. The synergistic combination of EAAs in a single nutraceutical complex ensures a multidirectional action ganging from modulation of serotonin and kynure­nine metabolism to regulation of epigenetic processes, antioxidant defense, gut barrier function, and energy metabolism, which is parti­cularly valuable in multifactorial pathological conditions. An integrative nutraceutical strategy utilizing EAAs in combination with vitamin cofactors holds promise for clinical implementation as an adjunctive approach to correct inflammatory, psychoemotional, and metabolic disorders, particularly under conditions of nutrient deficiency, multimorbidity, and stress-induced dysregulation.

незамінні амінокислоти; нутрицевтики; хронічне низькоінтенсивне запалення; стрес; біль; нейроімунна регуляція; огляд

essential amino acids; nutraceuticals; chronic low-grade inflammation; stress; pain; neuroimmune regulation; review

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