??????????? ?? ??????? ??? ??????? ???? ????? ??????, ??????????? ??? ???? ????????? ???????? ?????? ??????? ??? ??? ?? ??. ??? ???????, ???????? ?????????????? ??? ????? ?????? - ??? ???????? ?????? ???? ?????? ???? ??????????? ????????? ????? ???????? ??? ???? ??. ??????????? ?? ???????? ?????? ?? ????? ????? ????? ??? ????????, ???? ?????????? ????? ???????? ??? ?????? ?????????? ????????? ??????? ??????? ????? ??? ???? ??? ???, ?????? ??????? ???????? ???? ?????????? ???? ?????? ???? ????. ??? ???????? ?????? ?????? ????????? ?? ?????? ??? ??????? ???? ???? ??? ????? ???????? ????????? ???? ??: ????? ???????, ??????????? ??????????, ?????? ????????? ?? ??????? ??????????.

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???? ?????????: ??????? ????? ?????: ?????? ??? ?? ?????? ?????? ???????

1.1 ?????????????? ????????? ????????? ?????

????????????? ????????, ???? (??????????????) ???? ???? ?????? "????? ?????" ??? ????? ????. ????????? ????????, ????? ??????? ????? ??????? ???, ??? ?????????? ??????????? ?? ?????? ?????? ??? ???????? ????????????? ???????? ?? ??. ???? ?????, 2018 ?? Nature ?????? ?????? ??????? UK ?????? ????????? ??? ??? ?? ???????? ???????????? ??? ???????? ????????????? ???? ????? - ??????? ??????? ???? ??? ?????? ??? ?????? ????? ?????? ??? ????????? ???? ???? ?????? ?? ???? ????, ???????? ??? ??? ????? ??????? ????? ?????. ??? ????????? "?????? ???? ?????? ?????????? ????" ?? ???????? ??? ??????? ????? ????? ???, ?????????? ??????????? ????????? ???? ?? ??? ??????? ? ????? ????.

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1.2 ?????? ?? ??? ??????????? ?????????? ???????

???????? ??????????? ???, ??????, ???????? ?? ???? ???? ?????? ?? ?????????? ?? ?????? ?????? ???? ????? ????, ??????? ??????????????? ???????? ??? ??????????? ??? ????????? ?????? ??. ?????? ????? ???, ?????? ??????????? ?? ??????-6-???????? (M6P) ?????, ?? ?????????? ??????? ???? ????? ???? ??????? ???? ?????? ??? ?????. ??????? ????? ?????????? ??? ?????????? ????? ?????? ?????????? ????? ???? ?? ??: ????????? ?????????? ?? ?????? ????????????? ??? ??????? ??? ?????? ??????, ?? ????????? ?? ????? ???????? ????? ????. ??? ?????? ?????? ???????? ????? ????? ???? ?????? ??? ?????? ???? ?? ??, ????? ??? ?????? ???? ????? ???? ????? ??? ??????????? ?????? ????? ????????? ???? ?? ??.

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???? ?????????: ??????????? ???????: ???????? ?????? ???????? ?? ???????? ????????

2.1 ?????????? ???????????: ?????? ????? "???? ??????? ???" ??????? ???? ??? ?????.

?????? ????? (???????? ???? ??????? ??? ?????? ???? ????????????? ?? ??? ?????) ????????? ????? ???????? ?????? ??? ?? ?????? ????? ???????? ???????? ??????? ??? ????. ????????? ?????????? ??????? ???? ??????????? ????????? ???? ????? ?????? ?????? ??? ??? ????? ?? ???, ?? ???????????? ????? ??????????? ?? M6P ???? ??? ??? ??? ????? ???????????? ???? ?? ????. ??? "??????-??????????" ???????? ?????????? (GLUT) ?????? ????? ????? ????? ???, ?????????????? ???????? ??????????????? ??????? ?????? ? ??? ????, ??? ??????????? ??? ????????????? ?? ?????????????????? ???? ??????? ??????? ??????? ?????? ???, ??????? ?????? ??? ??? ????? ????????? ??? ???? (???? 1).

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2.2 ?????? ????????: ?????? ???????? ?????? ?????????????? ?????

2023 ?? ?????? ????? ????????? ?????? ??? ?????????? ?????? ????????? ??? ??? ?? ???????????? ???? ???? ???????? ?????????? ?????? ??????? ???????? ?????? ?????? ????? ?????????? ???????? ???? ?????? ???? ????. ?????? ??? ????????? ??? ????????? ?????? ?????, ????????? MYC ?? ????????? ?????? ?????????? ?????? ??? ?? ???, ??? ?????? ?????? ??????????????? ?????? ???? ??? ??????? ?? ?? ?????? ??????????? ?????? ?? ??. ??? ?????????? ???? ????????? ????? ?????? ????? ??????????? ?? ????? ????? ?????? ??? ???, ??????? ?????????? ??? ???????? ???? ??????????? ?????? ?????.

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2.3 ?????????????? ???????: PD-L1 ?? "??????? ????" ???? ?????.

???? ??? ????????? ????? ???, ?????? ?????? ?????????????? ??????? ?????????? ????? ?? ?? ???? ?? ?? ???????? ???? ???????. ?????? ???????????????? ????????? ????, ?????????? ?????? ??? ?????? ??? N-??????????????? ????? ?????? ???? ???????? PD-L1 ?????????? ??????? ????? ?? ??? ??????????????? ???? ??? ????. ???? ????? "??????? ????" ????? ??? PD-L1 ?????????, ??????????????? ???????? ?? ????? ???? ???? ???? ??? ??? ?????? T ??? ?? ???????? ????? ???? ????. ??????? ????? ??????? ??, ?????? ?? ??????-PD-1 ??????????? ??????? ?????? ?????????? ??????? 78% ????? ???? ?? ??? ?? ??? ??????????? ??? ???????? ???? ? (???? 2).

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?????? ?????????: ??????????? ??? ?????? ?????: ???????? ?????? ????????? ????? ???

3.1 ????? ?????? ????????? ??????????

???? ?????? ?????? ?????????, ?????? ?????? ???????? ?????? ???? ??????? ???????? ?? ??. ??????????? ????????? ????????? ?????? ????? ????? 20% ?? ?????? ????? ??? ??? ??????? ?? ???, ?????? ?????? ?????? 40% ????? ??????? ?? ????, ?????? ???? ?????? ?? ?????? ??? ????? ?????? ???? ???? ????. ???? ??? ?????????? ???, ???????????? ??? ???????? ?????? ?? ???, ??????? ???????? ???? 2.3 ???????? ???? ?? ???, ??? ??????? ????????-?????? ??? ????? ????. ?????? ?????? MD ????????? ?????? ???????????? ??????? ???????? ?????? ??????????? ?????? ?? ????? ????????-??? ??????? ?????? ?? ???????????????? ???? ????? ?????? ???? ??? ?????? ?????? ?? ?? ????? ?????? ????.

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3.2 ?????? ?????? ?????? ??????????? ?????? ?????

???????? ????? ?????? ???? ?????????, ???? ?????? ?????? ???????? ????????? ????? ????. 2022 ?? ????? ??? ?? ????? I ?????? ?????? ????? (NCT05220739) ?????? ?? ?????? ??? ?????? ??? ??? ?????? ?? ??????? ?????? ??? ?? ???? ?????????. ????? ????????? ???? ????? ?????? 5g ??????? ??????? ??????? ??? ??????? ??? ????, ???? ???????? ?????? ?? ?????? DNA (ctDNA) ?????? ?????? ???? ??? ??? ?? ??? ?????. ???? ?????, ???????? ??????? 10 ????? ??? ??? ???, ?????????? ????? ?????? 15% ?? ???? ????? ???????? ???, ??????? ?????? ???????? ?????? ?????????? ????? ????.

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3.3 ???????????? ??? ???????? ????

????????? ????????? ??? ?? ?????? ??????? ????, ?????? ???? ???????????? (????? ??????????? ??????????? 5 ?? ???????? ?????? ????) ??? ???? ???????? ??? ?????????? ?????? ?? ??? ?? ????? ??? ????????? ???????? ???????????? ??????? ??. ?????????, ????? ?????? ???????? ??? ?? Escherichia coli ????? ?????? ????????? 20 ???????? ???? ?? ???? ???, ?????? ??????? ??????????? ????? ???????? ??????? ????????????? ????? 50 ? ??? ??? ????. ?? ?????, ????-???????? ????????????? ???????? ?????? ????? ????? ?????????? ???????????? 80% ????? ???? ?? ???? ???, ?????? ????????? ???? ?????? ???????? ????.

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????? ????????? ?????? ?? ?????????: ????????? ????????? ???? ????????

4.1 ?????????? ??????????? "?????? ????" ?????

?????? ??? ?????? ?????? ???? ?? ????? ????? ???. ?????? ???????? ?????????? (PMI) ??????? ????? ?? ???? ?????? ??? ??????-6-???????? ????????-6-???????? ??? ????????? ?? ???? ???, ?? ? ?????? ????????????? ???????? ???? ?????? ????. ??? "?????????? ???????" ????????? ?????????? ?????? ??????????? ????? ?????? 7% ? ??????? ?? ???, ?? ???????????? ??????? ?????? ???????? ?????? ?????????? ????? ????.

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4.2 ????????? ≠ ?????????: ??????? ????? ?????? ????

?????? ?????? GRAS (???????????? ??????? ???? ???????) ??????????? ??? ?????? ????? ???? ????? ?? ????, ?????? ???? ??????????? ??? ????????? ??? ??? ????? ???????? ??? ?????? ?????. ???? ?????? ??????????? ??????? ????? ?????? ??? ?????????? ???????? ?????? ??? ???? ??? ??? ???? ????, ????? ?????????? ????????? ?????????? (?????????????? ????) ?? ???????? ???? ?? ?????. ?? ???? ????? ??????? ????? ???????? ???????????? ?? ???????? ???????? ????????????? ??????? ?? ???? ?? ?????? ??.

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4.3 ????? ???????? ?? ??????????? ??????????? ??? ????????

"?????? ???? ????" ?? ??????? ???????? ????? ???, ???? ???????? ?????? ?????? ?????????? ???????? ?????? ???????????? ???? ??. ?????? ?????? FDA ????? ??????? ???? ?????? ?????????? ???? ?????????? ????? ?????? ?????? ???? ?????? ?? ??? ???, "???? ????????? ??? ????????? ????????????? ?? ??????" ?? ??????? ????. ?????? ????? ???????? ????? ????? ?? ????????? ??????? ????? ???? ???????? ???? ??????????? ??????? ??? ??? ???????????? ????? ??????.

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??????: ?????? ???????? ????? ???????

?????? ?? ?????? ?????? ??? ???????????? ?????? ?? ???? ???????? ???????? ???????? ????? ???, ?????? ???? ??????????? ???????? ? ??. ?????????? ?????????????? ?????? ??? ?????????????? ???????? ?????? ?????????????? ????? ?????, ????????? ??????? ???? ??? ??? ???????????? ?????, ??? "?????? ???????" ?????? ??????????? ???? ??? ???? ??????? ????. ????? ?????? ??????? ??????? ??????, ?????? ?? ????? ?? ???????-???? ????? ??? ???????? ???????? ?????? ?????? ?? ?????? ??? ?? ???? ?? ???????? ?? ?????. ??????????? ????? ?????? ?????: "???????? ??????????? ??? ??? ???, ???????? ????????? ????? ??????? ??? ?? ??."

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