ИЗМЕНЕНИЯ МИКРОФЛОРЫ ПОЛОСТИ РТА И РАЗВИТИЕ ОРАЛЬНОГО МУКОЗИТА ПРИ ПРОВЕДЕНИИ СИСТЕМНОЙ ПРОТИВООПУХОЛЕВОЙ ТЕРАПИИ У БОЛЬНЫХ СО ЗЛОКАЧЕСТВЕННЫМИ НОВООБРАЗОВАНИЯМИ

Abstract

This paper is devoted to the problem of the relationship between the oral microflora and oral mucositis (OM) induced by systemic anti-tumour therapy in patients with malignant neoplasms (MN). The paper covers current views on the composition of the normal oral microbiota and its changes during chemotherapeutic treatment. It is shown that normal oral microbiota includes representatives of such genera as Actinomyces, Corynebacterium, Fusobacterium, Leptotrichia, Neisseria, Prevotella, Streptococcus, Veillonella and others. It is emphasized that even despite the existence of modern molecular genetic techniques and the formation of a database of oral microbiota, it is still difficult to determine the role of individual taxonomic units in oral homeostasis. Existing studies of changes in the qualitative and quantitative composition of oral microflora against the background of anticancer therapy have demonstrated that treatment is associated with significant changes in the oral microbiological landscape, namely increasing the number of Gram-negative anaerobic opportunistic pathogenic flora and decreasing representation of protective commensal flora. It is demonstrated that bacterial cell components can modulate local macroorganism reaction through the system of Toll-like receptors, thus acting multidirectionally. A number of unresolved fundamental questions relating to the place of the oral microbiota in the pathogenesis of OM have also been highlighted.