Особливості цитокінового статусу та активність запального процесу в осіб з генералізованим пародонтитом на тлі хронічного тонзиліту

Abstract

Introduction. The relationship of pathological processes occurring in the periodontal tissues and pharyngeal area had great importance due to the similarity of their etiological and pathogenetic stages. Recent studies have shown that cytokines are triggers of the inflammatory process in periodontal tissues and predictors of progression of pathological changes in them. Therefore, while studying the pathogenesis of generalized periodontitis on the background of chronic tonsillitis, it is important to assess the synergistic effect of proinflammatory cytokines, which can be markers of local changes and diagnostic criteria for severity and activity of pathological inflammatory process in periodontal tissues. The aim of the study was to study the level of proinflammatory cytokines and acute phase proteins in the serum of patients with generalized periodontitis on the background of chronic tonsillitis. Material and methods. The clinical and immunological study involved 97 patients aged 18 to 59 years, of which formed 3 study groups: group I – 32 people with periodontal disease on the background of chronic tonsillitis (CT); group II – 35 people with periodontal lesions without concomitant CT; control – 30 clinically healthy individuals. Results. The study of cytokine status in the serum showed a probable increase in levels of proinflammatory cytokines γ-IFN, TNF-α, IL-1β, IL-6 in patients of study group I compared with other groups, indicating a «cytokine explosion». There was a tendency of the hyperergic reaction formation and generalization of inflammatory process. The reflection of the degree of inflammatory process in patients with gingivitis and periodontitis on the background of chronic tonsillitis was an increased concentration of bone resorption marker IL-1β, which was determined as highest in group I with gingivitis and generalized periodontitis initial – I stage. The maximum level of C-reactive protein was determined in group I (4.4 times higher than in the control). Conclusions. Particular attention should be paid to patients of group I with periodontal disease on the background of CT, where level of the studied parameters was the highest compared to the data of other study groups. It should be added that depending on the degree of inflammatory and dystrophic-inflammatory processes in periodontal tissues an increased overproduction of IL-1β in serum could be reliably considered as an indicator of activity and progression of periodontal disease accompanying with chronic tonsillitis. Key words: periodontium, periodontitis, gingivitis, chronic tonsillitis, inflammation, cytokines.