Abstract
The purpose of the study was to investigate local resistance of the oral cavity in industrial workers with harmful factors, patients with generalized periodontitis. Materials and methods. For this study, 2 examination groups were formed. The main group (61 people) includes employees of three industrial productions of the Ivano-Frankivsk region: employees of chemical production, glass production and agro-industrial complex. The control group consisted of 30 conditionally healthy individuals with intact periodontium. The age of the examinees was 25–55 years. Work experience in production is from 0.5 to 15 years. In order to study the state of local resistance in generalized periodontitis under the influence of harmful factors of the production environment, individual indicators of the immunity of the capillary blood of the gums and oral fluid were studied: the total number of leukocytes and lymphocytes; to evaluate the T-system of immunity, calculation of subpopulations of lymphocytes was performed using monoclonal antibodies CD-3, CD-4, CD-8; the level of immunoglobulins IgA, IgG and sIA; circulating immune complexes; phagocytic index, spontaneous nitroblue tetrazolium test. Results and discussion. A comparative evaluation of the results of immunological research in 61 patients with generalized chronic periodontitis of the main group and 30 healthy individuals of the control group indicated certain changes in the quantitative data of cellular and humoral factors and deviations in the functional activity of individual parameters of non-specific protection in the capillary blood of the gums of patients compared to the indicators of individuals with intact periodontium. The total number of leukocytes and lymphocytes in workers with generalized periodontitis remained within the generally accepted norm and differed insignificantly from the similar indicators of the healthy group. At the same time, a difference in the subpopulation composition of T-lymphocytes was revealed. According to absolute indicators, the number of CD4+ lymphocytes in patients with generalized periodontitis was 0.57 ± 0.04109/l, which is by 1.2 times lower compared to 0.68 ± 0.03109/l in healthy individuals. The obtained indicators of CD4+ and CD8+ lymphocytes made it possible to state a decrease in the value of the immunoregulatory index in workers with generalized periodontitis by 19.31% from the value of healthy people (1.63 ± 0.04 versus 2.02 ± 0.02), which is characteristic of immunodepressive conditions. In patients of the main group, an increase in IgA production was recorded on average to 2.05 ± 0.06 g/l, which is by 11.41% higher compared to the indicator (1.84 ± 0.02 g/l) of the control group. In workers of industries with harmful factors, with a dystrophic-inflammatory process in the periodontium, the level of average globular circulating immune complexes exceeded the value of healthy people (0.10 ± 0.03 mg/ml) by 2.5 times. This may indicate exhaustion of the clearance function of the phagocytic system and the development of hyperimmune complex syndrome. Conclusion. Having studied individual indicators of the capillary blood of the gums and oral fluid, we can conclude that in chronic exogenous intoxication with industrial xenobiotics, phenomena of acquired combined immune deficiency were observed, which were manifested by a decrease in the immuno-regulatory index CD4+/CD8+; a violation in the humoral link of immunity – activation of IgA, IgG production and a decrease in sIgA secretion, disorders of the phagocytic system, manifested by a decrease in the phagocytic activity of neutrophils and activation of oxygen-dependent metabolism (nitroblue tetrazolium test), which indicated, on the one hand, the strengthening of redox processes in these cells and a certain antibacterial potential of them, but on the other hand – the deepening of the inflammatory process of autogenous origin. Exhaustion of the body's compensatory capabilities confirmed the increase in the level of medium-globular circulating immune complexes. Therefore, significant changes in the non-specific protection of the oral cavity were observed in industrial workers suffering from generalized periodontitis
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