Abstract
Chronic periodontitis in children and adolescents holds a lead place in morbidity pattern of dental pathology. Development of chronic periodontitis is accompanied by emergence of various complications in the maxillofacial region, leading to bite disturbance being of high relevance for pediatric patients. These and other complications are related to immune system immaturity in children and adolescents as well as virulence of microorganisms. However, the immunological changes developing in children with chronic periodontitis remain poorly studied. The aim of the work was to improve diagnostics of chronic periodontitis in children and adolescents based on informative parameters of systemic immunity and discriminative models taking into account such changes. We examined systemic immunity in 127 children and adolescents with chronic periodontitis, aged 12 to 16 years, by using flow cytometry and enzyme immunoassay. In control group, age-matched 108 patients lacking overt somatic and dental pathology were enrolled. Generation of mathematical models was carried out by using a discriminative approach, whereas informativeness was assessed in accordance with generally accepted formula. Relative and absolute count of peripheral blood CD13+ cells exert the peak informativeness holding the first and second ranking places with marked dominance of informativeness value for assessing relative amount of CD13+ cells are among immunological parameters in children with chronic periodontitis. High informativeness value evidencing about pronounced intensity of developed pathological changes and diagnostic significance for chronic periodontitis in children is intrinsic to the relative percentage of peripheral blood CD8+ cells being slightly lower than that one in absolute count of CD13+ cells. On the other hand, humoral immune-parameters were of lowest informative value among all analyzed immunological parameters in patients with chronic periodontitis serum referring to all antibody classes. Generated discriminative models for the most valuable immunological parameters ensure adequate medical diagnostics for chronic periodontitis in childhood. Diagnostic sensitivity for created mathematical models was high and reached 0.94, whereas diagnostic specificity — 0.92. Immunological examination of patients improves diagnostics of chronic periodontitis. It was found that patients with chronic periodontitis had lowered immune status peaking in decreased absolute and relative count of peripheral blood CD3+ lymphocytes. Finally, parameters of humoral immunity in children with chronic periodontitis were also reduced.
Highlights
Целью исследования является совершенствование диагностики Хронический пародонтит (ХП) у детей и подростков на основе информативных показателей системного иммунитета и дискриминантных моделей, учитывающих данные изменения
Определение иммуноглобулинов в сыворотке крови проводили методом иммуноферментного анализа с применением тест-систем с моноклональными антителами к человеческим иммуноглобулинам
Authors: Agarkov N.M., PhD, MD (Medicine), Professor, Professor of the Department of Biomedical Engineering, South-West State University, Kursk, Russian Federation; Senior Researcher, “Problems of Aging” Laboratory, Belgorod State National Research University, Belgorod, Russian Federation; Makaryan A.S., PhD (Medicine), Associate Professor, Department of Public Health, Health and Hygiene, Peoples’ Friendship University of Russia, Moscow, Russian Federation; Gontareva I.S., Assistant Professor, Department of Pediatric Dentistry, Belgorod State National Research University, Belgorod, Russian Federation
Summary
Цель работы — совершенствование диагностики хронического пародонтита у детей и подростков на основе информативных показателей системного иммунитета и дискриминантных моделей, учитывающих данные изменения. На проточном цитофлюориметре и иммуноферментным анализом исследован системный иммунитет у 127 детей и подростков от 12 до 16 лет с хроническим пародонтитом. Среди иммунологических показателей у больных детей хроническим пародонтитом наибольшей информативностью обладают относительное и абсолютное содержание в периферической крови кластеров CD13+, занимающих соответственно первое и второе ранговое место со значительным превосходством величины информативности для относительного содержания CD13+. Свидетельствующий о выраженности произошедших патологических изменений и диагностической значимости для хронического пародонтита у детей, свойственен относительному содержанию CD8+ в периферической крови, величина которого незначительно ниже, чем у абсолютного количества CD13+. Наименьшей информативностью среди анализируемых иммунологических отклонений у больных хроническим пародонтитом обладают параметры системного гуморального иммунитета.
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