DISTURBANCE OF IRON METABOLISM AND ULTRASTRUCTURAL FEATURES OF THE GINGIVA IN PATIENTS WITH Β-THALASSEMIA MAJOR

Abstract

Introduction: β-thalassemia major is a hereditary blood disease, a main pathogenetic factor of which is the disruption of the synthesis of β-chains of hemoglobin. Inevitable metabolic disorders that occur during regular blood transfusion form an additional risk of damage and cellular modification of organs and tissues, including the oral cavity. Aim: determination of the pathogenetic role of iron metabolism disorder in the development of chronic inflammatory periodontal diseases in patients with β-thalassemia. Material and methods: 12 patients with β - thalassemia major who had periodontal diseases were examined in the Republican Center of Thalassemia in Baku (average age is 18 ± 1.3 years). The control group consisted of 16 somatically healthy individuals with intact gingiva tissues (the average age is 18.0 ± 0.7 years). Serum Iron, ferritin, hepcidin, total iron-binding capacity (TIBC), level of Il2, Il6, Il10, TNFα were measured from peripheral blood samples. To determine the ultra-structural study of the periodontal tissues in patients with β-thalassemia major, the method of electron microscopy studies of gingiva biopsies was used. Results of the study: The study revealed an increase in the level of serum iron and ferritin against the background of a progressively decreasing TIBC in patients with β-thalassemia major. Also activation of pro-inflammatory cytokines - TNFα, Il6, Il10 was observed in homozygous patients. Metabolic indicators are compared with ultrastructural features of cellular elements of a gum. Signs of accumulation of iron in cellular elements both of its own plate and of the epithelial cover were compared. The presence of iron was recorded in immunocompetent cells - macrophages and lymphocytes. Conclusion: Summarizing the data obtained, we can conclude that deproteinization of ferritin cores and their detection both in the cytoplasm and in the nucleoplasm of immunocompotent cells leads to irreversible degenerative changes in cellular elements of the gingiva. The authors link the development of the generalized inflammatory - degenerative process in the periodontium with revealed exchange -structural violations.