FUNCTIONAL ACTIVITY CHANGES OF THE MONONUCLEAR PHAGOCYTE SYSTEM IN PATIENTS WITH RAPIDLY PROGRESSIVE GENERALIZED PERIDONTITIS WITH PERIODONTAL MICROORGANISMS SENSITIVE AND RESISTANT TO DRUGS

Abstract

Purpose. To reveal peculiarities of the mononuclear phagocyte functional activity in patients with rapidly progressive generalized periodontitis depending upon colonization of periodontal tissue by causative agents, sensitive and resistant to drugs, on the basis of studying activated blood monocytes, phagocytic activity of mononuclear phagocytes and production of the main classes of immunoglobulins, cytokine profile state. Material and methods. The investigation was carried out on 74 patients with rapidly progressive generalized periodontitis I-II and II-III severity, aged 35 to 50 years. Complex of the laboratory studies included immunophenotypic changes in the subpopulation composition of the mononuclear blood cells (CD3 +, CD4 +, CD8 +, CD14 +, CD16 +, CD25 +, HLA-DR and CD95+), phagocytic activity of neutrophils, level of cytokine production and synthesis of sIgA, IgA, IgG and IgM in the oral fluid. Results. On the basis of the conducted complex clinical-laboratory data it has been established that a significant decrease of the functional activity of the mononuclear phagocyte system stipulates the formation of the severe secondary deficiency of the cellular and humoral immunity in patients who are carries of the resistant strains of periodontal pathogenic agents of the rapidly progressive generalized periodontitis and moderate - at colonization of the periodontal complex with causative agents sensitive to drugs. The pathogenetic dependence of the drug sensitivity upon the nature of the disorders of the systemic and local humoral immunity has been shown: at the marked immunodeficiency the development of the bacterial resistance to drugs is possible, and preservation of the drug sensitivity to the causative agents of the rapidly progressive generalized periodontitis is associated with moderate disorders of anti-infectious mechanisms of the immune response. Conclusion. The assessment of the functional activity of the mononuclear phagocyte system, based on the study of the state of immunophenotypic changes in the subpopulation composition of mononuclear blood cells, phagocytic activity of monocytes, the content of immunoglobulins and cytokines in the oral fluid, gives valuable information to clarify the mechanisms of the development of various sensitivity of the periodontal-pathogenic flora of the periodontal tissue to protocol antibacterial therapy in the patients with rapidly progressive generalized periodontitis.