Oral Fluid Of Patients Research Articles

Nonalcoholic fatty liver disease as an endogenous factor of dysbiosis in the structure of oral microbiome

Objective — to study the dysbiotic impairment on the example of some aggressive periodontopathogens in the oral microbiome of patients with NAFLD.
 Materials and methods. The study involved 126 patients with NAFLD diagnosis against the background of I — III degrees of obesity or overweight (the main group) and 20 practically healthy subjects with normal body weight without clinical disorders of the digestive system and signs of liver steatosis (control group). All patients underwent investigation of the intestinal microbiota composition at the level of the main phylotypes by identifying total bacterial DNA and DNA of Bacteroidetes, Firmicutes and Actinobacteria by quantitative PCR. The dental examination was carried out according to the standard methods with determination of the OHI‑S hygienic index and periodontal indices. The following physical saliva indicators were evaluated: the salivation rate of unstimulated mixed saliva, viscosity and pH. To determine the periodontopathogens levels, material was collected from the periodontal pockets using paper endodontic absorbers by the real‑time polymerase chain reaction (PCR) method (qRT‑PCR) using universal primers. Determination of the concentration of gingipain K in the oral fluid was carried out by the immunoenzymatic method using the set of reagents.
 Results. Analysis of the intestinal microbiome (IM) structure demonstrated the presence of a dysbiotic shift in NAFLD patients towards the predominance of the Firmicutes phylotype over Bacteroides (p < 0.01). The level of endotoxemia was significantly higher in patients of the main group (0.9 [0.6; 1.08], p = 0.000) in contrast to the control group (0.43 [0.12; 0.55], p = 0.000). Negative changes in the physical indicators of saliva/ oral fluid in patients of the main group were recorded, namely, a decrease in the rate of salivation and pH (0.26 ± 0.006; 6.46 ± 0.01, respectively) and an increase in viscosity (3.13 ± 0.05). The results’ difference between groups was significant (p = 0.000). The presence of a dysbiotic shift in the econiche‑gingival sulcus in patients of the main group with the prevalence of aggressive periodontopathogens of the first order — Porphyromonas gingivalis (5.49 [3.5; 6.37] LogGE/ mL) and Tannerella forsythia (5.09 [3.65; 6.45] LogGE/ mL) was revealed, which was also characterized by an increase in the level of endotoxin (33.5 [23.8; 52.3]) and gingipain (98.9 [84.2; 128.6]) in oral fluid. In 67.4 % of patients of the main group, periodontal disease of an inflammatory‑destructive nature — chronic periodontitis (CP) was detected. The level of quality of performing oral hygiene at home was unsatisfactory in patients of the main group and was, on average, 2.3 points according to the OHI–S index.
 Conclusions. The chronic inflammatory process is the basis of the pathogenesis of NAFLD and CP and has a comorbid nature, due to the mutual production of systemically active proinflammatory cytokines and endotoxin. The entry of periodontopathogens of the first order into the intestine biotope from the source of CP against the background of NAFLD and maintenance of a dysbiotic shift in it has isolated confirmation in experiments, but requires further, compatible, in‑depth scientific studies of dentistry and internal medicine.

Clinical and Laboratory Assessment of Dental Status: Age Characteristics, Dynamics of Indicators of Resistance of Oral Fluid

As a result of aging process, the state of human body homeostasis undergoes the changes. In the tooth-jaw system, such changes lead to a shift of the balance in the remodeling-demineralization processes. Their intensity and dynamics depend on the properties of oral fluid, which plays an important role for the ensuring of physiological processes of oral cavity. The purpose of the work was clinical assessment of the dental status, examination of calcium homeostasis, activity of phosphatases and protein metabolism of oral fluid in patients of different age groups and their features under conditions of dental prosthetics. 103 patients aged from 18 to 89 years were examined who were assessed for the intensity of dental caries damage (DMF index), the state of hygiene and soft tissues (OHI-S and PMA indexes). The level of total and ionized calcium, the activity of acid and alkaline phosphatases, the content of total protein, and the state of its acid-base balance (pH) were determined in the oral fluid. It was found that with the age in the oral fluid the concentration of total and ionized calcium increases, acid and alkaline phosphatases become active, the content of total protein rises against the background of a decrease the intensity of salivation, the acid-base balance shifts to the alkaline side, the mineralization of tooth enamel increases, and the risk of hard dental deposits formation increases. Age characteristics of oral fluid resistance correlate with the intensity of dental caries damage, the state of hygiene and periodontal tissues. The changes of studied parameters in persons of the older age groups correlate with the results, that were found in patients with significant tooth loss (most of them are advanced and senile). It was found that the use of prostheses for replacement of dentition defects has a positive effect on the parameters of oral fluid, which ensure the resistance of hard teeth tissues and the bone base of the alveolar processes.

ДИНАМИКА ПОКАЗАТЕЛЕЙ ПРОТЕОЛИТИЧЕСКОЙ АКТИВНОСТИ РОТОВОЙ ЖИДКОСТИ У БОЛЬНЫХ САХАРНЫМ ДИАБЕТОМ 2 ТИПА В ПРОЦЕССЕ ОРТОПЕДИЧЕСКОГО ЛЕЧЕНИЯ С ИСПОЛЬЗОВАНИЕМ РАЗНЫХ СПЛАВОВ МЕТАЛЛОВ

The purpose of this article is studying biocompatibility of construction material of dental prostheses used in type 2 diabetes mellitus prosthodontic care. The article provides the analysis of findings concerning proteolytic activity of oral fluid in patients with type 2 diabetes when exposed to cobalt-chromium and nickel-chromium alloys of dental prostheses . According to the findings, usage of fixed whole piece prostheses intensifies proteolysis as the data of trypsin-like, elastic-like and entitripic activities of oral fluid attest.
 The results obtained during the study allow for a differentiated approach to the choice of constuction materials for prosthodontic treatment of patients with type 2 diabetes mellitus.

Changes in the Metabolism of Nitric Oxide, Hydrogen Sulfide of the Oral Fluid Taking into Account Age and Dental Status

The relevance of the study is conditioned by the prevalence of dental pathology, its complicated course in senior age and the search for the age-associated metabolic markers of oral fluid.
 Objective. The aim of the study is: to determine the age peculiarities of the content of nitric oxide and hydrogen sulfide metabolism in the oral fluid of patients, taking into account their dental status.
 Materials and Methods. Indicators of nitric oxide metabolism, L-arginine/arginase, hydrogen sulfide content in oral fluid, dental status of different aged people under conditions of intact dentitions, their defects and against the background of correction with different types of dentures, were studied.
 Results. It was determined that with age, changes in oral fluid are characterized by an increase in nitrite ion, the amount of nitrites and nitrates, increasing the formation of peroxynitrite against the background of lower levels of L-arginine and hydrogen sulfide, inhibition of arginase activity. The results obtained are confirmed by the presence of close correlations between the concentrations of hydrogen sulfide and peroxynitrite (reverse, strong), caries intensity and: the total level of nitrites and nitrates (direct, strong), peroxynitrite content (direct, medium strength).
 Conclusion. The studied biomarkers of oral fluid depend more on age, hygienic condition of the oral cavity, intensity of dental caries and defects of dentitions than types of dentures. Therefore, age-related changes in the biochemical composition of oral fluid, metabolic, somatic, comorbid pathologies are likely to be a trigger for structural-functional disorders of the dental-maxillofacial system.

Matrix metalloproteinases in the oral fluid as a characteristic of inflammatory-destructive process in periodontal tissues

The study of the imbalance between the activity of matrix metalloproteinases and their regulation markers in the oral fluid of patients with generalized periodontitis is necessary for creation of effective methods for early diagnosis and preventive treatment of the disease. The aim of the research was to examine the oral fluid of persons with healthy periodontal tissues, patients with chronic diffuse gingivitis and generalized periodontitis for concentrations of matrix metalloproteinases and their inhibitor, anti- and pro-inflammatory cytokines, markers of bone metabolism and to compare obtained results. 90 persons aged 32-45 years were examined, including 30 persons with intact periodontal tissues, 30 patients with chronic diffuse catarrhal gingivitis and generalized periodontitis of the initial degree and 30 ones with chronic generalized periodontitis of I-II degrees. Periodontal status was assessed using clinical indices and bone mineral density according to computed tomography data. The method of enzyme-linked immunosorbent assay (ELISA) was used to determine the concentration of matrix metalloproteinases MMP-2, MMP-3, MMP-8, MMP-9, MMP-13, tissue inhibitor of metalloproteinases TIMP-1, interleukins-1β, -6 and -4, bone metabolism markers – tartrate-resistant acidic phosphatase and bone alkaline phosphatase, osteocalcin in the oral fluid. The initiation of the inflammatory-destructive process in the periodontal tissues was characterized by an increase levels of MMP and pro-inflammatory IL-1β and IL-6 (р<0.05), a decrease in the concentration of TIMP-1 (р>0.05) and anti-inflammatory IL-4 (р<0.05), against the background of the absence of dynamics of bone metabolism markers in the oral fluid. The progression of the process at the І-II degrees of periodontitis was accompanied by a further increase in the concentration of pro-inflammatory interleukins, an increase in the activity of tartrate-resistant acid phosphatase and a decrease in bone alkaline phosphatase and osteocalcin (р<0.05) in the oral fluid, while the content of MMP did not change (р>0.05). The expression of MMP is important for the preventive diagnosis of generalized periodontitis, but it is not indicative for determining the severity of the disease. The imbalance of MMP and TIMP-1 in the early stages of the pathological process indicates the greatest expediency of using MMP inhibitors in the treatment of patients with gingivitis and periodontitis of the initial degree.

The content of microand macroelements in the oral fluid at different intensity of dental caries

Introduction. Due to the high prevalence of caries, the monitoring of enamel and dentin state remains an actual problem in dentistry and contributes to the development of new methods for diagnosing and predicting a cariogenic situation in the oral cavity. One of these methods is the study of the remineralization and demineralization processes in the oral cavity and of the microelements′ and macroelements′ level in the oral fluid.The aim of the study is to research the level of macroand microelements in the oral fluid in patients with different intensity of dental caries.Materials and methods. 13 people aged 21 to 35 were examined, including 10 women and 3 men. Based on the results of the dental examination, 2 groups of subjects were formed: 1st (n=4) healthy individuals and patients with a compensated form of caries; 2st (n=9) patients with decompensated form of caries. The subjects collected oral fluid by spitting into a test tube on an empty stomach, after brushing their teeth and rinsing their mouth three times with distilled water. Three samples were taken from each subject on different days, a total of 39 samples. The content of elements (Na, K, Ca, Mg, Fe, P, Mn) was determined by inductively coupled plasma atomic emission spectrometry.Results. An increase in the content of most microand macroelements (Na, K, Ca, Mg and P) in the oral fluid was found in patients with decompensated caries compared with the compensated form and healthy people (p<0,05). Perhaps, in the absence of a carious process or compensated caries, the mineral components are concentrated in hard tissues and the remineralization-restoration processes of the tooth mineral structures prevail.Conclusion. The study of the content of Na, K, Ca, Mg and P in the oral fluid can be used to diagnose and predict the course of the carious process.

PROGNOSTIC ROLE OF THE BIOMARKER FOR SQUAMOUS CELL CARCINOMA ANTIGEN IN ORAL LICHEN PLANUS

Lichen planus refers to chronic dermatoses with manifestation in the oral mucosa. Its clinical manifestations are displayed as disruption of the immune system balance. A prolonged course of lichen planus causes deregulation of the cell growth gene, dysplasia of the epithelium of the oral mucosa and the development of squamous cell carcinoma. Identification of circulating biological markers in blood and saliva enables to detect stable and reliable predictors of clinical significance in the diagnosis and the prognosis of diseases of the oral mucosa, including the onset of tumor transformation. Squamous cell carcinoma (SCC) antigen is one of these cancer markers. Saliva is an "ultrafiltrate of blood plasma", which makes it possible to evaluate biological markers by a safe non-invasive method. The aim of this study is to assess the concentration of squamous cell carcinoma antigen in mixed saliva samples of patients with various forms of lichen planus at the stages of diagnosis and treatment. Materials and methods. 47 women with a clinical diagnosis of "oral lichen planus" were examined and randomized in groups. They described the dental status, identified the causes of chronic injury, and made a comprehensive treatment plan. Monitoring was carried out at the diagnostic stage, after 14 and 90 days. During the first visit and after treatment, unstimulated mixed saliva was collected on an empty stomach. Results. During the diagnosis, the content of SC in the oral fluid of patients with lichen planus was <500 mcg/ml (489 mcg/ml) and a decrease in its concentration after treatment is characteristic of a benign course and susceptibility to therapy. The concentration of the marker >500 mcg/ml (527 mcg/ml) and an increase in the value after the treatment course indicates a severe recurrent nature of the disease and low efficacy of prescribed medications. Conclusion. The study of squamous cell carcinoma (SCC) antigen in oral fluid expands the applications of the biomarker in determining the prognosis of the course and effectiveness of therapy for oral lichen planus.

AGE PECULIARITIES OF PROOXIDANT-ANTIOXIDANT BALANCE OF THE ORAL FLUID IN PATIENTS AGAINST THE BACKGROUND OF INTAKT DENTITIONS, PARTIAL AND COMPLETE ANODONTIA

Relevance. The study is conditioned by a steady tendency of demographic aging of the population. On the part of the dental system, one of the most common age-related disorders is the tooth loss and the necessity to replace dentition defects. Changes in dental status can affect the course of oxidative reactions and antiradical protection of the oral fluid.
 Objective is to investigate the age peculiarities of the prooxidant-antioxidant balance of the oral fluid against the background of intact dentitions, partial and complete anodontia and their correction.
 Material and methods. There were examined 103 patients aged from 16 to 89, with intact dentitions, under the conditions of partial anodontia and correction with bridges or partial removable laminar dentures and complete anodontia and correction with complete removable laminar dentures. The intensity of the processes of free radical oxidation of lipids in oral fluid was assessed by the content of diene conjugates (DC) and products that respond to thiobarbituric acid (TBA-AP). The antioxidant reserve of the oral fluid was characterized according to the activity of superoxide dismutase (SOD), glutathione peroxidase (GP) and glutathione reductase (GR).
 Results. There was a significant increase of the indices of lipid peroxidation in the oral fluid, especially in middle-aged patients, which is confirmed by an increase in the content of DC and TBA-AP 5.9- and 4.5-fold, respectively, compared with data in adolescents. Such changes were consistent with a decrease in the activity of SOD, GP, GR of the oral fluid at 41.7-48.8% (p<0.05) relative to the values ​​in adolescence. In elderly and senile patients, the level of lipid peroxidation tended to decrease. The activity of antioxidant enzymes in elderly patients decreased at 28.6-49.8% (p<0.05), in the senile patients – at 29.6-63.6% (p<0.05) relative to the values ​​in the middle-aged patients. There has been an increase in the level of oxidative processes against the background of suppression of antiradical protection of the oral fluid in patients with partial or complete anodontia according to the data in the studied patients with intact dentitions, especially for people who use dentures.
 Conclusions. Prooxidant-antioxidant balance of the oral fluid depends on age and dental status. The most significant changes in oxidative processes in the oral fluid are observed in the middle-aged people with a tendency to decrease in the elderly and senile patients. The level of free radical processes increases under the conditions of partial and complete anodontia, correction of various types of denture designs and depends on the material they were made of. Such changes occur against the background of suppression of the antioxidant reserve of the oral fluid (especially the glutathione system).

EFFECTIVENESS OF MATRIX METALLOPROTEINASES INHIBITORS FOR PREVENTIVE TREATMENT OF GENERALIZED PERIODONTITIS

Generalized periodontitis is one of the most widespread human stomatological diseases; it is diagnosed in 11.0 % of the world's population. Despite the recognition of the microbial factor as leading in its etiopathogenesis, antimicrobial treatment of gingivitis, added with removal of dental plaque, does not prevent the further development of periodontitis. Dysbacteriosis causes inflammation which leads to an increase of proteolysis products. They are a nutrient medium for periodontal pathogenic microflora, they contribute to its growth. So, the use of anti-inflammatory drugs, such as matrix metalloproteinase inhibitors, is promising for preventive treatment of generalized periodontitis.
 The aim of the work is to conduct a clinical trial of complex treatment which includes matrix
 metalloproteinase inhibitors in patients with diffuse gingivitis and generalized periodontitis of chronic course.
 Materials and methods of the research. 60 patients with chronic course of diffuse gingivitis and generalized periodontitis of initial, I and II stages, were treated. The effectiveness of the treatment was evaluated in the early and distant term (after 1 year) according to data of the clinical and radiological examination, computer tomography, biochemical examination of oral fluid for matrix metalloproteinases-8 and -9 (MMP-8, -9) and immunohistochemical study of gingival biopsies for cytoplasmic expression of matrix metalloproteinase-1 (MMP-1).
 Results of the research. According to the data of the clinical examination, complete elimination of inflammatory symptoms in periodontal tissues was achieved in 93.3% of patients in the comparison group in 12-14 days and in 96.7% in the base group in 10-12 days. In patients in whom the developed therapeutic scheme was used, the best dynamics of the index assessment of the state of hygiene, gingiva and periodontal complex was established. The main difference between the research groups was the preservation of obtained results in 1 year after treatment in patients of the base group (p ˂ 0.05). In particular, a year later, the results of bone mineral density measurement for patients of the base group did not change from baseline, while in the comparison group there was their significant decrease (p ˂ 0.05), indicating the progression of inflammatory-destructive process in periodontal tissues.
 After treatment, a significant reduction in the level of MMP-8 and MMP-9 in the oral fluid of patients of both groups was achieved (p ˂ 0.05). In patients of the base group, in contrast to the comparison, these results were the same in the distant term (p ˂ 0.05). When assessing the cytoplasmic expression of MMP-1 in epithelial and stromal cells after treatment, zero result was in 96.7% of patients in the base group and in 80.0% – in the comparison group, and after 1 year – in 90.0% vs 63.3% respectively.
 It should be noted that the differences between the base and comparison groups were most observed for patients with gingivitis and generalized periodontitis of initial stage without destructive processes in periodontal tissues. It suggests the greatest effectiveness of the proposed treatment in the early stages of pathological process.
 Thus, based on the fact that the activity of matrix metalloproteinases characterizes the course of the inflammatory process in periodontal tissues, a decrease in their level according to biochemical and immunohistochemical studies in the base group against the comparison indicates a better anti-inflammatory effect of the developed treatment to prevent the progression of generalized periodontitis.
 Conclusion. The obtained results allow recommending the use of matrix metalloproteinase inhibitors as a preventive pathogenetic treatment for the patients with chronical course of gingivitis and generalized periodontitis of the initial stage, to inhibit the inflammatory component of the pathological process.
 Prospects for further research. It should be studied the indication for repeated courses of matrix metalloproteinase inhibitors in patients with periodontal disease.

Correlation between chemical composition of enamel and oral fluid in patients with intact teeth and cervical pathology

Annotation. Cervical pathology of teeth is widespread and polyetiological, saliva plays an important role in its occurrence and progression. The aim of the study is to determine the chemical composition of oral fluid in patients with cervical caries, wedge-shaped defect, intact hard dental tissues; establish correlations between oral fluid and cervical enamel. In this regard 33 patients were divided depending on the condition of hard dental tissues and there were determined: Сa2+, РО43-, SO42-, Na+, К+, Al3+, Mg2+, Zn2+ – by spectrometric methods, Cl- – using a chloride-selective electrode pH-meter. The chemical composition of cervical enamel of 29 removed intact teeth and with cervical pathology was studied using a scanning electron microscope JSM-6490 LV with energy-dispersive X-ray microanalysis system INCA Penta FETx3. Molar coefficients were calculated as the ratio of the number of chemical analytes in the supernatant. Statistical analysis was performed using the computer program Statistica 8.0 (STA862D175437Q). Applied: analysis of variance (Welch test), correlation analysis (Pearson's parametric correlation method) based on the determination of the parametric Brave-Pearson coefficient (r) at p<95%. The reliability of the obtained results was evaluated by Student's t-test and by Student's test using the Z-test (Fisher's z-test) at p≤0.05. There was no significant difference in the amount of chemical elements in saliva between the groups (p>0.05) and significant differences were determined in K/Na (p=0.0258). There was correlation between chemical analyte content in the oral fluid and cervical tooth enamel: direct ‑ between Са2+ and РО43-, К+ and Cl-, К+ and Na+; inverse – between Са2+ and К+, Са2+ and Cl-, РО43- and К+, РО43- and Cl- (p<0.0001). Correlation was identified: direct – between Ca/P and Ca/Mg, Ca/P and Ca/Cl, P/Ca and K/Na, Mg/Ca and Mg/P; inverse -‑between K/Na and Ca/P, K/Na and Ca/Cl, P/Ca and Ca/Cl, P/Ca and Ca/P (p≤0.05). Obtained results allowed to use Ca/Mg ratio as an indicator of enamel mineralization. We propose to use certain differences in correlation of chemical elements of oral fluid and tooth enamel to assess the mineral state of tooth enamel and control the effectiveness of preventive measures. Based on saliva parameters and microbiological indicators of dental biofilm the search for ways of preclinical diagnosis of cervical pathology is promising.

Dynamics of the lipoperoxidation process in the oral fluid of patients with chronic generalized periodontitis with the complex application of laser therapy and interval hypoxic training

The performed research is devoted to the study of lipid peroxidation processes in patients with chronic generalized periodontitis under the conditions of the course application of infrared laser therapy and normobaric interval hypoxic training. The results of the study allow us to conclude that the development of inflammatory destructive processes in periodontal tissues closely correlates with manifestations of oxidative stress, which develops as a result of an imbalance in the pro-oxidants-antioxidants system. Supplementing the standard therapy of chronic generalized periodontitis with the course use of physiotherapeutic factors in the mono-influence mode is accompanied by an increase in the potential of the antioxidant protection of the oral cavity. The complex use of physiofactors contributes to an increase in the activity of the antioxidant system, realized through the mechanisms of functional potentiation. The close relationship revealed between lipid peroxidation products and index characteristics of dental status, reflecting the pathogenetic role of pro-oxidant factors in the development of chronic generalized periodontitis, allows us to consider biomarkers of peroxide metabolism and the antioxidant protection coefficient as criteria for the effectiveness of the treatment.

PHYSICAL-CHEMICAL AND METABOLIC PROCESSES IN ORAL CAVITY: THEIR INTERACTION IN DENTAL PERI-IMPLANTITIS AND CHRONIC PERIODONTITIS

Intraosseous dental implantation is considered to be the most effective and technologically advanced method employed to restore individual and multiple dentition issues. It offers potential for significant improvement of comprehensive rehabilitation in dental patients. However, positive outcomes of the implantation that enable restoration of the dentition integrity, complete compensation of the patient’s chewing function and aesthetic looks, does not rule out complications involving inflammation. It still remains relatively high, within the range of 8 to 15%. Peri-implantitis, if taken as inflammation affecting the soft tissues around the implant, bears signs of bone destruction and accounts for one of the most common complication. The comprehensive study described here was aimed at evaluating the dental status, as well as the physical-chemical and metabolic parameters of the oral fluid in patients with dental peri-implantitis (n=31), chronic localized periodontitis (n=30) and chronic generalized periodontitis (n=30). The control group included patients (n=30) with no signs of dental pathology, all comparable in terms of their age and gender. In patients with dental peri-implantitis, chronic localized periodontitis and chronic generalized periodontitis, we revealed unidirectional dynamics of the oral fluid parameters (electrical conductivity, redox potential, concentration of calcium, magnesium, ammonium cation), the values being different, though. The identified features of the metabolic status of oral fluid will increase our understanding of pathogenetic mechanisms underlying peri-implantitis.

The effectiveness of the use of polypeptide drugs and their effect on the metabolic parameters of oral fluid in patients with generalized periodontitis in depending on blood type

The article presents the results of treatment of 157 patients with generalized periodontitis depending on blood type using polypeptide drugs. The concentration of total protein, C – reactive protein, IgG, TRACP, BSALP, albumin, amylase, lipase, Ca, Fe was determined in the oral fluid. The treatment allowed to reduce the content of total protein, C – reactive protein, TRACP in the oral fluid with increasing levels of calcium, Fe, BSALP, in relation to the relevant data before treatment. And also, polypeptide drugs helped to increase the level of albumin in representatives of 0 (I) and A (II) blood type in the oral fluid; contributed to a decrease: glucose, IgG with increasing activity, amylase and lipase in carriers of B (III) and AB (IV) blood type in the oral fluid, in relation to the values before treatment. The dynamics of indicators of oral fluid metabolism with the help of polypeptide drugs, convincingly proves the effectiveness of their use in the treatment of generalized periodontitis in patients with different blood type.

Morphofunctional parallels of the stomach in patients with chronic atrophic gastritis

Background. Despite some progress in addressing gastric cancer, a marked reduction in morbidity in all developed countries, the search for changes that precede carcinogenesis remains relevant and far from complete. The purpose of the study: to assess the content of aggressive and protective factors of gastric juice and oral fluid in comparison with morphological changes in patients with chronic atrophic gastritis. Materials and methods. The study included 56 patients: group I included 12 patients with atrophic changes of the gastric mucosa of varying severity, groupII— 24 patients with atrophic changes diagnosed with intestinal metaplasia only in the antrum of the stomach, in group III group— 20 patients with intestinal metaplasia in the body and antrum of the stomach. The control group consisted of 16 healthy individuals. Assessment of the degree of atrophy and inflammation in the gastric mucosa was performed with the subsequent determination of integral indicators— stage and degree of atrophy according to the OLGA system and metaplasia— according to the OLGIM system. According to the morphometric study of sections using a light microscope XSP-139TP (“Ulab“, Ukraine) calculated indicators: nuclear-cytoplasmic ratio, the ellipticity of the nuclei. The content of glycoproteins, sialic acids, fucose, hexosamines was determined in gastric juice and oral fluid. Results. Morphometric study showed a significant decrease in the nuclear-cytoplasmic ratio to (0.12±0.04)% in patients of group III. The coefficient of ellipticity of the nuclei of native cells decreased with the development of intestinal metaplasia: in group I it was equal to (0.76±0.04)%, for group II it was (0.65±0.11)%, and for group III— 0.41±0.12)%. In patients with intestinal metaplasia in 82% of cases with a 3-fold increase in the content of sialic acids in gastric juice was diagnosed with an increase in hexosamines by 35%, while patients with only atrophic changes in the stomach showed a decrease in hexosamines 2 times compared to controls (p<0.05). The spread of intestinal metaplasia in the stomach is associated with an increase in the amount of glycoproteins and hexosamines in the oral fluid of patients, while sialic acids in this biological fluid are increased in all study groups. There are direct relationships between the presence of intestinal metaplasia in the body of the stomach and the content of glycoproteins in both gastric juice (r=0.446, p=0.008) and in oral fluid (r=0.378, p=0.021). The relationship between the content of sialic acids in gastric juice with the degree and stage of gastritis by OLGA (r=0.431, p<0.01; r=0.482, p<0.01), the level of hexosamines in oral fluid with the coefficient of ellipticity of the nuclei (r=0.447, p=0,037). Conclusions. A comprehensive study of morpho-functional changes in the stomach and the ratio of aggressive and projective factors of oral fluid will determine the risk groups of patients with precancerous conditions.

Prognostic model of early inflammation development in periodontal tissues by biochemical parameters of oral fluid in patients with orthodontic appliances

One of the main etiological risk factors and pathogenetic mechanisms for the development of inflammatory diseases of the periodontal disease is a bite pathology or dentofacial anomalies. Therefore, in recent years, scientists make attempts to find new markers that would allow to predict the course of the disease at the preclinical stage of its diagnostics, which would allow to take preventive treatment. In recent years, individual proteins of the mouth, which include matrix metalloproteinases (MMP-8), which can hydrolyze the main proteins in extracellular space and lactoferrin, catelitsidine, KLOTHO protein should be considered leading markers. The purpose is to predict the emergence of early inflammation in periodontal tissues in patients with non-removable orthodontic appliance by studying protein content in the oral fluid in the dynamics of treatment. Among the 113 patients surveyed by us, which underwent orthodontic treatment with non-removable appliance, according to clinical and laboratory studies, 82 people (72,57%) had signs of early inflammation of periodontal tissues. All exa­mined young people were students or students of educational institutions who appealed for advice and treatment to a dental clinic. Biochemical studies of oral fluid and their analysis was conducted at the beginning of orthodontic treatment and 3 and 6 months after the delivery of non-removable orthodontic appliance. The oral fluid was collected in the morning, and the quantitative determination of proteins in it was carried out by the IFA method. In order to assess the probability of prognostication of early inflammation in patients with orthodontic appliance, there was made rank correlation analysis with the determination of the correlation coefficients of the disparity (rs), ROC analysis with the deter­mination of Optimal Cut-Off Point (OСР) – the value of the indicator for prediction and simple and multiple logistic regressions with the calculation of the odds ratio and the construction of a prognostic model (logistics regression equation). For the analysis of factors, on the basis of which it is possible to predict early inflammation of periodontal tissues in patients with orthodontic appliance, a correlation analysis was performed, which showed that the largest changes were in the biochemical parameters of the mouth, namely: MMP-8 (rs=0.58; p<0.001), lactoferin (rs=0.45; p<0.001), catelitsidine (rs= -0.59; p<0.001) and KLOTHO protein (rs= -0.58; p<0.001), with which statistically significant correlations were established. ROC analysis was used to evaluate the discriminatory capacity of the markers investigated, which showed the presence of statistically significant correlations with early signs of inflammatory process in periodontal tissues. As a result of the correlation analysis, it has been found that the most significant changes in the inflammatory process in periodontal tissues were in the biochemical parameters of the mouth, such as MMP-8 (rs=0.58; p< 0.001), lactoferin (rs=0.45; p< 0.001), catholicidine (rs= -0.59; p< 0.001) and Klotho protein (rs= -0.58; p< 0.001), with which statistically significant correlations of average force were detected. The chances of patients with non-removable orthodontic appliance for the development of inflammation in the periodontal tissues are increased by 4. times.

Дослідження цитокінового спектру ротової рідини хворих із генералізованим пародонтитом на тлі метаболічного синдрому

The purpose of the study was to study the state of cytokine regulation of oral fluid in patients with generalized periodontitis and metabolic syndrome. Materials and methods. For this study, 3 groups of surveys were formed. The main group included 30 people with generalized periodontitis on the background of metabolic syndrome; 30 people with generalized periodontitis, without somatic pathology, formed a comparison group. The obtained results were compared with the data of 20 practically healthy individuals with intact periodontium who were included in the control group. The content of pro-inflammatory cytokines IL-1β, IL-6, TNF-α and anti-inflammatory cytokines IL-4, TGF-β1 in the oral fluid of the study groups was determined by solid-phase enzyme-linked immunosorbent assay. Results and discussion. According to the research, on average, the highest levels of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) were observed in patients with periodontal disease on the background of metabolic syndrome. We investigated increase in the concentration of proinflammatory IL-1β. The average value of IL-6 in the oral fluid of patients with metabolic syndrome exceeded this figure in persons not burdened with somatic pathology by 1.3 times, the difference with healthy individuals was more significant: the indicators differed by 2 times. That can be considered an immune response to the inflammatory process in periodontal tissues. The next stage is the beginning of the cytokine cascade, which is characterized by increased production of IL-6 and TNF-α – inducers of acute phase protein synthesis. TNF-α causes an increase in the number of free radicals and can lead to intensification of apoptosis. Due to the fact that anti-inflammatory IL-4 blocks the induced expression of pro-inflammatory IL-6 and TNF-α, a decrease in its level in oral fluid can be considered an unfavorable factor in the course of inflammatory-dystrophic periodontal lesions in patients with syndrome X. Given that TGF-β1 is an immunosuppressive factor, a decrease in its concentration indicates a deficiency of local factors of immune protection in patients with periodontal disease on the background of metabolic syndrome. Conclusion. Patients with metabolic syndrome and periodontal disease have significant disorders of cytokine regulation, which are complicated by age: expression of proinflammatory IL-1β, IL-6, TNF-α on the background of reduced anti-inflammatory cytokines IL-4 and TGF-β1. Such changes in cytokine homeostasis indicate chronic inflammation, insufficient efficiency of regenerative processes in tooth-retaining tissues, and, as a consequence, lead to a more severe course of periodontal disease in people with metabolic syndrome

Monitoring of biochemical parameters of the oral fluid in patients with recancerous of the oral mucosa.

Orthopedic treatment is of particular difficulty in the complex therapy and rehabilitation of patients with precancerous diseases of the oral mucosa. In this regard, in patients with chronic inflammatory and destructive lesions of the oral mucosa, it is necessary to control changes in the oral cavity, taking into account clinical and laboratory data. Oral fluid is most often used as a diagnostic material in dental research, the composition and properties of which reflect functional changes in the body. However, the studies that substantiate rational orthopedic treatment in such patients are extremely insufficient: there are no data on the effect of orthopedic structures on the primary metabolism in the oral cavity in patients with precancerous diseases. In this regard, the purpose of this work was to study the biochemical parameters of the oral fluid in patients using orthopedic structures to identify the prognostic factors of precancerous conditions. In the oral fluid, the levels of total protein, total cholesterol, triglycerides, and lactate were determined. Free radical oxidation was assessed by the intensity of induced biochemiluminescence and by the levels of lipid peroxidation products. In the oral fluid of patients with mucosal precancer compared with patients in the control group, a significantly higher intensity of free radical oxidation was revealed with a corresponding decrease in antioxidant activity. The level of the end products of lipid peroxidation - Schiff's bases - was statistically significantly increased. Among the metabolites of the oral fluid, there was a decrease in protein levels and an increase in cholesterol and lactate levels. At the same time, a positive correlation was established between the indicators of free radical oxidation and lactate, free radical oxidation and cholesterol, but negative with the levels of protein and triglycerides. Regarding the antioxidant system, there was a negative correlation between the tg (-2α) value and the lactate level and positive with the triglyceride level, as well as a positive correlation between the Z parameter and the total protein level. The obtained changes in the biochemical parameters of the oral fluid can be used to confirm the diagnosis of precancer of the oral mucosa in patients with orthopedic structures.

ЦИТОКИНОВЫЙ ПРОФИЛЬ РОТОВОЙ ЖИДКОСТИ У БОЛЬНЫХ ЖЕЛЕЗОДЕФИЦИТНОЙ АНЕМИЕЙ

The incidence of iron deficiency anemia (IDA) is increasing every year. IDA is characterized by a variety of clinical manifestations, including in the oral cavity, which is explained by a wide range of metabolic disorders. In patients with sideropenia, the body's resistance to infectious and inflammatory diseases decreases, which is associated with depression of humoral and cellular immunity. At the same time, data on the level of pro- and anti-inflammatory cytokines in patients with IDA are very contradictory; there is no clear understanding of the significance of changes in the oral cavity cytokine levels in this category of patients. The aim of the research was to study the content of pro- and anti-inflammatory cytokines in the oral fluid in patients with IDA. The study involved 168 patients. The main group included patients with IDA, the comparison group — patients with inflammatory periodontal diseases without somatic pathology, the control group — persons without concomitant diseases and inflammatory processes in the oral cavity. In all patients, the dental status was determined, as well as the content of IL-1β, IL-6, IL-4 and IFN-γ in the oral fluid. The results of dental examination showed the presence of inflammatory periodontal diseases in all examined with IDA. The combination of inflammatory periodontal diseases with IDA led to a significant decrease in the concentration of pro-inflammatory cytokines IL-1β and IL-6 in the oral fluid of the participants compared with similar indicators in patients with inflammatory periodontal diseases without somatic pathology, which indicates immune deficiency in these patients. The dental examination results showed the presence of inflammatory periodontal diseases in all examined with IDA. The combination of inflammatory periodontal diseases with IDA led to a significant decrease in the concentration of pro-inflammatory cytokines IL-1β and IL-6 in the oral fluid of the examined, compared with the similar indicators in patients with inflammatory periodontal diseases without somatic pathology, which indicates immune deficiency in these patients.

Группы крови и секреторное состояние при COVID-19

INTRODUCTION: Despite the achievements of modern medicine, healthcare system is lacking in knowledge about the new coronavirus infection caused by the SARS-CoV-2 virus. AIM: To establish the relationship of the new coronavirus infection with the blood group according to the AB0 blood system in the Samara region and assess the secretory status of the oral fluid in patients with COVID-19. MATERIALS AND METHODS: This study was conducted from June 2019 to December 2020, and included 89 healthy individuals (38% males, 62% females, average age 24 ± 2.5 years) and 92 patients with COVID-19 (24% males and 76% females, average age 55.68 ± 1.83 years). The material for the study was oral fluid and venous blood. Determination of the blood group according to the AB0 system was carried out by a cross method, the secretory status of saliva according to the I. Vidas method. Descriptive methods were used for statistical data processing (arithmetic mean, error of the mean), calculation of the percentage of a whole number using computer programs IBM SPSS Statistics 23 and Microsoft Office Excel 2010. RESULTS: The distribution by blood group in patients with COVID-19 was as follows: A (II) blood group was found in 43.5%, O (I) in 36.9%, B (III) in 17.4%, AB (IV) in 2.2%. Rh-positive status was determined for 92.4%. Among secretory representatives, antigen A was secreted in 92.1%, and antigen B was secreted in 7.9% of cases. Antigens A and B were absent in the oral fluid of patients with AB (IV) blood group. CONCLUSIONS: This study confirmed the prevalence of A(II) blood group carriers among patients with COVID-19. In this case, the secretion of antigen A into the oral fluid is 92.1%. Group A antigen, being a glycoprotein, can act as a factor facilitating the mechanism of penetration of the SARS-CoV-2 into the human body. The results of the study indicate the need for a personalized approach at the stage of diagnosis and monitoring of the treatment of new coronavirus infection, as well as taking into consideration the blood group to develop preventive measures for COVID-19.

The role of oral fluid biological markers in the clinical course of lichen planus

Relevance. The pathogenetic mechanisms, which initiate oral mucosa cancer in patients with lichen planus, have not been entirely studied yet. However, endogenous factors, including matrix metalloproteinases (MMP), can be crucial in malignization. The study aimed to analyze the levels of MMP-8, tissue inhibitor of matrix metalloproteinase (TIMP)-1 and MMP-8/TIMP-1 ratio in the oral fluid of patients with various forms of lichen planus.Materials and methods. We examined and treated 24 women, aged 35-70 years old, with reticular (14 patients) and atrophic (10 patients) oral lichen planus. The study determined the concentration of biological markers MMP-8 and TIMP-1 in the oral fluid before and after the treatment. The local treatment consisted of anti-inflammatory therapy with antiseptic solutions as oral baths with an exposure of 1 minute, application of vitamin A and E oil solutions on the gauze for 15-20 minutes, immune-corrective therapy was applied. We followed up with the patients at the diagnostic stage, after 14 days of treatment and 3 months later.Results. The study revealed statistically significant differences in the ratio of MMP-8 and TIMP-1 levels in the oral fluid of lichen planus patients compared to the controls (p = 0.006). 11 patients exhibited an increase of MMP-8/TIMP-1 ratio in comparison with the ratio maximum in control (p = 0.006).Conclusion. To assess the course of the disease in patients with various forms of oral lichen planus, the clinicians should evaluate the concentration ratio of biological markers MMP-8/ TIMP-1 in the mixed saliva. Clinicians should monitor the changes in the level of MMP-8/TIMP-1 in the oral fluid at least once every three months.