THE COURSE OF TONSILLAR INFECTION AND PERIODONTAL DISEASES CONSIDERING CERTAIN ASPECTS OF ETIOPATHOGENESIS (LITERATURE REVIEW)
About the author:
Hodovana O. I., Bezhuk Yu. A.
Type of article:
The article presents a review of literature data on the causative aspects of periodontal diseases along with the development and progression of tonsillar infection, in particular, chronic recurrent tonsillitis (compensated and decompensated forms). Only local signs of inflammation characterize the compensated form of recurrent tonsillitis, and the level of the barrier function of the tonsils and the responsiveness of the body is still able to localize the chronic inflammatory process in the organ and prevent the generalized reaction of the organism. Patients with this form of tonsillitis do not have frequent relapses; they also lack tonsillogenic intoxication and complications. The decompensated form is characterized not only by local signs of chronic tonsillitis but also by manifestations of decompensation in the form of recurrent acute tonsillitis, paratonsillitis, peritonsillar abscesses, various pathological reactions, diseases of distant organs and systems (cardiovascular, endocrine, respiratory systems and gastrointestinal tract, etc.). The toxic effect on the body is most likely in the chronic palatine tonsillitis due to the toxin dissemination by the hematogenous or lymphogenous route. The article presents statistical data on the prevalence of periodontal diseases, acute and recurrent tonsillitis among people of all ages. The analysis of literature data on the features of microbiota composition, changes in the microbial biocenosis of the oral cavity and pharynx in the conditions of development of the pathological process, chronicity of its course and features of inclusion of local and general factors of immune defense is presented. The tonsils, as lymphoid formations, have a number of functions related to the implementation of nonspecific defense against infectious agents: • secretion and mucus bind bacterial lipopolysaccharide (LPS), preventing them from attaching to the mucosa; • acute phase proteins (APP), pentraxins, collectins opsonize antigens and accelerate their phagocytosis by macrophages and neutrophils; • lipid transferases recognize LPS, which induces macrophages to bind the LPS via CD14 and phagocytize bacteria; • antigens phagocytized by macrophages are presented by T-lymphocytes; • the cytotoxic action of natural killers (CD16) is carried out directly, as well as involving specific antibodies; • activation of mast cells, eosinophils, dendritic cells occurs; • the complement is activated and its cytotoxic action is carried out; • synthesis of cytokines, interferon, chemokines is induced; • Toll-like receptors (TLRs) activate a specific and nonspecific defense. Therein lies the commonality of immune responses on the surface of all mucous membranes of the human body (mucosal immune solidarity). The following literature data were analyzed: the foci of chronic tonsillar infection and the infectious process in periodontal diseases as factors contributing to immunopathological disturbances with the development of humoral and cell-mediated autoimmune responses that lead to the failure of immunological tolerance and the formation of the autoimmune pathological status, which is the cause the development of concomitant diseases (nephropathy, cardiopathy, connective tissue damage, etc.).
periodontal diseases, tonsillar infection, etiology, pathogenesis, immune mechanisms, literature review.
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 2 Part 2 (151), 2019 year, 24-29 pages, index UDK 616.311.2-002+616.314.17-008.6)-06:616.322-002.2]-02-092