CONCENTRATION OF CIRCULATING IMMUNE COMPLEXES IN PHLEGMONS OF THE MAXILLOFACIAL AREA

Matolych U. D.

CONTENTS

Scentific article

Number of patients with phlegmons of maxillofacial area is not reduced each year. The problem of improving the diagnosis and treatment of this pathology is one of the most topical in maxillofacial surgery. There is a growing number of severe inflammatory diseases and complications that are dangerous to human life. Mainly, immunological disorders are the pathogenetic factor of the occurrence of these conditions. The formation and presence of circulating immune complexes (CIC) in the fluids are one of the demonstrations of the immune response of body to appearance of antigens and an important factor in providing immunity. The average molecular fraction is the most toxic because it can pass through the vessel wall and lie over in the tissues, causing inflammation. The aim of the study was to investigate the immune system, in particular, the level of the average molecular fraction of CIC in patients with phlegmons of maxillofacial area . 79 patients were examined to achieve our purposes. Patients were divided into 3 groups depending on the severity of the disease and the general characteristics of the patients. The first group (mild course – group A) consisted of 48 patients with phlegmons, localized on one anatomic site, group №2 (moderate group B) – 26 patients with phlegmons, localized in two or more anatomical area, group №3 – 5 seriously ill (group C) with phlegmons of soft tissues of the mouth, half of face (A. A. Timofeev, 2004). The diagnosis was established due to the complaints, to the history of disease and life, objective and local status, results of conventional clinical and laboratory studies. All patients received a basic comprehensive treatment. To assess the state of humoral immune defined level of the average molecular (11S-19S) immune complexes in serum. Immunological examination of patients was performed during hospitalization and in 5th and 9th day. Determining the level of CIC was performed by differential precipitation in 3,5% solution of polyethylene glycol with a molecular weight of 6000 daltons. As a control serum used 20 healthy individuals. Analysis of the data indicates that healthy individuals has negligible number of CIC, in average, 58 items of extinction, which corresponds to the physiological norm (30-100 items of extinction). A significant increase of standards of pathogenic fraction of CIC was established for surgery in three groups: the 1,84 times in group A, 2,05 times in group B, 2,67 times in group C. These changes are an important factor in the prognosis of a wide range of pathological reactions and indicates stimulation of the immune response. In the second study of CIC some positive dynamics of immunological parameterswere set. Thus, in patients of group A a significant concentration of reduc-tion of CIC was noticed on 5th day (130 items of extinction, р<0,05), on the 9th day of CIC levels returned to normal. In group B on the 5th day a gradual decrease in the concentration of CIC was noticed when it was compared to the original 1,2 times (172 items of extinction) that exceeded the normal value of 1,7 times. On the 9th day of CIC levels got higher than the values of the control group in 1,3 times and was at the level of performance of patients in group А on 5th day and decreased when was compared with the previous value of 1,26 times (135 items of extinction). In group C in the postoperative period CIC kept increasing. On 5th day of CIC levels decreased in 1,27 times and amounted to 213 items of extinction, which exceeded the value of 2,1 times of the norm. The concentration of CIC on 9th day significantly increased compared with the normal 1,8 times , with group A 1,7 -fold, from group В to 1,33 times. High values of CIC showed that patients remain probable violations of the immune homeostasis, which may be unfavorable in terms of the progression of the inflammatory process and the development of complications. Malfunction of humoral immunity of patients with phlegmons of maxillofacial is determined by increased level of CIC, which correlates with the severity of disease. It is determined that the biggest malfunctions in the immune system is observed in critically ill patients. The identified changes are indicators for the differentiated immunological correction depending on the initial state of the immune system.

phlegmons, maxillofacial area, circulating immune complexes

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«Bulletin of problems biology and medicine» Issue 2 part 1 (107), 2014 year, 245-247 pages, index UDK 617. 52 -002. 36-07:616. 155. 321-07