STATE OF LOCAL IMMUNITY OF THE ORAL CAVITY IN ADOLESCENTS DIABETIC PATIENTS

Khmil E. V., Karpenko O. A., Berezhnaya E. E., Soloshenko Yu. I.

CONTENTS

Scentific article

Most of the diseases of the internal organs are accompanied by functional and organic changes of mucous membrane of oral cavity (MMOC). They are often the first and among the most common symptoms of diabetes mellitus (DM). Under the influence of endocrine dysfunction caused or aggravated by certain violations of the immunological status. In patients with diabetes, there is quite a significant reduction in reactivity and resistance, which in turn leads to severe courses of chronic diseases. The impact of diabetes on the course of pathological processes caused profound disturbances of all kinds of metabolism and inhibition of immunological defense mechanisms. The aim of our study was to investigate the status of local immunity of the oral cavity in adolescents with diabetes. It examined 32 diabetic patients (18 boys and 14 girls) aged 12 to 16 years. The duration of diabetes was 10 people in 1 year, 13 – 1 to 5 years, 9 – over 5 years. Oxygen forming ability of neutrophilic leukocytes investigated in flushing out of the oral cavity according to the modified method of Sayapina L. M. and Tseberzhynskiy O. I. We studied the reaction of spontaneous recovery nitro blue tetrazolium ( sNST test) and the reaction induced by stimulants ( Insta-test). The degree of activation distinguished by plane occupied by dyformazan granules (0 – cells without granules dyformazan; I-25% of cells stained cytoplasm ; II-75%; III-100%). Phagocytic activity (PA) of Oral cavity leukocytes investigated by the method of Coast A. E. and Stenko A. H. (1968) with modifications of MarchenkoI. According to our data in patients with diabetes significantly increased the number of spontaneously activated neutrophils. Percentage of positive formazan leukocytes in the flushing out of the mouth of adolescents with diabe-tes (42,3±3,7% formazan positive cells) above of this indicator in the control group (28,3±2,5% formazan positive cells) by 49. 5%. Comparing the data in adolescent patients with diabetes in adolescents without background pa-thology determined that the background of diabetes leukocyte count, which was restored nitro blue tetrazolin and the degree of activation is higher (p< 0. 05). We found that in patients with diabetes with increasing values of sNST test is no inhibition of phagocytic activity of neutrophils. FA of neutrophils of oral cavity in diabetic patients (27,06±1,11%) compared with controls (29,80±0,95%, p<0,05) corresponded almost norms. Adolescents without background pathology of reactive oxygen species pro-duction and oral leukocyte FA is within normal limits. In Insta-test in each group surveyed, an increase of the values of all parameters compared with sNST test data. Reproduced in the presence of promoters Insta-test number of activated neutrophils and the index of activity in the background diabetes compared with the performance of the control group had no significant difference. Analysis of the results of the study showed that adolescent patients with diabetes altered state of local immunity of the oral cavity. Evidently in patients with diabetes there are hyperproduction of reactive oxygen species by leuko-cytes. This fact suggests that enhanced oxygen forming function of leukocyte oral cavity is one of the reasons for the activation mechanisms of mucous membrane and periodontal tissues damage in adolescents diabetic patients. So, activation oxygen forming function of leukocytes in the oral cavity and hyperproduction of reactive oxygen species in adolescents with diabetes causes a decrease in local immunity and may contribute greatly damaged of periodontal tissues and mucous membrane.

diabetes, local immunity, oral cavity

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