THYROID AND CORTICOID STATUS IN CHILDREN WITH ATOPIC BRONCHIAL ASTHMA IN THE PRESENCE OF DENTAL DISEASES

Abstract

The leading role of hormones in the formation of protective and compensatory mechanisms determines the role of the study of the neuroendocrine system in asthma. Researchers studying this problem have noted that the body responds to the entry and action of an allergen with a complex cascade of protective and adaptive reactions with the indispensable participation of the main control and regulatory adaptive systems – pituitary-adrenal and pituitary-thyroid [4; 8; 9; 16]. Endogenous activation of the reticular zone of the adrenal cortex, and hence an increase in the content of endogenous adrenal androgens in the bloodstream, is observed during chronic stress exposure [1; 2; 12; 13]. During chronic exposure, the stress-limiting effect of adrenal androgens is necessary as a protective one in cases where a long-term high level of glucocorticoids can be dangerous due to their catabolic effects in the body. Adrenal androgens, along with non-immune protection and activation of anabolic processes, cause immune protection and anti-immunodepressive effects, providing anti-allergic, anti-infective, and anti-oncogenic protection [6; 7; 10; 11; 15]. The aim of the study to study thyroid and corticoid status in children with atopic bronchial asthma in the presence of inflammatory periodontal diseases without caries complications. In order to study the features of thyroid and corticoid status in children with dental morbidity on the background of asthma, 195 children were examined. 120 children with asthma and dental diseases formed the main group, the comparison group consisted of 49 people with dental caries and periodontal diseases without concomitant somatic diseases. The control group consisted of 26 somatically healthy children with intact periodontal and teeth. An immunological method was used to assess the hormonal spectrum of blood serum, and the degree of inflammatory phenomena in the gums was studied using the PMA index. Materials and methods. Analysis of the concentration of thyroid hormones and cortisol in children of different ages with dental diseases on the background of asthma showed that the highest serum TSH levels were determined in 7–9 year old children (2.62 ± 0.47) μM/ml with minimum values at the age of 13–15 years (1.54 ± 0.13) μM/ml. In the comparison group, the same serum TSH values were determined in the age interval of 7–9 years and 10–12 years, and in children 13–15 years, an increase in serum TSH values to (2.08 ± 0.28) μM/ml was noted. The same T4 values were recorded in the serum of children 7–9 and 10–12 years of the main group, which on average amounted to (127.12±6.84) nmol/l. In the comparison group, the maximum values of T4 were determined in 7–9 year-olds (110.71 ± 8.63) nmol/l with minimum values (92.66 ± 4.83) nmol/l in children aged 13–15 years. Analysis of the content of thyroid hormones and cortisol in the blood serum of children, depending on the nosological form of dental disease, showed that in children of the main group with periodontal diseases, the TSH level was 8.95 % higher (p > 0.05) than in persons of the same group with caries. At the same time, in children of the comparison group with periodontal diseases, the TSH content was 7.81 % lower (p1 > 0.05) than in persons of the main group with periodontal diseases and 8.57 % lower (p1 > 0.05) than in children of the main group with caries. Conclusions. Thus, in children with asthma of the main group, regardless of the nosological form of dental disease, higher values of thyroid hormones and cortisol in blood serum were noted compared to the data in children of the comparison group. In both groups of the study, in the presence of inflammatory diseases of periodontal tissues, higher values of the analyzed hormones were observed than in the case of dental caries. Thus, in children with dental morbidity on the background of asthma, greater deviations in the functioning of the pituitary-thyroid system were studied, which required adequate therapeutic treatment taking into account the somatic and dental status of children with asthma.