The role of the cellular link of adaptive immunity in the development of chronic generalized periodontitis in patients with a combined course of type 2 diabetes mellitus

Abstract

Summary. In the mechanisms of the inflammatory processes development of the oral cavity, an important role is played by the immune responses of the local and systemic nature, especially against the background of other combined pathologies.

The aim of the study – to find out the nature of the changes and to evaluate the parameters of the cellular level of adaptive immunity in chronic generalized periodontitis, type 2 diabetes and their combination.

Materials and Methods. A survey was conducted on 20 practically healthy persons (control group), 36 patients with clinically diagnosed type 2 diabetes mellitus (DM), 32 patients with a confirmed diagnosis of chronic generalized periodontitis (CGP) and 32 patients with combined DM and CGP (group 4). Cell immunity studies were performed on the Epic-XL flow cytometer manufactured by Beckman Coulter (USA).

Results and Discussion. Patients with type 2 diabetes mellitus, CGP and their combination significantly decreased the level of CD3⁺ and CD4⁺ T lymphocytes in relation to control. The lowest levels of CD3⁺ and CD4⁺ T lymphocytes were observed in patients with CGP on the background of DM type 2. In this case, their content in the blood decreased, respectively, in 2.3 and 1.4 times (p<0.001). The development of cell-mediated immunosuppression in patients with CGP in combination with type 2 diabetes is also confirmed by a decrease in the immunoregulatory index (CD4⁺/CD8⁺) in the blood of patients with type 2 diabetes (15.0 %) and in patients with a combination of diabetes and periodontitis (13.4 %), (p<0.05). The decrease in the activity of natural killers indicates a decrease in the protective functions of the system of cellular immunity in patients with CGP on the background of DM 2 type.

Conclusions. Development of chronic generalized periodontitis on the background of type 2 diabetes is accompanied by an imbalance of subpopulations of T and B lymphocytes with a decrease in the content of the major populations of lymphocytes with the phenotype – CD3⁺, CD4⁺, CD8⁺ and increased with the phenotype CD22⁺.