EFFICIENCY OF TREATMENT OF GENERALIZED PARODONTITIS IN DRUG-DEPENDENT PATIENTS WITH TOXIC HEPATITIS
DOI:
https://doi.org/10.11603/2415-8798.2018.2.9089Keywords:
generalized parodontitis, drug addiction, toxic hepatitis, local immunity, cytokines, nuclex, mexidol.Abstract
Generalized parodontitis (GP ) occurs and proceeds against a background of violations of the indices of local immunity of the oral cavity of patients. Modern ideas about the causes of inflammatory parodontal diseases are based on the violation of local and general immune mechanisms, sensitization of the organism to antigens produced by pathogenic microorganisms, the presence of somatic pathology. The use of narcotic drugs causes disturbances in the functioning of the immune system. For the complex treatment of inflammatory parodontal diseases, the use of a drug with immunomodulating activity - nuklex and agents, which reduces the amount of oxidized stress products and has a hepatoprotective effect – mexidol is suggested.
The aim of the study – to learn the dynamics of general and local immunity indices (for the concentration of cytokines) in patients with generalized parodontitis with toxic hepatitis in opioid dependence during complex treatment.
Materials and Methods. 65 patients with GP were examined in the stage of unstable remission: 19 women (29.2 %) aged 20 to 45 years and 46 men (70.8 %) aged 19 to 47 years. All patients are on dispensary supervision with an expert in narcology about opioid addiction. At the stomatologic examination, GP of the second degree, toxic hepatitis is established. To determine the cytokine profile, samples of blood serum and mixed saliva were used in drug addicts, patients with Hepatitis B with toxic hepatitis, and healthy donors (reference norm).
Results and Discussion. Development of GP , especially in persons with toxic lesions (drug addiction), is accompanied by significant changes in the state of immune mechanisms of oral protection, which are manifested in local changes in the composition of gum cells, as well as the content of immunoglobulins and cytokines in the saliva. As a result of the conducted studies, before the beginning of preventive treatment, an increase in the level of IL-6, IL-8 and IL-10 was observed against the background of a decrease in γ-IFN. After finishing the treatment in patients with GP with opioid dependence with toxic hepatitis, there was an improvement in the indices of the studied cytokines (IL-6, IL-8, γ-IFN and IL-10). At the same time, a more pronounced positive dynamics of these indices was manifested in patients, an additional combination of nucleax and mexidol was taken.
Conclusions. To study the activity of local immunity in drug-dependent patients with toxic hepatitis, it is expedient to determine the level of cytokines by a non-invasive method. Imbalance of pro-inflammatory and anti-inflammatory cytokines is considered as a reflection of the inflammatory and autoimmune process. In the treatment of generalized parodontitis with the inclusion of a combination of nucleic acid and mexidol, the production of cytokines is restored. The use of this combination reduces the destructive-inflammatory process in the parodontium and the severity of immunodeficiency.
References
Abagidi, M.А., Luksushkina, E.F. & Mayansky, I.V. (2002). Uroven tsitokinov v sekrete rotovoy polosti u detey s bronkhialnoy astmoy [The level of cytokines in the secretion of the oral cavity in children with bronchial asthma]. Tsitokiny i vospaleniye – Cytokines and inflammation, 1, 3, 9-14 [in Russian].
Voronina, T.A. (2012). Mexidol: Spectr pharmacologicheskich effectov [Mexidol: a spectrum of pharmacological effects]. Zhurnal nevrologii i psikhiatrii im. C.C. Korsakova. – Journal Neurologii i Psychiatrii im. C.C. Korsakova, 112, 12, 86-90 [in Russian].
Dmitrieva, L.A. & Krainova, A.G. (2004). Sovremennie predstavleniya o roli microflory v patogeneze zabolevaniy parodonta [Modern concepts of the role of microflora in the pathogenesis of periodontal diseases]. Parodontologiya – Parodontologi, 1 (30), 8-15 [in Russian].
Zatolokin, V.D., Luneva, N.V. & Yatsun, S.M. (2010). Otsenka effektivnosti primeneniya meksidola i aktovegina v kompleksnom lechenii ostrogo toksicheskogo gepatita [Estimation of the efficacy of mexidol and actovegin in the complex treatment of acute toxic hepatitis]. Vestnik eksperimentalnoy i klinicheskoy khirurgii – Bulletin of Experimental and Clinical Surgery, 3, 3, 273-274 [in Russian].
Zelenova, Ye.G., Zaslavskaya, M.I., Salina, Ye.V. & Rassanov, S.P. (2004). Mikroflora polosti rta: norma i patologiya [Microflora of the oral cavity: norm and pathology]. Nizhniy Novgorod: Izdatelstvo NGMA, p. 156 [in Russian].
Kozlov, V.A. (2002). Nekotoryye aspekty problemy tsitokinov. [Some aspects of the problem of cytokines]. Tsitokiny i vospaleniye – Cytokines and inflammation,1, 1, 5-8 [in Russian].
Lapach, S.N., Chubenko, A.V. & Babich, P.N. (2002). Osnovnyye printsipy primeneniya statisticheskikh metodov v klinicheskikh ispytaniyakh [Basic principles of the application of statistical methods in clinical trials]. Kiyev: Morion, p. 160 [in Russian].
Lyakh, Yu.Y., Huryanov, V.H. & Khomenko, V.N. (2006). Osnovy kompyuternoy byostatystyky: analyz ynformatsyy v byolohyy, medytsyne y farmatsyy statystycheskym paketom MedStat [Fundamentals of computer biostatistics: analysis of information in biology, medicine and pharmacy by statistical package MedStat]. Donetsk, p. 214 [in Russian].
Meksydol: instruktsiia dlia medychnoho zastosuvannia preparatu [Mexidol: instruction for the medical use of the drug]. Zatverdzheno MOZ Ukrayiny vid 2014-08-22 r. № 594 – Approved by the Ministry of Health of Ukraine from 08-08-2018, no. 594 [in Ukrainian].
Nukleks: instruktsiia dlia medychnoho zastosuvannia preparatu [Nukleks: the instruction for the medical application of the drug]. Zatverdzheno MOZ Ukraí̈ni víd 2015-07-15 r. № 432 – Approved by the Ministry of Health of Ukraine from 2015-07-15, no. 432 [in Ukrainian].
Poskotinova, L.V., Shevchenko, O.E., Demin, D.B. & Krivonogova, Ye.V. (2010). Soderzhaniye interleykina-6 i interleykina-10 pri razlichnykh tipakh organizatsii bioelektricheskoy aktivnosti golovnogo mozga u podrostkov 15-17 let [The content of interleukin-6 and interleukin-10 in different types of organization of bioelectric activity of the brain in adolescents 15-17 years]. Ekologiya cheloveka. Voprosy ekologicheskoy immunologii – Ecology of the person. - Issues of environmental immunology, 5, 46-50 [in Russian].
Rusinova, T.V. (2016). Mekhanizm vliyaniya preparatov nukleinovykh kislot na produktsiyu provospalitelnykh tsitokinov in vitro v norme i pri infektsionnom protsesse [Mechanism of the influence of nucleic acid preparations on pro-inflammatory cytokine production in vitro and in the infectious process]. Sovremennyye problemy nauki i obrazovaniya – Modern problems of science and education, 3, 20 [in Russian].
Spasennykov, B.A. & Spasennykova, M.H. (2016). Meksydol: 30-letnyy opyt éksperymentalnoho y klynycheskoho yzuchenyya [Mexico City: 30 Years of Experience in Experimental and Clinical Studies]. Novainfo.Ru, 2, 52, 258-270 [in Russian].
Trufanov, S.Yu. (2013).Vyrazhenist syndromu endohennoi "metabolichnoi" intoksykatsii u khvorykh na khronichnyi parodontyt, spoluchenyi z khronichnoiu patolohiieiu hepatobiliarnoi systemy, ta yoho korektsiia z vykorystanniam nukleinatu [Expression of the syndrome of endogenous "metabolic" intoxication in patients with chronic periodontitis, combined with chronic pathology of the hepatobiliary system, and its correction using nucleate]. Problemy ekolohichnoi ta medychnoi henetyky i klinichnoi imunolohii – Problems of ecological and medical genetics and clinical immunology, 3, 165-171 [in Ukrainian].
Tsvetikova, L.N., Chernykh, Yu.N., Lobeyeva, N.V. & Khatipov, S.R. (2015). Interleykin-6, pokazateli oksidativnogo stressa i kharakteristika kognitivnykh protsessov pri gipoksii [Interleukin-6, indicators of oxidative stress and characteristics of cognitive processes in hypoxia]. Uspekhi sovremennogo yestestvoznaniya – Progress of Modern Natural Science, 9, (Pt 2), 253-255 [in Russian].
Black, K.P., Merril, K.W., Jackson, S. & Kats, J. (2000). Cytokine profiles in parotid saliva from HIV–1–infected individuals: changes associated with opportunistic infections in the oral cavity. Oral Microbiol. Immunol., 15, 2, 74-81.
Botros, M. & Sikaris, K.A. (2013). The De Ritis Ratio: The Test of Time. Clin Biochem Rev., 34 (3), 117-130.
Brandstadter, J.D. & Yang, Y. (2011). Natural Killer Cell Responses to Viral Infection. J. Innate Immun., 3 (3), 274-279.
Brook, I. (2003). Microbiology and management of periodontal infections. Gen. Dent, 51, 5, 424-428.
Marsh, P. & Martin, M.V. (Eds.) (2009). Oral Microbiology. Elsevier, p. 222.
Steele, C. & Fidel, P.L. (2002). Cytokine and chemokine production by human oral and vaginal epithelial cells in response to Candida albicans. Infec. Immun., 70, 2, 577-583.
Downloads
Published
How to Cite
Issue
Section
License
Authors who sent their manuscript to "Вісник наукових досліджень. Bulletin of Scientific Research" Surgery agree to the following terms:
a. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal. 
b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
