CATION COMPOSITION OF ORAL SECRETION IN PRIMARY SCHOOL-AGED CHILDREN
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i3.14072Keywords:
children, RRIs, trace elements, saliva metal profile, ionomeAbstract
SUMMARY. Recurrent respiratory infections (RRIs) currently have the greatest medical and social burden among infectious diseases worldwide, with the highest prevalence and incidence rates of acute respiratory infections in children. Recent studies indicate the role of inadequate immune response and the development of recurrent acute respiratory infections (ARI) in children due to deficiencies in essential trace elements in the body, which are crucial for the proper functioning of physical barriers and the immune system. The hypothesis of our study assumed that, considering the recurrence of at least 6 episodes of ARI per year, children with RRIs may have changes in salivary ion levels, which could serve as a basis for local immune suppression of the upper respiratory mucosa.
The aim – to investigate the levels of metals in the saliva of children of primary school age with recurrent respiratory infections in comparison with episodically ill peers and establish the relationship of these changes with the state of local immunity.
Material and Methods. In the actual study, 40 children participated, with 30 of them (the main group) being children with recurrent respiratory infections and 10 other children who had episodic illnesses were assigned to the control group. The levels of metal cations in the saliva were examined using inductively coupled plasma atomic emission spectrometry, including essential metals such as copper, manganese, zinc, calcium, cobalt, potassium, magnesium, sodium, phosphorus, selenium, iron, chromium, and sulfur. Additionally, levels of conditionally essential metals like lithium, nickel, and boron were measured. The levels of secretory IgA and lysozyme in saliva were determined using the enzyme-linked immunosorbent assay method.
Results. The main group was not homogeneous; therefore, we divided it into two clusters. Respondents in one cluster had significantly lower relative levels of essential ion content in saliva. Specifically, calcium was lower in 64 % (p=0.003), copper in 76.5 % (p=0.001), manganese in 41.1 % (p=0.008), magnesium in 64 % (p=0.02), and zinc in 58.8 % (p=0.027). This fact can be explained by their increased losses due to frequent inflammatory processes in the upper respiratory tract, resulting in higher daily replenishment needs compared to their peers. Correlation analysis revealed a connection between illness incidence and the levels of copper (p=0.008), sodium (p=0.00005), and phosphorus (p=0.028), indicating potential associations between saliva metal profiles and the frequency of ARI in children with RRIs. The presence of dental caries correlated with lithium (p=0.02), copper (p=0.032), and nickel levels (p=0.037). Integral indicators of local immunity, such as lysozyme and secretory IgA, exhibited correlations with metal levels in saliva (Li, Cu, Ni, Na, Co, P, Zn), confirming the hypothesis of their role in regulating immune reactions in the oral cavity.
Conclusions. Cluster analysis of the metal profiles of the group of children with RRI shows its heterogeneity, 43 % of representatives of this cohort had significantly lower levels of calcium (p=0.003), copper (p=0.001), manganese (p=0.008), magnesium (p=0.02) and zinc (p=0.027) than the control group. Which may indicate the presence of deficient conditions in some children with PRI as a result of the increased need for their recovery. The presence of caries, the level of SIgA, lysozyme (clinical indicators of local immunity of the oral cavity) have certain relationships with the levels of essential and conditionally essential levels of salivary metals (Li, Cu, Ni, Na, Co, P, Zn), which indicates the benefit of the connection between the metal profile of saliva and the state of local immunity.
References
Cuppari, C., Colavita, L., Miraglia Del Giudice, M., Chimenz, R., & Salpietro, C. (2020). Recurrent respiratory infections between immunity and atopy. Pediatric Allergy and Immunology, 31, 19-21. DOI: https://doi.org/10.1111/pai.13160
Chiappini, E., Santamaria, F., Marseglia, G.L., Marchisio, P., Galli, L., Cutrera, R., ... & Villani, A. (2021). Prevention of recurrent respiratory infections. Italian Journal of Pediatrics, 47(1), 1-17. DOI: https://doi.org/10.1186/s13052-021-01150-0
Vysochyna, I.L. (2013). Osoblyvosti stanu mistsevoho imunitetu slyzovykh verkhnikh dykhalnykh shlyakhiv u ditey-vykhovantsiv dytyachykh budynkiv ta efektyvnist sezonnoyi profilaktyky HRVI z vykorystannyam bahatokomponentnoho roslynnoho preparatu [Peculiarities of the state of local immunity of the mucosa of the upper respiratory tract in children in orphanages and the effectiveness of seasonal prevention of ARI using a multicomponent herbal preparation]. Medychni perspektyvy – Medical perspectives, 18(3), 77-83 [in Ukrainian]. DOI: https://doi.org/10.26641/2307-0404.2013.3.18997
Vysochyna, I., & Kramarchuk, V. (2022). Clinical and anamnestic predictors of the recurrent respiratory infections in children of primary school age. Modern stages of scientific research development, 14, 254.
Abaturov, O.Ye., Kryuchko, T.O., Kryvusha, O.L., Babych, V.L., Tokaryeva, N.M., & Tkachenko, O.Ya. (2023). Vplyv poyednanoyi terapiyi solyamy kaltsiyu ta vitaminom D na kontsentratsiyu makro- ta mikroelementiv u slyni ditey rannioho viku [The effect of combined therapy with calcium salts and vitamin D on the concentration of macro- and microelements in the saliva of young children]. Zdorovia dytyny – Childs Health, 18(1), 12-16 [in Ukrainian] DOI: https://doi.org/10.22141/2224-0551.18.1.2023.1552
Baima G., Iaderosa G., Corana M., Romano F., Citterio F., Giacomino A., Berta G.N., & Aimetti M. (2022). Macro and trace elementssignature of periodontitis in saliva: A systematic review with quality assessment of ionomics studies. J. Periodontal Res, 57(1). 30-40. DOI: 10.1111/jre. 12956. Epub 2021 Nov 27. PMID: 34837226; PMCID: PMC9298699. DOI: https://doi.org/10.1111/jre.12956
Natarajan, K., Gayathri, R., & Vishnu Priya, V. (2016). Analysis of electrolytes in saliva of periodontitis and healthy individuals. Int. J. Pharm. Sci. Rev. Res., 41(1), 12-14.
Gaur, S., & Agnihotri, R. (2017). Trace mineral micronutrients and chronic periodontitis – a review. Biological trace element research, 176, 225-238. DOI: https://doi.org/10.1007/s12011-016-0832-y
Marín Martínez, L., Molino Pagán, D., & López Jornet, P. (2018). Trace elements in saliva as markers of type 2 diabetes mellitus. Biological trace element research, 186, 354-360. DOI: https://doi.org/10.1007/s12011-018-1326-x
Sejdini, M., Meqa, K., Berisha, N., Çitaku, E., Aliu, N., Krasniqi, S., & Salihu, S. (2018). The effect of Ca and Mg concentrations and quantity and their correlation with caries intensity in school-age children. International journal of dentistry. DOI: https://doi.org/10.1155/2018/2759040
Inonu, E., Hakki, S.S., Kayis, S.A., & Nielsen, F.H. (2020). The association between some macro and trace elements in saliva and periodontal status. Biological trace element research, 197, 35-42. DOI: https://doi.org/10.1007/s12011-019-01977-z
Poletto, A.C., Singi, P., Barri, R.M., Casanova, A.A., Garbelini, C.C.D., da Silva, C.C., & Venancio, E.J. (2021). Relationship of levels of trace elements in saliva and dental caries in preschool children using total reflection X-ray fluorescence technique (TXRF). Journal of Trace Elements in Medicine and Biology, 63, 126663. DOI: https://doi.org/10.1016/j.jtemb.2020.126663
Romano, F., Iaderosa, G., Corana, M., Perotto, S., Baima, G., Di Scipio, F., ... & Berta, G.N. (2022). Comparing Ionic Profile of Gingival Crevicular Fluid and Saliva as Distinctive Signature of Severe Periodontitis. Biomedicines, 10(3), 687. DOI: https://doi.org/10.3390/biomedicines10030687
Mehri, A. (2020). Trace elements in human nutrition (II)–an update. International journal of preventive medicine, 11.
Bevinagidad, S., Setty, S., Patil, A., & Thakur, S. (2020). Estimation and correlation of salivary calcium, phosphorous, alkaline phosphatase, pH, white spot lesions, and oral hygiene status among orthodontic patients. Journal of Indian Society of Periodontology, 24(2), 117. DOI: https://doi.org/10.4103/jisp.jisp_440_19
Mrag, M., Kassab, A., Omezzine, A., Belkacem, C.R., Ben, F.I.F., Douki, N., ... & Ben, A.F. (2020). Saliva diagnostic utility in patients with type 2 diabetes: Future standard method. Journal of Medical Biochemistry, 39(2), 140. DOI: https://doi.org/10.2478/jomb-2019-0019
Rosa, L.K., Costa, F.S., Hauagge, C.M., Mobile, R.Z., de Lima, A.A.S., Amaral, C.D., ... & de Araujo, M.R. (2021). Oral health, organic and inorganic saliva composition of men with Schizophrenia: Case-control study. Journal of Trace Elements in Medicine and Biology, 66, 126743. DOI: https://doi.org/10.1016/j.jtemb.2021.126743
Ng, J., Sjöstrand, M., & Eyal, N. (2019). Adding lithium to drinking water for suicide prevention – the ethics. Public Health Ethics, 12(3), 274-286. DOI: https://doi.org/10.1093/phe/phz002
Pathak, M., Shetty, V., & Kalra, D. (2016). Trace Elements and Oral Health: A Systematic Review. Journal of Academy of Advanced Dental Research, 7, 12-20. DOI: https://doi.org/10.1177/2229411220160203
Sruthi, K.S., Yashoda, R., & Manjunath, P.P. (2019). Diagnostic potential of saliva as a biomarker in early childhood caries: a review. Children, 11(12), 14.
Velasco-Ibáñez, R., Lara-Carrillo, E., Morales-Luckie, R.A., Romero-Guzmán, E.T., Toral-Rizo, V.H., Ramírez-Cardona, M., ... & Medina-Solís, C.E. (2020). Evaluation of the release of nickel and titanium under orthodontic treatment. Scientific Reports, 10(1), 22280. DOI: https://doi.org/10.1038/s41598-020-79221-1
Primasari, A., Octiara, E., & Yanti, N. (2019, July). Risk factor of secretory immunoglobulin A and salivary lysozyme level in children aged under 3 years to severe early childhood caries. In IOP Conference Series: Earth and Environmental Science, IOP Publishing, 305, 1, 012001. DOI: https://doi.org/10.1088/1755-1315/305/1/012001
