The purpose of the study was to study the relationship between the state of the oral cavity microbiocenosis and the level of local immunity in children and adolescents with chronic liver diseases. Materials and methods. 45 children aged 10 to 16 years, who were treated in the public utility "City Children's Clinical Dental Hospital of the Poltava City Council" were examined. All children were divided into 2 groups: the main group – children and adolescents with chronic hepatitis (n = 26) with diseases of concomitant oral mucosa and periodontal disease; control group – children of the same age without concomitant somatic pathology (n = 20). In all observation groups, the state of oral hygiene was recorded using the simplified oral hygiene index (Green-Vermillion, 1964) and the intensity of the inflammatory process in the periodontal tissues, which was assessed by the papillary-marginal-alveolar index modified by Parma (1960). The degree of dysbiosis in the oral cavity was determined using the enzymatic method of A. P. Levitsky by the ratio of the relative activity of urease and lysozyme. The state of local immunity was investigated by the level of immunoglobulins IgA, IgM, IgG and secretory immunoglobulin sIgA. Results and discussion. It was found that the majority of patients with chronic hepatitis had an unsatisfactory and even poor state of oral hygiene, according to the Green-Vermillion simplified oral hygiene index, in combination with moderate and severe gingivitis (according to the papillary-marginal-alveolar index). The most negative results were registered in children 9-13 years old. The effect of the low level of oral hygiene in children and adolescents with chronic liver diseases, which is accompanied by increased dysbiosis, was studied, which indicates a drop in the level of antimicrobial protection, suppression of local mucosal immunity, a decrease in lysozyme activity and a decrease in the content of secretory sIgA in the oral fluid. The mediated mechanism of sIgA action through the phagocyte activation system with subsequent lysis of pathogenic microorganisms is considered. Conclusion. Chronic liver diseases reliably lead to changes in the body's immunobiological reactivity, and also cause suppression of the protective mechanisms of the oral cavity and its local immunity, characterized by a decrease in the activity of lysozyme and secretory IgA in the oral fluid of sick children and adolescents

Keywords: microflora, microbiocenosis, dysbiosis, comorbid pathology, mucosal immunity

Full text: PDF (Ukr) 262K

1. Savychuk NO. Kolonizatsiyna rezystentnist porozhnyny rota [Colonization resistance of the oral cavity]. Ukr med chasopys. 2012;4(90). [Ukrainian]. Available from: http://www.umj.com.ua/article/39590
2. Wilkins LJ, Monga M, Miller AW. Defining Dysbiosis for a Cluster of Chronic Diseases. Sci Rep. 2019 Sep 9;9(1):12918. https://www.ncbi.nlm.nih.gov/pubmed/31501492. https://www.ncbi.nlm.nih.gov/pmc/articles/6733864. https://doi.org/10.1038/s41598-019-49452-y
3. Brüssow H. Problems with the concept of gut microbiota dysbiosis. Microb Biotechnol. 2020 Mar;13(2):423-434. https://www.ncbi.nlm.nih.gov/pubmed/31448542. https://www.ncbi.nlm.nih.gov/pmc/articles/7017827. https://doi.org/10.1111/1751-7915.13479
4. Khavkin AI, Ippolitov YuA, Aleshina EO, Komarova ON. Mikrobiota i bolezni polosti rta [Microbiota and oral disease]. Eksp Klin Gastroenterol. 2015; 6(118): 78-81. [Russian]
5. Muñoz Aguilera E, Suvan J, Buti J, Czesnikiewicz-Guzik M, Barbosa Ribeiro A, Orlandi M, et al. Periodontitis is associated with hypertension: A systematic review and meta-analysis. Cardiovasc Res. 2020 Jan 1;116(1):28-39. https://www.ncbi.nlm.nih.gov/pubmed/31549149. https://doi.org/10.1093/cvr/cvz201
6. Kolesnikova OV, Radchenko AO. Osoblyvosti proyaviv hastroenterolohichnykh zakhvoryuvan u lyudey starshoho viku [Features of manifestations of gastroenterological diseases in older people]. Hastroenterolohiya. Hepatolohiya. Koloproktolohiya. 2020; 1(55): 26-27. [Ukrainian]
7. Denburg MR, Koepsell K, Lee JJ, Gerber J, Bittinger K, Tasian GE. Perturbations of the Gut Microbiome and Metabolome in Children with Calcium Oxalate Kidney Stone Disease. J Am Soc Nephrol. 2020 Jun;31(6):1358-1369. https://www.ncbi.nlm.nih.gov/pubmed/32381601. https://www.ncbi.nlm.nih.gov/pmc/articles/7269359. https://doi.org/10.1681/ASN.2019101131
8. Kanner EV, Gorelov AV, Pechkurov DV, Gorelova EA, Maksimov ML, Ermolaeva AS. Mukozalnaya immunnaya sistema pishchevaritelnoho i respiratornoho traktov: vozmozhnosti profilaktiki i lecheniya infektsionnykh zabolevaniy [Mucosal immune system of digestive and respiratory tracts: possibilities of prevention and treatment of infectious diseases]. Med Sovet. 2019;(11):100-107. [Russian]. https://doi.org/10.21518/2079-701X-2019-11-100-107
9. Zaura E, Brandt BW, Buijs MJ, Emingil G, Ergüz M, Karapinar DY, et al. Dysbiosis of the Oral Ecosystem in Severe Congenital Neutropenia Patients. Proteomics Clin Appl. 2020 May;14(3):e1900058. https://www.ncbi.nlm.nih.gov/pubmed/32026584. https://www.ncbi.nlm.nih.gov/pmc/articles/7317524. https://doi.org/10.1002/prca.201900058
10. Bilello J, Okereke I. Impact of Environmental and Pharmacologic Changes on the Upper Gastrointestinal Microbiome. Biomed. 2021;9(6):617. https://www.ncbi.nlm.nih.gov/pubmed/34072493. https://www.ncbi.nlm.nih.gov/pmc/articles/8229529. https://doi.org/10.3390/biomedicines 9060617
11. Lutskaya IK. Proyavleniya na slizistoy obolochke polosti rta zabolevaniy vnutrennikh organov i SPIDa [Manifestations on the oral mucosa of the oral cavity of internal organs and AIDS]. Mezhdunarodnye obzory: klinicheskaya praktika i zdorove. 2013;2:75-81. [Russian]
12. Lyubchenko O, Severyn L. Biochemical parameters of oral fluid in infants with respiratory system diseases (RSD). ScienceRise: Med Sci. 2019;29(2):41-4. https://doi.org/10.15587/2519-4798.2019.161854
13. Khmil EV, Khmil DA. Terapevticheskaya effektivnost tsikloferona v lechenii retsidiviruyushchego gerpeticheskogo stomatita u podrostkov [Therapeutic Efficiency of Cyclopheron in Treating Recurrent Herpesistic Stomatitis in Adolescents]. Ukr Zh Med Biol Sport. 2018;4(13):156-160. [Russian]. https://doi.org/10.26693/jmbs03.04.156
14. Levitskiy AP, Makarenko OA, Selivanskaya IA. Fermentativnyy metod opredeleniya disbioza polosti rta dlya skrininga pro- i prebiotikov [Enzymatic method for determining the dysbiosis of the oral cavity for screening of pro- and prebiotics]. Metod. rekomendatsii. K: GFTs; 2007. 26 s. [Russian]
15. Instruktsiya po primeneniyu nabora reagentov dlya immuno-fermentnogo opredeleniya sekretornogo IgA A v biologicheskikh zhidkostyakh «Sekretornyy IgA-IFA» [Instructions for the use of a set of reagents for the Іmmuno-enzyme definition of secretory IgA and in the biological fluids "Secretor IGA-ІFA"]. M: Khema-medica; 2013. 17 s. [Russian]
16. Moskalenko VF. Biostatistika [Biostatistics]. K: Kniga plyus; 2009. 256 s. [Russian]
17. Romano F, Perotto S, Castiglione A, Aimetti M. Prevalence of periodontitis: misclassification, under-recognition or over-diagnosis using partial and full-mouth periodontal examination protocols. Acta Odontol Scand. 2019;77(3):189-196. https://www.ncbi.nlm.nih.gov/pubmed/30623706. https://doi.org/10.1080/00016357.2018.1535136
18. Bostanci N, Mitsakakis K, Afacan B, Bao K, Johannsen B, Baumgartner D, et al. Validation and verification of predictive salivary biomarkers for oral health. Sci Rep. 2021 Mar 19;11(1):6406. https://www.ncbi.nlm.nih.gov/pubmed/33742017. https://www.ncbi.nlm.nih.gov/pmc/articles/7979790. https://doi.org/10.1038/s41598-021-85120-w
19. Costa FO, Cortelli SC, Silva TA, Costa AA, Lima RPE, Cortelli JR, et al. Cytokine levels in crevicular fluid associated with compliance during periodontal maintenance therapy. Clin Oral Investig. 2 2019 Sep;23(9):3517-3526. https://www.ncbi.nlm.nih.gov/pubmed/30539293. https://doi.org/10.1007/s00784-018-2770-x
20. Gazhva SI, Kasumov NS, Kotunova NA. Stomatologicheskiy status patsientov s diffuznymi porazheniyami pecheni [Dental status of patients with diffuse lesions of the liver]. Mezhdunarodnyy nauchno-issledovatelskiy zhurnal. 2016; 12-5(54):72-74. [Russian]
21. Daley TD, Armstrong JE. Oral manifestations of gastrointestinal diseases. Can J Gastroenterol. 2007 Apr;21(4):241-4. https://www.ncbi.nlm.nih.gov/pubmed/17431513. https://www.ncbi.nlm.nih.gov/pmc/articles/2657699. https://doi.org/10.1155/2007/952673
22. Tada A, Senpuku H. The Impact of Oral Health on Respiratory Viral Infection. Dent J. 2021;9(4):43. https://www.ncbi.nlm.nih.gov/pubmed/33924596. https://www.ncbi.nlm.nih.gov/pmc/articles/8069613. https://doi.org/10.3390/dj9040043
23. Wu Z, Gong Y, Wang C, Lin J, Zhao J. Association between salivary s-IgA concentration and dental caries: an updated meta-analysi. Biosci Rep. 2020 Dec 8;40(12):BSR20203208. https://www.ncbi.nlm.nih.gov/pubmed/33289514. https://www.ncbi.nlm.nih.gov/pmc/articles/7755122. https://doi.org/10.1042/BSR20203208
24. Rezende RM, Cox LM, Weiner HL. Mucosal tolerance therapy in humans: Past and future. Clin Exp Neuroimmunol. 2019 Mar 14; 10(51): 20-31. https://doi.org/10.1111/cen3.12500