Immunopathogenetic features of the functioning of congenital immunity in children with dental and disabling somatic pathology

• Main Authors: M. A. Havrylenko, Т. Ye. Shumna
• Format: Article
• Language: English
• Published: Zaporozhye State Medical University 2019-09-01
• Series: Patologìâ
• Subjects: gene expression; toll-4 receptor; toll-like receptor 2; matrix RNA; interleukin-1β; interleukin-17A; disabiled children
• Online Access: http://pat.zsmu.edu.ua/article/view/177195/178615

Purpose.To study the immunopathogenetic mechanisms of the functioning of congenital immunity in children with dental and disabling somatic pathology. Materials and methods. A general dental examination was conducted by 416 children with disabilities, who had a dental pathology, aged 2 to 18 years. Yes, I group of observation were 98 children with CNS diseases, II group – 150 children with blood diseases; III group - 70 children with respiratory diseases; IV – 98 children with mental disorders, and the control group V was 50 children without somatic invalidating pathology. The examined children, according to DentalHealthFoundation recommendations, took into account age periods of development of teeth, which correlated with the main stages of childhood and the critical periods of the formation of the immune system: the age of temporary bite (from 2 to 5 years), bite (from 6 to 10 years), constant bite (from 11 to 18 years old). The surveyed methods of research were used: clinical and laboratory – for studying the state of solid teeth tissues, periodontal tissues, oral hygiene; photocolormetric - to study the level of lysozyme, linked immunosorbent assay – secretory immunoglobulin A (sIg A). Microbiological study of plaque and molecular genetics – to determine the expression of the Toll-like receptor (TLR) type 2 and type 4, the nuclear factor kV (NF-κB) and proinflammatory interleukins (IL-1β and IL- 17A) were carried out in 93 children with special needs and caries and chronic catarrhal gingivitis and 25 somatically healthy children. The CFX96 ™ Real-Time PCR Detection Systems (Bio-Rad, USA) amplifier was used to determine the expression level. Specific pairs of primers for analysis of the studied and reference genes were selected using the software Primer-BLAST (NIH, USA) and manufactured by Metabion (Germany). Statistical processing was carried out using the package of the licensed program Statistica for Windows 13 (StatSoft Inc., № JPZ804I382130ARCN10-J). For all types of analysis, the level of statistical significance was used P < 0.05, at which differences were considered reliable. Results. It has been established that in children with disabilities the frequency of caries was registered in the range of 41.67–82.14 %, but in all examined patients in the dental plaque microorganisms such as: Streptococcus non-haemolyticus, Streptococcusheemolyticus, Corynebacterium matruschotti were isolated. In this case, the level of secretory Ig A in the oral liquid in all children with disabilities was in the I group of 0.47 (0.46; 0.48) g / l; in ІІ – 0,45 (0,31; 0,47) g / l; in III – 0,42 (0,41; 0,43) g / l; in IV – 0,33 (0,31; 0,35) g / l, and significantly exceeded the similar indicators in the comparison group – 0,28 (0,26; 0,28) g / l. Lysozyme, by contrast, had a lower level in children with disabling diseases (in the I group it was 5.75 (5.25; 5.89) mg / l; in II – 5.1 (3.25; 5.45) mg/l in the third – 5.74 (5.65; 5.78) mg/l, in IV – 5.62 (5.35; 5.85) mg/l than in the comparison group – 7.26 ( 7,12; 7,45) mg/l. The molecular genetic study of congenital immunity reliably demonstrated a 5.6- and 1.6-fold increase in the transcriptional activity of the mRNA of the TLR2 and TLR4 gene in the buccal epithelium of children with diseases of the central nervous system, 8, 5- and 2.4-fold increase in children with respiratory diseases, 7.8- and 16.6-fold In children with mental disorders, there was no significant change in the level of the mRNA of the TLR2 and TLR4 genes, activation of the pattern recognition receptors causes transcriptional induction of the NF-κB gene and proinflammatory cytokines IL-1β and IL-17A with the epithelium of the buccal epithelium: levels of expression of IL-1β and IL-17A mRNA in children with CNS diseases increased by 8.9 and 7.7 times (P < 0.05), respectively, in children with mental illness, IL-17A levels increased by 2, 2 times (P < 0.05), in children with respiratory diseases and diseases of the system trench expression of IL-1β increased 6.5 and 2.9 times (P < 0.05), respectively, IL-17A - 3.8 and 3.0 times (P < 0.05). Conclusion. The pathogenetic signaling pathways for the implementation of the functioning of congenital immunity depending on the disabling disease and the mechanisms of the formation of odontogenic pathology under the conditions of life of non-hemolytic and hemolytic streptococci and corynebacterium in dental plaque and peculiarities of sIgA products, lysozyme: in children with CNS diseases – due to transcriptional activity of membrane tolu- like receptors 4, expression of the nucleic factor kV (NF-κB) and the activity of the matrix RNA of proinflammatory cytokines IL-1β and IL-17A; with blood diseases - when activating matrix RNA of membrane toluic receptors 2, 4, nuclei factor kV (NF-κB), interleukin 17A; with diseases of the respiratory system - expression of interleukin 17A; with mental disorders - when activating interleukin 1β and membrane toll-like receptors by interleukin 17A.