Introduction: Periodontitis, as an extreme variant of complicated caries, is an inflammation of the periodontal tissue, which develops, as a rule, in the presence of pathways for the outflow of inflammatory products from the periodontium (usually into the tooth cavity). Of the total number of patients with caries, periodontitis develops in 35-50% of cases [1]. Periodontitis, occurring as acute or chronic inflammation of the periodontium, in the vast majority of cases (up to 90%) is of infectious origin and occurs under the influence of nonspecific pathogens, most often staphylococci, or streptococci in symbiosis with other types of bacteria [2]. In recent years, a significant role of anaerobic infection in the development of chronic periodontitis has been established [3]. There is no doubt that the development of chronic periodontitis (CP) is possible only against the background of an immunodeficiency state, and, above all, insufficiency of the body’s phagocytic system, and therefore the study of the functional activity of neutrophils and monocytes in patients with periodontitis is extremely important [4, 5].
Aim of this investigation was to study the state of phagocytic activity of monocytes and neutrophils in the blood of patients with CP.
Materials and methods. We observed 56 patients aged from 47 to 55 years (average age – 51.5±2.5 years), including 32 men (57.1%) and 24 women (42.9%). Fibrous CP occurred in 6 (10.7%), granulating CP – in 15 (26.8%), granulomatous CP – in 35 (62.5%). In 48.2% of cases (27 people) CP was uncomplicated, while in 51.8% of cases (29 people) the disease was complicated, including periostitis (17 people, 30.4%), and soft tissue phlegmon face and neck (12 people, 21.4%).
The reference norm group consisted of 53 practically healthy donors, without acute or chronic dental pathology, aged from 45 to 57 years (average age - 51.0±2.6 years), including 17 men (51.5%), women – 16 (48.5%).
Populations of monocytes and neutrophils from peripheral blood were isolated by centrifugation on a double density gradient of 1.077 and 1.093 fecol-verografin [6]. The purity of the monocyte suspension (89-98%) was confirmed by immunofluorescence using monoclonal antibodies to CD14 receptors. The viability of cells in the suspension was confirmed in a trypan blue test (it was 95-98%). The working concentration of suspensions of neutrophils and monocytes is 2*106/ml.
Determination of the phagocytic activity of neutrophils and monocytes in peripheral blood was carried out using the plate method [7]. The following were calculated at the 30th and 120th minutes of the experiment: 1) phagocytic index (PI) – the percentage of phagocytic cells; 2) phagocytic number (PN) – the number of absorbed staphylococci per 1 phagocytic cell; 3) bactericidal index (BI) according to the formula: BI = (Number of killed bacteria/Number of absorbed bacteria) ×100; 4) phagocytic number coefficient (PNC) according to the formula: PNC=PN30/PN120. Statistical processing of the obtained data was carried out using the Student's test.
Results. It was established that in the phase of exacerbation of CP there is a decrease in the phagocytic function of neutrophils and monocytes, which was manifested in a decrease in their ÐI, ÐN, ÐNC and BI (Table 1).
The PI of neutrophils at the 30th and 120th minutes of the experiment was reduced, against the reference norm, by 1.34 and 1.37 times, respectively, and the PI by 1.42 and 1.90 times. The degree of decrease in the PI of monocytes at the 30th and 120th minutes of the experiment was 1.22 and 1.20 times, and the FI - 1.15 and 1.34 times, respectively. These changes were accompanied by an increase in the ÐNC of neutrophils by 1.34 times, and the ÐNC of monocytes by 1.16 times.
Òable 1. Indicators of phagocytosis of neutrophils and monocytes in patients with chronic periodontitis in the acute phase
The absorption capacity of neutrophils and monocytes was significantly reduced. Nn30 and Nn120 for neutrophils and monocytes, relative to the reference norm, turned out to be lower by 1.15 and 1.16 times, respectively. Along with this, there was a decrease in the inactivation of absorbed bacteria, as evidenced by a decrease in the Chu index, which at the 30th and 120th minutes of the experiment in neutrophil cultures was reduced by 1.38 and 1.36 times, respectively. For monocytes, similar degrees of changes were 1.41 and 1.29 times. These changes were accompanied by a decrease in IBN30 by 1.21 times, IBN120 by 1.18 times, IBM30 by 1.23 times, and IBM120 by 1.11 times.
Conclusions. The development of exacerbation of CP is accompanied by a violation of the phagocytic activity of neutrophils and monocytes in the blood of patients, namely a decrease in their PI, PN, PNC, BI. In CP, the most pronounced negative changes are observed in the neutrophilic link of the phagocytic system, less significant – in the monocyte link.
Referencese:
1. Kuznyak N.B., Dronyk I.I. Peculiarities of changes of main clinical signs in patients with chronic generalized periodontitis depending on the methods of comprehensive therapy. Êëiíi÷íà ñòîìàòîëîã³ÿ. 2017. ¹1. Ñ. 10-13.
2. Bhansali R.S.,Yeltiwar R.K., Bhat K. Evaluation of peripheral neutrophil functions in aggressive periodontitis patients and their family members in Indian population: An assessment of neutrophil chemotaxis, phagocytosis, and microbicidal activity. Journal of Indian society of periodontology. 2017 .Vol. 21, ¹ 6. P. 449-455.
3. Tapashetti R.P., Sharma S., Patil S.R., Guvva S. Potential effect of neutrophil functional disorders on pathogenesis of aggressive periodontitis. Journal of contemporary dental practice. 2013. Vol. 14, ¹ 3. P. 387-393.
4. Lin B.,Yuejiao X., Dingyu D.,Yi X. Advances in macrophage function and its anti-inflammatory and proresolving activity and role in periodontitis development. West China journal of stomatology. 2017. Vol. 35, ¹ 4. P. 427-432.
5. Liu Y.J., Liu Y., Xu Y. Developments of neutrophil function and the relationship between neutrophils dysfunction and periodontitis. West China journal of stomatology. 2016. Vol. 34, ¹ 2. P. 210-214.
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