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20THE SPECIFIC MICROBIOLOGICAL COMPOSITION OF DENTAL PLAQUE IN CHILDREN WITH RAMPANT CARIES ON A BACKGROUND OF GASTROINTESTINAL TRACT DISEASES
Rozhko V.
Department of pediatric dentistry, PhD, assistant Higher State Education Institution of Ukraine "Bukovinian State Medical University "
Petruniv V.
Department of pediatric dentistry, PhD, Ass. Prof. Ivano-Frankivsk National Medical University
Havaleshko V.
Department of orthopaedic dentistry, PhD, assistant Higher State Education Institution of Ukraine "Bukovinian State Medical University" Piasetska L.
Department of orthopaedic dentistry, PhD, assistant I. Horbachevsky Ternopil National Medical University
Marchuk I.
Department of pediatric dentistry, assistant Higher State Education Institution of Ukraine "Bukovinian State Medical University"
Abstract
The wide prevalence and intensity of caries remains an urgent problem of dentistry, it affects almost all adults and children in the world. The oral cavity is an ecological system inhabited by various types of microorganisms. The article presents the results of study of the specific microbiological composition of dental plaque in children and adolescents with rampant caries on a background of gastrointestinal tract diseases.
Keywords: caries, bacteria, dental plaque, children.
Introduction. The wide prevalence and intensity of caries remains an urgent problem of dentistry, it affects almost all adults and children in the world. The oral cavity is an ecological system inhabited by various types of microorganisms. The composition of the resident microflora can change under the influence of various adverse factors that reduce the body's defense mechanisms. As a result, there are quantitative and qualitative shifts in the population of microorganisms in the ecosystem of the oral cavity, which can lead to the development of major dental diseases. The relationship in the ecological system "microorganisms - oral cavity - external factors" determine all subsequent events during the onset and initial stage of caries [1-4].
The microflora of the oral cavity, which has increased adhesive, invasive and toxic properties, is diverse and depends on the nature of the disease. Populations of microorganisms that colonize the oral cavity are involved in the pathological processes of the macro-organism, and conversely, the presence of bacteria in other organs can cause and worsen the course of dental diseases [3,5-7].
The bacterial microflora of the oral cavity is mul-ticomponent, numbering at least 400 species, so the selection of one or more cultures of bacteria does not always accurately reflect the state of the oral microbioce-nosis. Studies of direct counting of the number of bacteria in oral cavity, using universal cell dyes and slide tablets provide an opportunity to use them in the objectification of formed elements in biological fluids [2,4,8,9].
The aim. To study the specific microbiological composition of dental plaque in children and adolescents with rampant caries on a background of gastrointestinal tract diseases.
Material and research methods. We examined 120 children aged 6-15 years with diseases of the gastrointestinal tract. The main group (MG) consisted of 80 children with rampant caries on the background of gastrointestinal diseases. The comparative group (CG) included 40 children with intact teeth with similar somatic lesions of the gastrointestinal tract.
Microbiological study of dental plaque was performed by seeding and cultivation on solid nutrient media. Identification of isolated pure cultures was performed by morphological, tinctorial, cultural and biochemical characteristics, using the Bergey's classification scheme.
Statistical processing of the obtained indicators was performed by determining the Student criteria, as well as the coefficient of probability.
Results of the study and their discussion.
As a result of our research, we found that the total number of bacteria in children with rampant caries of the main group was in 7.0 higher than in children with intact teeth of the comparative group 3.14*107 ± 0.50x107 col./ml against 4.27x106 ± 0.24x106 col./ml, (p <0.05).
The results of microbiological studies showed that dental plaque in this group of patients is inhabited by various microorganisms (Table 1). However, the degree of total contamination in the main group was higher and was 3.07 ± 0.12 lg OTU / ml against 1.85 ± 0.08 lg OTU / ml in comparative group (p <0.001).
Table 1
Qualitative composition of microorganisms in dental plaque in children of the study groups
Groups of microbes Types of microogran-isms Main group, n=80 Comparative group, n=40
selecti De nsity insemination lg OTU/ml, M±m selecti D ensity insemination lg OTU/ml, M±m
Strepto-Coccus Str.mutans 62,5 4,44±0,11*** 20,8 1,72±0,06
Str.salivarius 42,0 3,78±0,12*** 40,5 1,26±0,05
Str.mitis 36,5 2,15±0,10*** 30,0 1,15±0,05
Str.sanguis 58,3 3,25±0,11*** 32,4 1,86±0,06
Staphylo-Coccus Aureus 9,0 1,86±0,08 8,0 1,73±0,05
Epidermidis 10,0 1,80±0,07 8,0 1,80±0,08
Gram-positive optional rods Lactobacterium 68,5 4,00±0,12*** 33,3 2,54±0,18
Nocardia 21,6 2,45±0,13*** - -
Gram-negative optional rods H.pylori 54,2 3,50±0,11*** 26,0 2,52±0,13
Proteus 48,2 3,00±0,14*** 22,0 2,00±0,15
Fungi Candida alb. 59,7 3,62±0,12*** 30,8 1,86±0,13
Notes. Significant difference in values relative to the comparative group data: * - p <0.05, ** - p <0.01, *** - p <0.001.
The frequency and density of plaque contamination in children of the study groups was heterogeneous and was characterized by certain features. First of all, it was noted that due to the presence of gastrointestinal lesions, the incidence of Helicobacter pylori in the main group was in 2.0 times higher (54.2 vs. 26.0%) than in CG with intact teeth. The concentration of Helicobacter pylori in the MG was 3.50 ± 0.11 lg OTU / ml against 2.52 ± 0.13 lg OTU / ml in CG (p <0.001).
The frequency of seeding and the density of strep-tococcal contamination in MG was higher than in CG. But in general, Str.mutans and Str.sanguis were most often sown in children of the study groups.
However, if in main group Str.mutans was indexed at 62.5% at a colonization density of 4.44 ± 0.11 lg OTU / ml (p <0.001), and Str.sanguis - at 58.3% at a concentration of 3, 25 ± 0.11 lg OTU / ml, (p <0.001), then in comparative group, the frequency of Str.mutans was 20.8% at an insemination density of 1.72 ± 0.06 lg OTU / ml and Str.sanguis - in 32.4% at a colonization density of 1.86 ± 0.06 lg OTU / ml. It was noted that the frequency of Str.mitis and Str.salivarius in children of the study groups was the same, but in children with rampant caries, the concentration of these microorganisms was higher than in children with intact teeth of the comparative group.
Thus, we investigated that the concentration of Str.mitis in MG was in 1.9 times higher than in CG (2.15 ± 0.10 lg OTU/ml, (p <0.001) vs. 1.15 ± 0,05 lg OTU/ml). At the same time, the concentration of Str. salivarius in children of the main group was 3 times higher than in individuals of the comparison group 3.78 ±0.12 lg OTU / ml against 1.26 ± 0.05 lg OTU/ml, (p <0.001).
In both study groups, staphylococci (aureus, epi-dermidis) were identified with the same frequency of secretion and density of colonization (p> 0.05). In children with multiple caries, the maximum frequency of excretion was Lactobacterium 68.5% at a colonization density of 4.00 ± 0.12 lg OTU/ml, (p <0,001). It was noted that in CG the frequency of Lactobacterium se-
cretion was 2.0 times lower than 33.3%, and the insemination density was 1.6 times less than 2.54 ± 0.18 lg OTU/ml than in MG (p <0.001).
If gram-positive facultative Nocardia rods were indexed in children with rampant caries, with an excretion rate of 21.6% and an insemination density of 2.45 ± 0.13 lg OTU/ml, this type of microorganism wasn't detected in children with intact teeth of the comparative group.
Also it was noted that in children of the main group gram-negative optional Proteus rods were found 2.2 times more often than in the comparative group (48.2 vs. 22.0%, respectively), at a higher concentration density (3.00 ± 0.14 Ig OTU/ml vs. 2.0 ± 0.15 Ig OTU/ml, p <0.001).
Yeast fungi of the genus Candida in children with multiple caries were sown with a frequency of 59.7% at a colonization density of 3.62 ± 0.12 lg OTU/ml, (p <0.001). In children of the comparison group, this type of microorganism was indexed 2.0 times less often (26.0%) at a lower concentration of 1.86 ± 0.13 lgKYO / ml than in children of the main group.
Conclusions. Therefore, as a result of research, it was found that the frequency of allocation and the degree of contamination of plaque in children with rampant caries was higher than in people with intact teeth.
Significant prevalence of cariogenic microorganisms (Str.mutans, Str.sanguis, Lactobacterium) in children with rampant caries convincingly proves their pathogenetic effect, and the increase in the frequency and density of inoculation with Gram-negative facultative Escherichia coli and fungi of the genus Candida indicates the presence of immunosuppressive states in children with rampant caries on the background of gastrointestinal diseases.
It should be noted that in the presence of Helicobacter pylori in children of both groups of the study, higher seeding frequency and insemination density in children of the main group, can be regarded as an additional pathogenetic mechanism of intensification of lesions of organs and tissues of the oral cavity.
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ТОЛЛ-ПОДОБНЫЕ РЕЦЕПТОРЫ ПРИ АТЕРОСКЛЕРОЗЕ
Чаулин А.М.
очный аспирант кафедры гистологии и эмбриологии Самарский государственный медицинский университет врач клинической лабораторной диагностики Самарский областной клинический кардиологический диспансер
TOLL-LIKE RECEPTORS IN ATHEROSCLEROSIS
Chaulin A.
full-time post-graduate student of the Department of histology and embryology
Samara state medical University doctor of clinical laboratory diagnostics Samara regional clinical cardiology dispensary
Аннотация
В статье рассматривается роль толл-подобных рецепторов (TLR) в патогенезе атеросклероза и сердечно-сосудистых заболеваниях. Обсуждаются сложные патофизиологические взаимодействия между TLR и воспалением, и иммунным ответом при атеросклерозе.
Abstract
The article discusses the role of toll-like receptors (TLR) in the pathogenesis of atherosclerosis and cardiovascular diseases. Complex pathophysiological interactions between TLR and inflammation and the immune response in atherosclerosis are discussed.
Ключевые слова. Толл-подобные рецепторы, врожденный иммунитет, атеросклероз, сердечно-сосудистые заболевания.
Keywords: Toll-like receptors, innate immunity, atherosclerosis, cardiovascular disease.
Введение
Атеросклероз вызывает сердечно-сосудистые заболевания, ведущую причину смерти во всем мире [1, 2, 3]. Поэтому изучение патофизиологии атеросклероза является важнейшим исследовательским направлением современного здравоохранения [4, 5, 6]. Поиск новых биомаркеров необходим для совершенствования диагностики атеросклероза и сердечно-сосудистых заболеваний [7, 8, 9, 10].
Атеросклеротический процесс, также описываемый как «уплотнение (затвердение) артерий», вызывается множеством местных и системных факторов риска и часто проявляется наряду с сопутствующими сердечно-сосудистыми заболеваниями, такими как сахарный диабет 2 типа, метаболический синдром, дислипидемия и гипертония [11, 12, 13]. Появляется все больше доказательств того, что механизмы врожденного иммунитета могут инициировать и ускорять атеросклероз [14, 15, 16]. Недавние данные связывают врожденную чувствительность с нижележащими молекулярными
