Assessment of the State of Systemic Immunity in Patients with Inflammatory Periodontal Diseases
Inflammatory periodontal diseases are characterized globally by a high prevalence of 55 to 98%, a variety of clinical manifestations, and a decrease in local or general factors of specific or nonspecific immunity. Immunological imbalance contributes to the chronicity of the course of somatic pathology, depletes compensatory mechanisms, and forms foci of chronic infection. The study aimed to assess the state of systemic immunity in patients with inflammatory periodontal diseases. Materials and methods: The general immune status was assessed in 120 patients of working age from 20 to 60 years. At the first stage, medical history and questionnaires were collected to identify immunopathological and immunodeficiency states. At stage II, the authors performed immunophenotyping of CD3, CD4, CD8, CD16, CD20 lymphocytes out according to level 1 tests (tests for confirming immunodeficiency), immunoglobulins (Ig A, M, G), circulating immune complexes, phagocytic, and oxygen-dependent metabolic activity of neutrophilic leukocytes. At stage III, level 2 tests (tests of differentiation of the damaged link), the immunoregulatory index, leuko T-cell index, leuko-B-cell index, and leukocyte-CD16+ index were determined. Results and discussion: Analysis of the clinical manifestations of immunological disorders in inflammatory periodontal disease patients revealed a high percentage of people with chronic diseases: 12% had one somatic disease, 34% had 2, and 54% had three or more. 19.47% of the participants were referred to the first health status group, 37.17% to the second, and 43.36% to the third prophylactic observation group. The state of general immunity was characterized by a combined insufficiency of the cellular T-link, humoral B-link of lymphocytes (CD20+), oxygen-dependent metabolism of segmented neutrophils with an increase in the level of CD16+ cells, phagocytic activity, and circulating immune complexes in the blood. An increase in the circulating immune complexes in peripheral blood by 2-3 times may indicate active binding of antigens entering the bloodstream. T-lymphocyte indices (immunoregulatory index and leuko T-cell index) changed in different directions: the immunoregulatory index decreased with increasing severity, and the leuko T-cell index increased, which indicates an increase in the deficiency of T-lymphocytes, and impaired immunoregulation with an increase in the severity of inflammatory periodontal diseases. The suppression of the absorption, bactericidal activity, and reserve capabilities of phagocytes against the background of an increase in the content of immune complexes indicates the presence of an immunocomplex and an autoimmune component in the pathogenesis of inflammatory periodontal diseases.