FEATURES OF CHANGES IN INDICATORS OF LOCAL IMMUNITY OF THE ORAL CAVITY AND BLOOD SERUM OF PATIENTS AGAINST THE BACKGROUND OF GENERALIZED PERIODONTITIS AND TYPE 2 DIABETES MELLITUS

Abstract

Aim: to evaluate the nature of changes in innate humoral immunity in oral fluid and blood serum in patients with generalized periodontitis against the background of type 2 diabetes mellitus and in their combination. Materials and methods. We examined 68 patients with a clinically established diagnosis of type 2 diabetes mellitus (of which 32 were additionally diagnosed with chronic generalized periodontitis), who were divided into 4 groups. The content of the main classes of immunoglobulins Ig A, Ig G and Ig M in blood serum and oral fluid was determined by radial immunodiffusion in a gel using monospecific antisera according to G. Manchini (Manchini G., 1965). Statistical processing of data was carried out using the Shapiro criterion. The level of statistical significance of differences between samples was assessed using the nonparametric Mann-Whitney test. Results. The lowest sIg A values and the highest Ig G values in the oral fluid were found in patients of group 4 with generalized periodontitis against the background of type 2 diabetes mellitus. A probable decrease in the level of sIg A was established, in particular, in the 2nd group by 1.27 times, the 3rd by 4.98 times and the 4th by 7.48 times in relation to the data of the control group (p<0, 01). The level of Ig G was probably higher in group 2 by 1.62 times, respectively, in group 3 – by 2.29 times and in group 4 – by 3.35 times, relative to control values (p<0.01 ). At the same time, when studying indicators in blood serum, the results of our studies indicate an imbalance of immunoglobulin fractions in the pathologies under study. Thus, the level of Ig A in the 2nd group was probably 1.7 times higher, in the 3rd group – 1.6 times higher, and in the 4th group – 2.0 times higher, relative to the data in the control group (p<0.001). The level of Ig M in the 2nd group was statistically significantly lower by 1.2 times, while in the 3rd and 4th groups it was probably higher by 1.7 and 1.2 times, respectively. The level of Ig G was probably higher in the 2nd and 3rd groups – by 1.3 times and in the 4th – by 2.0 times, relative to control values (p <0.05). This indicates that type 2 diabetes complicates the course of chronic periodontitis, as evidenced by changes in the concentrations of the main classes of immunoglobulins. Conclusions. Thus, generalized periodontitis against the background of type 2 diabetes mellitus is accompanied by significant changes in local immunity in biological fluids, as evidenced by disruption of the functioning of the humoral part of the adaptive immune system, which is manifested by an increase in the content of the main classes of immunoglobulins Ig A, Ig M, Ig A.