Analysis of local protection factors in the patience of the mouth in patients with rheumatoid arthritis (a comparative clinical-immunological and biochemical study)

Abstract

The aim of the study was a comparative analysis of a number of factors of nonspecific and specific immune defense in the oral cavity in patients with rheumatoid arthritis (RA). In a blindly controlled study, 75 volunteers of both sexes aged 35-44 years, equally divided into three groups, participated. In group 1 there were patients with newly diagnosed RA, in group 2 - patients with chronic generalized periodontitis and multiple caries of teeth without concomitant general somatic pathology, in group 3 - practically healthy patients with CFR<10. The concentration of lysozyme, neopterin, γ-interferon, neutrophil elastase, thiol status and IL-4 was studied in the oral fluid. It was revealed that at 100% prevalence of dental caries and inflammatory periodontal diseases in RA patients there were hypo salivation phenomena, a decrease in the concentration in oral liquid (OL) lysozyme, IL-4 and thiol status. On the contrary, there was an increase in the levels of neopterin, γ-interferon and elastase. It was concluded that the activity of local cellular and humoral immunity in the oral cavity decreased in patients with RA, in particular, the increase in proteolytic activity of OL and the decrease in its antioxidant protection. Recommended preventive and therapeutic dental activities in patients with RA primarily focus on stimulating salivation and minimizing the cytotoxic immune response. In the second turn - to reduce the proteolytic activity of mixed saliva and increase the anti-oxidant protection of periodontal and mucosal tissues.