Ефективність використання поліоксидонія у комплексному лікуванні гострого одонтогенного остеомієліту тіла нижньої щелепи у дітей

Abstract

У статті представлені результати обстеження 10 дітей з гострим одонтогенним остеомієлітом тіла нижньої щелепи, яким до складу протокольного лікування додатково був введений поліоксидоній. Встановлено його виражений позитивний вплив на клінічний прояв захворювання і вагомий імуномодулюючий вплив на цитокіновий статус на рівні організму і порожнини рота, що проявлялося зниженням рівня прозапальних і підвищенням протизапальних інтерлейкінів в ротовій рідині і сироватці крові на момент клінічного одужання; В статье представлены результаты обследования 10 детей с острым одонтогенным остеомиелитом тела нижней челюсти, которым в состав протокольного лечения дополнительно был введен полиоксидоний. Установлено его выраженное положительное влияние на клиническое проявление заболевания и весомое иммуномодулирующее воздействие на цитокиновый статус на уровне организма и полости рта, что проявлялось снижением уровня провоспалительных и повышением противовоспалительных интерлейкинов в ротовой жидкости и сироватке крови на момент клинического выздоровления; Treatment of acute odontogenic osteomyelitis of the jaws; despite availability of modern diagnostic equipment in local clinics and presence of a significant number of new pharmacological medications the challenge for maxillofacial surgery still remains as evidenced by the fairly frequent occurrence of atypical disease and chronization of inflammation process. Multiple pathogenic factors, including immunologic ones participating in the development of acute odontogenic osteomyelitis of the jaws, cause the search for new technologies of treatment of this disease with the use of pharmacological medication that enable targeted influence on elimination of revealed violations , including cytokine status. Cytokines are known to be part of the biological active substances contained in various biological substrates and tissues, determine, to some extent, the resistance of the oral cavity, the activity of monocytes and macrophages in the mucosa of the mouth. With the development of inflammation in most cases, the content of proinflammatory cytokines significantly increases both in systemic circulation and locally that has both diagnostic and prognostic significance. This paper studies changes in the content of proinflammatory and anti-inflammatory interleukins in oral fluid and peripheral blood of children with acute odontogenic osteomyelitis of the body of the mandible body to determine the need for additional inclusion of Polyoxidonium to the drug treatment. According to research, it activates nonspecific resistance of the organism, phagocytosis, humoral and cellular immunity, and it refers to a group of high - molecular and chemically pure immunomodulators. The article presents the results of a survey of 10 children with acute odontogenic osteomyelitis of the body of the mandible aged 7 to 12 years and 10 healthy children of the same age who were treated according to the protocol of medical care with additional immunomodulator polyoxidonium. To determine its pharmacological activity, oral fluid intake and blood serum tests were taken from all patients at the time of hospitalization, clinical recovery, which conducted the study of the levels of proinflammatory and anti-inflammatory interleukins. The analysis of the data showed the pronounced positive effect of polyoxidonium on the course of wound healing and its pronounced immunomodulatory effect on cytokine profile, both at the level of the body and mouth. It was shown by the decreased levels of pro-inflammatory and increased anti-inflammatory interleukins in oral fluid and blood serum for the clinical recovery. The results obtained were compared with those established in the group of children treated with the protocol of treatment. Its application was approved to lead to the correction of immunological parameters that were studied, both at systemic and local levels. But additional use of polyoxidonium allowed normalizing levels of IL-1β in oral fluid and blood serum and IL-4 and IL-10 in oral fluid. This significantly reduced the concentration of IL- 6 and IL- 8 in oral fluid and there was a trend towards restoration of physiological amounts of IL-4, IL-6, IL-8, IL- 10 in blood serum. Despite the positive results, the problem of treatment of acute odontogenic osteomyelitis of the body of mandible remains open to further scientific developments in this field.