Імунологічні показники у дітей із флюорозом зубів, що проживають в регіонах із різним умістом фтору в питній воді

Abstract

За підсумками обстеження 120 дітей 6-7 років, які проживають у регіоні із різним умістом фтору в питній воді (Полтава – оптимальний, Шишаки – високий), виявлено, що перебіг флюорозу відбувається на фоні зниження показників місцевого імунітету ротової рідини (лізоцим і секреторний імуноглобулін А). Із підвищенням вмісту фтору в питній воді, що призводить до посилення тяжкості флюорозу, показники місцевого імунітету ротової рідини погіршуються. По результатам обследования 120 детей 6-7 лет, которые проживают в регионе с разным содержанием фтора в питьевой воде (Полтава – оптимальный, Шишаки – высокий), выявлено, что течение флюороза происходит на фоне снижения показателей местного иммунитета ротовой жидкости (лизоцим и секреторный иммуноглобулин А). При повышении содержания фтора в питьевой воде, усиливающего тяжесть флюороза, показатели местного иммунитета ротовой жидкости ухудшаются. Saliva examination is a non-invasive method used for objective assessment of somatic pathology and oral cavity abnormalities. It was found that fluoride ion inhibited phagocytes functions of granulocytes, decreased the viability of polymorphonuclear leukocytes, and affected macrophages. Also fluoride intoxication decreases IgA та IgG level in blood. High level of fluoride in drinking water probably may worsen immune factors in oral liquid. Lysozyme is produced by polymorphonuclear leukocytes and macrophages, SIgA is a base immunoglobulin of oral cavity protection. Thus, we were interested in how content of fluoride in drinking water impacts on lysozyme and SIgA content in oral liquid in children with dental fluorosis. Aim of study was to exanimate such immune indexes of oral liquid as lysozyme activity and SIgA content in children with dental fluorosis who live in areas with different content of fluoride in drinking water (Poltava - optimal fluoride content, Shishaki – high one). 20 children aged 6 years were examined: 60 children from Poltava, 60 children from Shishaki. Dental fluorosis was estimated with WHO classification. Our research earlier revealed that moderate fluorosis predominated in children from region with high fluoride content (68,8±4,14%), very mild fluorosis in children from region with optimal one (63,1±2,06%). Children from Poltava had mild and very mild fluorosis, whereas children from Shishaki had mild and moderate fluorosis. Oral fluid was collected in centrifuge tubes for 10 minutes on an empty stomach in the morning. Samples were stored for testing at -20°C, than recovered at room temperature and centrifuged at 3500 rpm/min for 15 minutes. The level of lysozyme and secretory immunoglobulin A in the flow separated part of the oral liquid in children was determinated by biochemical analysis. Probability of differences between data was assessed by Student's–Fischer t criterion. The lysozyme index present in children from Poltava with dental fluorosis was 19,85 ± 0,3 mM/l, compared with that in the children from Shishaki, 17,31 ± 0,32 mM/l (p<0,001). The same trend was observed for the SIgA index - 1,06 ± 0,03 g/l and 0,87 ± 0,01 g/l (p <0,001). It can be explained by the fact that lysozyme activity and SIgA index worsened with disease severity that depends on fluoride level in drinking water. The lysozyme index was significantly higher in children from Poltava with very mild fluorosis, 20,63±0,3 mM/l (p<0,001), compared with the children who have mild fluorosis, 18,9±0,22 mM/l. The same trend was observed for the SIgA index - 1,10±0,03 g/l and 1,06±0,01 g/l, respectively (p<0,001). The lysozyme index was significantly higher in the children from Shishaki with mild fluorosis, 18,01±0,2 mM/l (p<0,001) than in children with moderate fluorosis (16,7±0,31 mM/l). The same trend was observed for the SIgA index – 0,88±0,01 g/l and 0,83±0,02 g/l, accordingly (p<0,001). Immune indexes of oral liquid in children who live in regions with high and optimal fluoride level in drinking water and have mild fluorosis were significantly different. The lysozyme index present in children with mild fluorosis from Poltava was 18,9 ± 0,22 mM/l, compared with that in the children from Shishaki, 18,01 ± 0,2 mM/l (p<0,05). The same trend was observed for the SIgA index - 1,01±0,01 g/l and 0,88±0,01 g/l, respectively (p<0,001). This fact showed that fluoride content has strong influence on immune indexes of oral liquid in children. Thus, such immune indexes of oral liquid as lysozyme activity and SIgA index decreased in children with fluorosis. Especially this trend was revealed if the fluoride content in drinking water was high and disease severity worsened. Taking all these aspects into consideration, it can be concluded that in the coming future examination the immune indexes of oral cavity will be a very helpful tool for different treatment-prevention means efficacy monitoring.