scholarly journals DYSFUNCTIONS OF NEUTROPHILIC GRANULOCYTES IN CHILDREN WITH CONGENITAL CLEFT LIP AND PALATE

2019 ◽  
Vol 21 (5) ◽  
pp. 885-894
Author(s):  
M. N. Mitropanova ◽  
G. A. Chudilova ◽  
I. V. Nesterova ◽  
S. V. Kovaleva
Keyword(s):  
Respiratory Tract ◽  
Bacterial Infections ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Age Groups ◽  
Healthy Children ◽  
Upper Respiratory Tract ◽  
Control Groups ◽  
Congenital Cleft ◽  
The Impact

The problem of rehabilitation of children with congenital cleft lip and palate (CCLP) is a difficult task and doesn’t lose its relevance. Children with CCLP often suffer from repeated acute viral and bacterial infections of the respiratory tract and upper respiratory tract, which leads to a forced delay in surgical, orthodontic treatment, adequate speech therapy and complications after staged surgical operations. The development of inflammatory processes in children with CCLP is associated with anatomical and topographic features that facilitate the penetration of pathogenic microflora in oral and nose mucosa and, consequently, negative changes in the immune system (IS). The key cells of IS in maintaining homeostasis and ensuring oral health are neutrophil granulocytes (NG). NG dysfunctions in CCLP interfere with the elimination of pathogens and support their persistence. This can occur against the background of previously existing defects in the functioning of the NG system and is aggravated by the significant pathogenicity and massiveness of the impact of various infectious agents. Full diagnostics of NG dysfunctions is necessary for the further implementation of their timely immune correction and prevention of the development of pathological chronic inflammation in response to the pathogenic microflora long-term on the mucous membrane of the mouth and nose. For this purpose study was conducted of the functional activity and phenotypic characteristics of NG in children with CCLP at different stages of complex rehabilitation. Blood samples of 56 children with CCLP 1-3 years (n = 20, group 1), 4-6 years (n = 20, group 2), and 7-12 years (n = 20, group 3) at different stages of complex rehabilitation and 30 conditionally healthy children (control groups) of the corresponding age was studied. A violation of the microbiocenosis of the mucous membranes of the oral and nasal cavities was revealed, which may be a cause or a consequence of a decrease in antibacterial immunity, first of all NG dysfunctions. Common for all age groups children with CCLP NG dysfunction was found: the appearance of NG expressing CD14 receptors that are absent in children of all three control groups, which indicates the presence of viral and bacterial load; defects of phagocytosis associated with a decrease in the number of actively phagocytic NG, impaired NG capture functions; impaired NADPH oxidase release with partial or complete blockade of the response to additional antigenic load, even in the absence of acute clinical manifestations. Comparative analysis of the studied indicators of the expression level of the receptors CD64, CD16, CD32, CD14 NG in children with CCLP demonstrates different equipment, which determines the inconsistency of the phagocytic and microbicidal function of NG in different age periods. Thus, an increase in the expression of these membrane markers, especially CD64 and CD14, in older age groups is accompanied by more significant defects in phagocytic and killing functions of NG, which is associated not only with recurrent viral respiratory infections, but also with a high frequency of associated bacterial infections of the respiratory system and ENT – organs. Revealed NG dysfunctions in children with CCLP of various age groups indicate their inability to implement adequate anti-infective protection, which can lead to atypically occurring viral – bacterial infections and the occurrence of various, including purulent complications in the postoperative period, which requires the development of targeted immunotherapy, included in the program of comprehensive rehabilitation in children with CCLP and aimed at restoring impaired NG functions.

Pathogenetic justification for the use of immunotherapy for the treatment of recurrent co-infections of the upper respiratory tract in children with congenital cleft lip and palate

2020 ◽  
Vol 18 (4) ◽  
pp. 117-126
Author(s):  
I.V.Nesterova I.V.Nesterova ◽  
◽  
M.N.Mitropanova M.N.Mitropanova ◽  
G.A.Chudilova G.A.Chudilova ◽  
S.V.Kovaleva S.V.Kovaleva ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Respiratory Tract ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Microbiological Analysis ◽  
Upper Respiratory Tract ◽  
Congenital Cleft ◽  
Upper Respiratory

The synergism of the action of co-infecting microorganisms contributes to their overcoming the epithelial barrier, modification of the function of cells of the immune system (IS) and evading the immune response. In children with congenital cleft lip and palate (CCLP), despite elimination of the anatomical defect at an earlier age, the frequency of infectious and inflammatory diseases of the respiratory tract and oral cavity involving pathogen associations increases as they get older, at the same time defects in the functioning of IS are preserved. Objective. To develop immunotherapy program for children with CCLP, suffering from recurrent co-infections of the upper respiratory tract and oral cavity, based on the study of the dynamics of the microbial landscape transformation, IS dysfunction, clinical manifestations of infectious and inflammatory diseases of the upper respiratory tract and oral cavity in children with CCLP at different ages. Patients and methods. The study included 120 children from 1 to 12 years of age with CCLP at different stages of surgical treatment. The study was carried out: T and B lymphocytes, natural killer cells (FC500 "Beckman Coulter", USA), phagocytic and microbicidal functions of neutrophilic granulocytes (NG), serum IgA, IgM, IgG and sIgA levels in the oral fluid (ELISA), detection of microbial pathogens (microbiological analysis, ELISA) and viral (PCR). Results. Comprehensive examination of children with CCLP at different age periods, including characteristics of the clinical manifestations of infectious and inflammatory diseases, assessment of the microbial landscape of the oral cavity and upper respiratory tract with the identification of co-infection features, clarification of the variants of IS dysfunction, made it possible to reveal children with the most severe clinical manifestations of recurrent co-infections and to optimize treatment. Conclusion. The developed program of combined local interferon and systemic immunotherapy for immunocompromised children with CCLP contributes to the restoration of IS functions, anti-infective resistance and achievement of positive clinical effects in the form of regression of clinical signs of immunocompromise in patients with recurrent co-infections, which allows to obtain a protective effect and provide timely surgical care, to avoid complications in the postoperative period and at the stage of recovery, and by improving anti-infective immunity to enhance the quality of life of children with CCLP. Key words: children, congenital cleft lip and palate, co-infection, systemic immunity, microbiocenosis, immunotherapy

scholarly journals MOLECULAR GENETIC STUDY OF THE IMPACT OF SNP C677T OF THE GENE MTHFR IN THE DEVELOPMENT OF CONGENITAL ISOLATED CLEFT LIP AND PALATE

2018 ◽  
Vol 25 (5) ◽  
pp. 104-110
Author(s):  
V. S. Uchaeva ◽  
Yu. A. Vasiliev ◽  
A. S. Gracheva ◽  
O. V. Gulenko ◽  
I. G. Udina
Keyword(s):  
Genetic Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
Population Genetic Study ◽  
Molecular Genetic Study ◽  
Increased Risk ◽  
Significant Difference ◽  
Congenital Cleft ◽  
The Impact

Aim. This research was designed to conduct an associative population genetic study for the consideration of the impact of SNP C677T of the gene MTHFR in the congenital maxillofacial developmental anomalies (CMDA): congenital cleft lip (CCL), congenital cleft palate (CCP), congenital cleft lip and palate (CCLP) in the Krasnodar territory. The aim of the study is to establish the associations between SNP C677T of the gene MTHFR and the development of congenital cleft lip and/ or palate.Materials and methods. In this research, the peculiarities of distribution of SNP C667T of the gene MTHFR in children with congenital cleft lip and/or palate (n=223) and their mothers (n=78) in comparison with the control group (n=124) were studied in the Krasnodar territory. The genetic demographic questionnaires were gathered for children with CMDA, the information about diagnosis was obtained from the medical records. The biological samples, including blood or scrapings of oral mucosa, were collected from children with the pathology and their mothers. The DNA was extracted from the samples by the standard method. The study of the peculiarities of distribution of alleles of SNP C677T of the gene MTHFR was performed by PCR-PFLP with endonuclease Hinf I or by tetra-primer ARMS-PCR method in children with CCL, CCP, CCLP, their mothers and the control group. Statistical processing of the obtained data was performed by the algorithms of the “Statistica” program.Results. While comparing the profiles of frequencies of SNP C677T in children with CCL, CCP and CCLP with the control group, there were identified no significant differences in the frequency of this SNP and no peculiarities of genotypes distribution. There was identified a significant difference in the peculiarities of genotypes distribution with the control group (G=19,5232, d.f.=1, p<0,001) as well as united genotypes (С/C и С/T) in accordance to T/T (G=10,4657, d.f.=1; p<0,001) and united genotypes (C/T и T/T) in accordance to C/C (G=15,1896, d.f.=1, p<0,001) for the mothers of children with CCL, CCP and CCLP.Conclusion. As a result of the study, we established the association of SNP C677T of the MTHFR gene with the development of congenital cleft lip and/or palate: mothers’ T/T genotype is associated with the increased risk of giving birth to a child with CCL, CCP and CCLP (in comparison with mothers with C/C+C/T genotype): odds ratio [OR]=16,63, 95% CI: 3,86-71,71; p=0,0003 and also for mothers with genotypes (C/T+T/T) in comparison with mothers with genotypes C/C: OR=3,22, CI:1,71-6,08; p=0,0002. The amount of risk is not significant in children with CMDA for T/T genotype. So it is possible to make a conclusion about the impact of C677T of the gene MTHFR in the development of CCL, CCP and CCLP only in mother’s genotype. 

своеDifferentiated immunotherapy in the integration program for the rehabilitation of immunocompromised children with congenital cleft lip and palate

2020 ◽  
Vol 15 (6) ◽  
pp. 7-17
Author(s):  
I.V. Nesterova ◽  
◽  
M.N. Mitropanova ◽  
S.V. Kovaleva ◽  
G.A. Chudilova ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Respiratory Tract ◽  
High Frequency ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Inflammatory Diseases ◽  
Clinical Status ◽  
Integration Program ◽  
Different Ages ◽  
Congenital Cleft

One of the development directions of osteoimmunology is the search for new therapeutic approaches in the pathology of bone tissue, in the pathogenesis of which the interaction between the immune and bone systems plays an essential role. In children with congenital cleft lip and palate (CCLP), the physiological deficiency of the immune system (IS) and its anatomical disorders lead to intense tension in the immature mechanism for maintaining immune homeostasis, which is accompanied by clinical features of immunodeficiency in the form of recurrent viral, bacterial and fungal infectious and inflammatory diseases of the respiratory tract, ENT organs and oral cavity. Objective. To develop an integration program for the rehabilitation of children with CCLP, which includes not only traditional complex rehabilitation, but also measures aimed at restoration of the normal functioning of IS with the use of new approaches to conduct differentiated immunotherapy for each age period. Patients and methods. The study included 210 children of different ages: 150 children with CCLP and 60 conditionally healthy children without CCLP. Immunophenotyping of lymphocytes was conducted by flow cytometry; testing of phagocytic activity of neutrophilic granulocytes (NG), spontaneous and induced production of reactive oxygen species in the NBT test, determination of the level of serum IgA, IgM, IgG and sIgA in oral fluid. Results. Common for all age groups of children with CCLP, NG dysfunctions of different severity were found: defects of phagocytosis, an increase of spontaneous activity of NADPH oxidase and dysfunction of adequate response in the form of partial or complete blockade of NADPH oxidase activity during additional antigenic bacterial load in the system in vitro. Taking into account revealed defects in the functioning of IS and peculiarities of the clinical status of immunocompromised children of different ages with CCLP who suffer from a high frequency of infectious and inflammatory diseases of the respiratory tract, ENT organs and oral cavity, we have developed programs of differentiated immunotropic therapy for children of different ages with CCLP. Considering revealed defects in the functioning of IS and peculiarities of the clinical status of immunocompromised children of different ages with CCLP who suffer from a high frequency of infectious and inflammatory diseases of the respiratory tract, we have developed and used an integration program of immunorehabilitation with a positive clinical and immunological effect. Conclusion. The developed integration program for the rehabilitation of immunocompromised children with CCLP with a high frequency of infectious and inflammatory diseases of the respiratory tract, ENT organs and oral cavity, organically including differentiated immunotherapy along with methods of surgical, orthodontic and social rehabilitation and speech therapy, optimizes the treatment of patients with this pathology. The principles of differentiated immunotherapy are based on the revealed clinical and immunological peculiarities of immunodeficiency, which have both common features and differences depending on age, infectious and inflammatory manifestations and the stage of surgical treatment of children with CCLP. Key words: congenital cleft lip and palate, immunocompromised children, immunotropic therapy, rehabilitation

scholarly journals The impact of demographic factors on the possibility of cleft lip and palate occurrence

2007 ◽  
Vol 54 (1) ◽  
pp. 34-43 ◽  
Author(s):  
Julija Radojicic ◽  
Tatjana Tanic
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Demographic Factors ◽  
First Trimester ◽  
Control Group ◽  
Healthy Children ◽  
Military Medical Academy ◽  
Education Of Women ◽  
Mother And Child ◽  
The Impact

Introduction: Lip and palate clefts (cheilognathopal atoschisis) are very severe congenital anomalies. Aim: To examine the impact of demographic factors in the first pregnancy trimester on the occurrence of lip and palate cleft. Subjects and Methods: Children born in the period between March 1999 to December 2003, as well as their parents were included in the study. The study group consisted of 96 children with cleft lip and palate treated at the Gynecology - Obstetrics clinics of the Clinical Center in Nis (Neonatology ward), VMA (Military Medical Academy) Belgrade (Institute for plastic surgery), Mother and Child Institute - Novi Beograd and University children's Clinic, Belgrade. The control group comprised 142 healthy children. The examination was carried out using two questionnaires. One was for mothers and consisted of 41 questions related to the first pregnancy trimester. The other questionnaire was filled in by fathers and had 16 questions also related to the period of the first trimester of their wives' pregnancies. Results: The results showed that unilateral lip and palate cleft occurred in the same percentage in boys and girls (53.1%). Isolated palate cleft was more frequently found in boys, and unilateral lip cleft in girls. Statistically higher possibility for lip and palate cleft was found in the third child. The age of mothers in the time of conception does not represent risk factor for the cleft occurrence. Mothers who gave birth to children with clefts were younger (26.4 years old) than mothers in control group (28.4 years old). Conclusion: There is a need for constant education of women on risk factors that they can be exposed to during pregnancy. .

The impact of disbalance of regulatory cytokines and osteocalcin on osteogenesis in children with congenital cleft lip and palate in postnatal ontogenesis

Stomatologiya ◽  
2020 ◽  
Vol 99 (1) ◽  
pp. 77
Author(s):  
I. V. Nesterova ◽  
M. N. Mitropanova ◽  
G. A. Chudilova ◽  
L. V. Lomtatidze ◽  
T. V. Gaivoronskaya
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Postnatal Ontogenesis ◽  
Congenital Cleft ◽  
The Impact

The Psychosocial Impact of Cleft in a Western Australian Cohort Across 3 Age Groups

2018 ◽  
Vol 56 (2) ◽  
pp. 210-221 ◽  
Author(s):  
Wendy Nicholls ◽  
Linda A. Selvey ◽  
Craig Harper ◽  
Martin Persson ◽  
Suzanne Robinson
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Age Groups ◽  
Psychosocial Problems ◽  
Team Approach ◽  
Adult Age ◽  
Treatment Providers ◽  
Significant Difference ◽  
The Impact ◽  
Western Australian

Background: Management of a cleft of the lip and/or palate (CL/P) involves a multidisciplinary team approach lasting from birth to potentially postskeletal maturity. This condition is complex, with both medical and psychosocial implications that may place individuals with a cleft at higher risk of developing psychosocial problems. Methodology: A self-administered questionnaire was completed by a sample from the Western Australian cleft population comprising 3 age groups: child (n = 100), adolescent (n = 101), and adult (n = 158). Results: Public speaking, being photographed, special relationships, and participation in school were identified as the areas most impacted by having a cleft. Hearing and speech were reported to have a higher importance than facial and dental appearance. Participants rated support given to them by their parents as the most important, with high ratings for treatment providers. For teasing, the impact of cleft was significantly higher among participants with cleft lip and palate for both the adolescent and adult age groups. There was little significant difference by gender across the variables, which suggests that males are just as likely to require support as females. Conclusion: The impact of a cleft across multiple psychosocial domains needs to be recognized and addressed as part of craniofacial team care across age groups.

Sri Lankan Cleft Lip and Palate Study Model Analysis: Clefts of the Secondary Palate

1993 ◽  
Vol 30 (2) ◽  
pp. 227-230 ◽  
Author(s):  
Andrew Mccance ◽  
David Roberts-Harry ◽  
Martyn Sherriff ◽  
Michael Mars ◽  
William J.B. Houston
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Model Analysis ◽  
Control Group ◽  
Tooth Size ◽  
Sri Lankan ◽  
Control Groups ◽  
Secondary Palate ◽  
Comparable Control ◽  
And Control

The study models of a group of adult Sri Lankan patients with clefts of the secondary palate were investigated. Tooth-size and arch-dimension comparisons were made with a comparable control group. Significant differences were found between the cleft and control groups in tooth sizes, chord lengths, and arch widths. The cleft group dimensions were generally smaller than those of the control group. Overjets were larger in the cleft group.

Cultural "latrogenic" Cleft Palate

PEDIATRICS ◽  
1986 ◽  
Vol 78 (3) ◽  
pp. 511-511
Author(s):  
AMIN Y. BARAKAT ◽  
USAMA ITANI ◽  
GEORGE M. ZAYTOUN
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Distress ◽  
Cleft Palate ◽  
Respiratory Tract Infection ◽  
Upper Respiratory Tract ◽  
Difficulty Breathing ◽  
Congenital Cleft ◽  
Upper Respiratory ◽  
Feeding Difficulty

Pediatricians are familiar with congenital cleft palates and those occurring as a part of a multisystem abnormality. We have encountered a child with a cultural "iatrogenic" cleft palate. The patient is a 5-year-old girl who appeared normal until 4 months of age, at which time she became febrile and had difficulty breathing as a result of an upper respiratory tract infection. She was not attended to by a physician, but a uvulectomy, supposedly to prevent respiratory distress, was performed by a laywoman considered by the villagers to be a "specialist" in the procedure. Following the uvulectomy, the infant experienced feeding difficulty, choking on solid and liquid foods.

Seroconversion Rates to Combined Measles-Mumps-Rubella-Varicella Vaccine of Children With Upper Respiratory Tract Infection

PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 514-516
Author(s):  
Penelope H. Dennehy ◽  
Georges Peter ◽  
Cheryl L. Saracen
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Seroconversion Rate ◽  
Varicella Vaccine ◽  
Upper Respiratory Tract Infection ◽  
Healthy Children ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Antibody Levels

Objective. To determine if upper respiratory tract infection (URI) affects the seroconversion rate or quantitative response to each component of a combined measles-mumps-rubella-varicella vaccine. Subjects and methods. One hundred forty-nine children between 15 and 18 months of age were prospectively divided into two groups according to the presence of URI or recent history of URI symptoms within the 4 weeks before vaccination. Once stratified, 74 children in the healthy group and 75 children in the URI group were randomly assigned to receive one of three lots of measles-mumps-rubella varicella vaccine by subcutaneous injection into the deltoid area. Serum was obtained from each child just before vaccination and 4 to 6 weeks later for measuring antibody levels against each virus. Results. Prevaccination antibody levels against each virus in the URI and healthy groups did not differ. Nine children had pre-existing antibodies to varicella and six to mumps; no child had positive serologies for measles or rubella before vaccination. Children with pre-existing antibody were excluded from analysis of seroconversion for that virus. Seroconversion to measles, mumps, and rubella occurred in 100% of children in both groups. Mean antibody levels did not differ between the healthy and URI groups for measles (111 vs 122), mumps (97 vs 108), or rubella (96 vs 102). Three (4%) of 70 children with URIs in whom varicella serologies were available failed to seroconvert to varicella vaccine although none of the 69 healthy children had vaccine failure (P = .24). The mean varicella antibody level was 11.3 ± 1.4 in the healthy children, which did not differ significantly from the level of 9.5 ± 0.9 in the URI group. Conclusions. Seroconversion to measles, mumps, rubella, and varicella was not significantly affected by the presence of a concurrent or recent URI in 15-to 18-month-old children.

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