PREVENTION OF CANDIDIASIS IN PATIENTS USING REMOVABLE DENTURES

Despite innovations in orthopedic dentistry, removable dentures belong to the most popular orthopedic care category. Removable dentures are combined stimuli that affect the mucous membrane and neuro-receptor apparatus. Acrylic plastic prostheses, widely used in prosthetic dentistry, have a negative side mechanical, chemical-toxic, sensitizing, and thermal insulating effect on oral tissue and prosthetic impression area. This is often complicated by a violation of the biocenosis of the oral cavity, the growth of pathogenic microflora that releases toxins, especially an increase in the number of yeast colonies that irritate the oral mucosa and prosthetic stomatitis. It was observed 100 patients with oral candidiasis of various age groups from 45 to 65 years. Of these, 60 patients with removable plate prostheses; 40 patients with partially removable prostheses. Chronic forms of candidiasis were diagnosed in 40 patients and with exacerbation of chronic forms of candidiasis in 60 people. The number of untreated carious cavities and poor hygienic condition of the oral cavity directly affects the severity of candidiasis. Acute forms of candidiasis were observed mainly in patients with high DMF and PMA indices. The severity of candidiasis depends on the degree and duration of wearing dentures and hygienic conditions - the most severe forms of invasive candidiasis were observed in the presence of removable plate prostheses, the complete absence of teeth, and the use of a prosthesis for more than 10-15 years. A combined lesion of the oral mucosa and the red border of the lips was observed mainly in patients older than 60 years. The presence of candidiasis in the oral cavity in patients with removable plate prostheses leads to a statistically significant change in the indicators of local immunity of the oral cavity: an increase in the concentration of serum IgG and IgA and the values of the coefficient of the balance of local immunity factors.

Sialidase Activity in the Cervicovaginal Fluid Is Associated With Changes in Bacterial Components of Lactobacillus-Deprived Microbiota

IntroductionSialidase activity in the cervicovaginal fluid (CVF) is associated with microscopic findings of bacterial vaginosis (BV). Sequencing of bacterial 16S rRNA gene in vaginal samples has revealed that the majority of microscopic BV cases fit into vaginal community-state type IV (CST IV), which was recently named “molecular-BV.” Bacterial vaginosis-associated bacterial species, such as Gardnerella spp., may act as sources of CVF sialidases. These hydrolases lead to impairment of local immunity and enable bacterial adhesion to epithelial and biofilm formation. However, the impact of CVL sialidase on microbiota components and diversity remains unknown.ObjectiveTo assess if CVF sialidase activity is associated with changes in bacterial components of CST IV.MethodsOne hundred forty women were cross-sectionally enrolled. The presence of molecular-BV (CST IV) was assessed by V3–V4 16S rRNA sequencing (Illumina). Fluorometric assays were performed using 2-(4-methylumbelliferyl)-α-D-N-acetylneuraminic acid (MUAN) for measuring sialidase activity in CVF samples. Linear discriminant analysis effect size (LEfSe) was performed to identify the differently enriched bacterial taxa in molecular-BV according to the status of CVF sialidase activity.ResultsForty-four participants (31.4%) had molecular-BV, of which 30 (68.2%) had sialidase activity at detectable levels. A total of 24 bacterial taxa were enriched in the presence of sialidase activity, while just two taxa were enriched in sialidase-negative samples.ConclusionSialidase activity in molecular-BV is associated with changes in bacterial components of the local microbiome. This association should be further investigated, since it may result in diminished local defenses against pathogens.

THE NEGATIVE IMPACT OF ALIMENTARY OBESITY ON THE STATE OF LOCAL IMMUNITY OF THE VAGINAL MUCOSA AND THE EFFECTIVENESS OF THE THERAPY OF BACTERIAL VAGINOSIS

Проведен анализ результатов стандартного лечения бактериального вагиноза у 143 больных с учетом наличия у них алиментарного ожирения. Все женщины, принимавшие участие в нашем исследовании, дали письменное информированное согласие на участие в нем. Лечение БВ проводилось по общепринятой методике метронидазолом и клиндамицином. В зависимости от наличия алиментарного ожирения больных бактериальным вагинозом разделили на 2 группы. В I группу вошли 97 без алиментарного ожирения. Во II группе у 46 больных отмечалось увеличение массы тела, соответствующее алиментарному ожирению II степени. Исследования проводили до начала лечения и через 14 суток после его завершения. Сравнительный анализ результатов лечения БВ в исследуемых группах показал, что на фоне АО II степени отмечались достоверно более выраженные увеличение количества «ключевых клеток» (P<0,05) и смещение pH в щелочную сторону (P<0,05) во II группе. При этом эффективность лечения у больных II группы, где отмечалось алиментарное ожирение II степени была достоверно меньше, чем в I (P<0,05), что свидетельствовало о негативном влиянии алиментарного ожирения на состояние локального иммунитета слизистой оболочки влагалища и результативность проводимой терапии бактериального вагиноза. The results of standard treatment of bacterial vaginosis in 143 patients were analyzed, taking into account the presence of alimentary obesity in them. All the women who took part in our study gave written informed consent to participate in it.BV was treated according to the generally accepted method with metronidazole and clindamycin. Depending on the presence of alimentary obesity, patients with bacterial vaginosis were divided into 2 groups. Group I included 97 people without alimentary obesity. In group II, 46 patients had an increase in body weight corresponding to alimentary obesity of the II degree. Studies were conducted before the start of treatment and 14 days after its completion. A comparative analysis of the results of BV treatment in the study groups showed that against the background of grade II AO, there was a significantly more pronounced increase in the number of "key cells" (P<0.05) and a pH shift to the alkaline side (P<0.05) in group II. At the same time, the effectiveness of treatment in group II patients with grade II alimentary obesity was significantly less than in group I (P<0.05), which indicated a negative effect of alimentary obesity on the state of local immunity of the vaginal mucosa and the effectiveness of the therapy of bacterial vaginosis.

Dynamics of quantitative changes of diffuse lymphoid tissue cells of bronchi and lungs of guinea pigs sensitized with ovalbumin

Background. There is a progressive increase of respiratory allergic diseases nowadays in the world, made it necessary to study the participation of the components of the immune system in these processes. From the point of view of modern aspects about the organs of the immune system, interesting are the patterns of morphogenesis and function of bronchus associated lymphoid tissue, occupied a special place in the immunological protection of the body due to the large area of contact with various antigens. Morphogenesis and reactive changes in the local immunity in respiratory system in conditions of allergic inflammation remain urgent issue of modern morphology. Objective. To study the changes in diffuse lymphoid tissue of bronchi and lungs of guinea pigs sensitized with ovalbumin. Methods. We have studied the lung of 48 guinea pigs, using histological, immunohistochemical, morphometric, statistical methods, under conditions of experimental ovalbumin-induced allergic inflammation, assessed the average number of lymphocytes, macrophages and plasma cells in the diffuse lymphoid tissue. Results. The average number of lymphocytes in diffuse lymphoid tissue of bronchi and lungs increased from the 23rd day of observation and remained at a high level until the end of the experiment, the maximum was during the early period of the development of allergic inflammation, the increasing coefficient was 4.7. The average number of plasma cells also acquired maximum elevation in the early period of allergic process, the increasing coefficient was 2.0. The most significant average number of macrophages was on the 23rd day of observation with same increasing coefficient. Among all types of immunocompetent cells of diffuse lymphoid tissue in bronchi and lungs, T-lymphocytes prevailed during the experiment elevated almost by 5 times. Conclusions. In the early period of development of experimental ovalbumin-induced allergic inflammation, the specific resistance of the respiratory system manifests itself in the form of activation of local links of cellular and humoral adaptive immunity, as evidenced by the dynamics of changes in the average number of lymphocytes (the maximum increasing coefficient 4.7 in the 1st experimental group), macrophages and plasma cells (maximum increasing coefficient 2.0 in the 1st experimental group) of diffuse lymphoid tissue of bronchi and lungs of guinea pigs.

The influence of parenteral influenza vaccination on local immunity indices and microbiota of oropharyngeal secretion in patients with chronic inflammatory diseases of the upper respiratory tract

When studying the effect of vaccines against influenza, attention is mainly paid to obtaining high titers of protective antibodies in the blood and reducing the incidence of respiratory infections among vaccinated people. At the same time, the changes occurring in patient,s body from the factors of local specific and innate immunity remain insufficiently studied. The aim of the study was to determine the effect of parenteral influenza vaccination on the state of local immunity, cytology and microbiota of oropharyngeal secretion (OS) in patients with chronic inflammatory diseases of the upper respiratory tract. The study of immunological and microbiological parameters was performed in 32 patients with chronic inflammatory diseases of the upper respiratory tract, including 11 diagnosed with chronic rhinosinusitis, 9 – with chronic tonsillitis, 12 – with chronic pharyngitis, 3 and 12 weeks after vaccination with trivalent inactivated influenza-vaccine (PASTEUR, SA, France), which was administered intramuscularly. Single vaccination against influenza A and B has been shown to normalize reduced local humoral immunity indices, in particular sIgA and immune complexes concentrations, increase lymphocyte output to oropharyngeal secretions and cause a significant decrease in the representation of OS transient microflora without affecting the overall level of bacterial contamination. In both periods after the vaccination the reduced content of interferon-α in the OS of patients with chronic inflammatory diseases of the upper respiratory tract did not change. The obtained data allow to recommend vaccination against influenza virus in the period up to 3 months before the the beginning of mass infections as an effective means of stimulating the protective reactions of local immunity of oropha­rynx and nasopharynx mucous membranes in patients with chronic inflammatory diseases of the upper respiratory tract.

Immunoglobulin A Mucosal Immunity and Altered Respiratory Epithelium in Cystic Fibrosis

The respiratory epithelium represents the first chemical, immune, and physical barrier against inhaled noxious materials, particularly pathogens in cystic fibrosis. Local mucus thickening, altered mucociliary clearance, and reduced pH due to CFTR protein dysfunction favor bacterial overgrowth and excessive inflammation. We aimed in this review to summarize respiratory mucosal alterations within the epithelium and current knowledge on local immunity linked to immunoglobulin A in patients with cystic fibrosis.

Mononuclear subsets and cytokine profile of venous and capillary blood in patients with psoriasis and healthy people

Psoriasis is considered an autoimmune disease with a predominantly cellular mechanism for the development of disorder. Studies in immune pathogenesis of psoriasis were performed either in animal model, which is not just similar to humans, or the data were obtained in patients by means of skin window method, which is traumatic, or by examining venous blood. However, it is difficult to discern parameters of the local immune response in venous blood samples. We have attempted to find an adequate method which would be convenient both for the patient and for the researcher, in order to assess local immune processes occurring in the skin affected by psoriasis. We examined 20 patients with a verified diagnosis of psoriasis, the average age was 44.3 years. The control group included 15 healthy adults, with average age of 46.6 years. Capillary blood was taken by fingerprick, whereas, in psoriatic patients, the samples were taken near the psoriatic lesion at a final volume of 400 μL in two microvettes. Venous blood (3 mL) was taken from the cubital vein into a vacuum tube with EDTA. Clinical analysis of venous and capillary blood was performed in automated hematological analyzer. Immunophenotyping was performed by four-color staining of whole capillary and venous blood followed by lysis of erythrocytes. Cytofluorometry was performed using techniques and reagents from BD Biosciences (USA). Plasma cytokines were determined by multiplex approach (MagPix, BioRad, USA). Upon clinical analysis of blood, the difference between capillary and venous blood was not found, either in healthy group, or among patients with psoriasis. In healthy people, the subsets of mononuclear cells, did not differ between venous and capillary blood. The samples of capillary and venous blood in the patients with psoriasis showed significantly increased levels of double-positive lymphocytes (CD45RA+/CD45R0+), B lymphocytes and NKT lymphocytes (both for relative and and absolute values). A significant increase in the percentage of naive T lymphocytes, activated helpers (Thact) and Treg, as well as B1 cells and Breg, and a significant decrease in B2 lymphocytes was registered in capillary blood of the patients with psoriasis. In venous blood samples from psoriatic patients, only a significant increase in Thact, Treg, and Breg was revealed. In the capillary blood of patients with psoriasis, we found a significant increase in the levels of non-classical M2 monocytes and inflammatory Minfl monocytes, and a decrease in classical M1 monocyte levels; in venous blood of psoriatic patients, only an increase in inflammatory Minfl monocytes was revealed. In capillary blood, all the studied cytokines in psoriasis patients significantly exceeded the levels of corresponding cytokines in healthy controls, except of IL-10. The levels of this cytokine did not differ from healthy group. In venous blood, the levels of most studied cytokines in the group of patients with psoriasis did not differ from the group of healthy ones. Approximately two-fold increase was revealed for IL-4, IL-21, IL-23 and TNF. First, the subsets of mononuclear cells and the cytokine profile of capillary and venous blood of healthy people did not differ significantly. Secondly, our proposed method for determining the subsets of mononuclear cells and capillary blood cytokines profile from the area of psoriatic lesions may be used to monitor local immunity in the patients with psoriasis. This approach is significantly less traumatic than the skin window method and more informative than the studies of venous blood.

Review of global use of licensed vaccines and development of new vaccines for the prevention of pneumococcal infection

Streptococcus pneumoniae infection is the most common cause of high morbidity and mortality among children under 5 years of age, immunocompromised people, and the elderly. Despite significant success, the approved pneumococcal conjugate and polysaccharide vaccines are of limited efficacy, providing protection against a small fraction of the known pneumococcal serotypes. The rapid spread of multidrug-resistant strains exacerbates the global challenge of treating infection caused by S. pneumoniae. At the same time, the emerging new strains dictate the need to include new serotypes into vaccines. In view of this, further improvement of vaccines for the prevention of pneumococcal infections is an urgent task. The aim of this study was to review advances in the development of polysaccharide, conjugate, whole-cell pneumococcal vaccines, as well as vaccines based on protein antigens and vaccines with an antigen delivery system. Genomics and proteomics data have helped to improve approaches to the creation of polysaccharide and protein-based vaccines, as well as whole-cell vaccines with the potential for population prophylactic coverage against various pneumococcal serotypes that are not included in the licensed pneumococcal vaccines. The method of antigen delivery to the cell is of great importance in the development of vaccines. The most promising strategy for improving pneumococcal vaccines is the creation of vaccines based on bacterium-like or synthetic particles carrying several antigens, including pneumococcal surface proteins. In conclusion, it should be noted that top-priority vaccines are those that provide a wide range of protection against circulating pneumococcal serotypes and, in addition to eliciting a systemic immune response, also induce local immunity.

Vitamin D in periodontology

Generalized periodontitis is one of the most common dental diseases that can lead to tooth mobility and tooth loss. Plaque is main etiological factor, but periodontitis is a multifactorial disease. There are data on the effect of vitamin D levels on generalized periodontitis. Vitamin D has a pleiotropic effect by affecting various links in the pathogenesis of generalized periodontitis. Stimulating the secretion of antimicrobial peptides, vitamin D increases local immunity and adversely affects periodontal pathogens; modulating the immune system, it affects inflammation in periodontal tissues and the immune response; increasing the absorption of calcium and reducing the release of parathyroid hormone, vitamin D stimulates bone mineralization. The high prevalence of vitamin D deficiency and insufficiency worldwide indicates the relevance of studying its effects on the human body in general and the oral cavity in particular.

PREVENTION OF CANDIDIASIS IN PATIENTS USING REMOVABLE DENTURES

Background: Despite innovations in orthopedic dentistry, the manufacture of removable dentures belongs to the most popular orthopedic care category. Removable dentures are combined stimuli that affect the mucous membrane and neuro-receptor apparatus. Acrylic plastic prostheses, widely used in prosthetic dentistry, have a negative side mechanical, chemical-toxic, sensitizing, and thermal insulating effect on oral tissue and prosthetic impression area. This is often complicated by a violation of the biocenosis of the oral cavity, the growth of pathogenic microflora that releases toxins, especially an increase in the number of yeast colonies that irritate the oral mucosa and prosthetic stomatitis. According to the WHO, one-fifth of the world s population suffers or has suffered various candidiasis forms at least once. The worldwide increase in the incidence of the disease is primarily related to the fact that this infection is opportunistic, more than half of the world s population is a carrier of fungi of this kind, i.e., in most cases, it is an endogenous infection, which makes candidiasis different from other opportunistic mycoses. Aims: The purpose of this study was to study the prevalence of candidiasis in patients using removable dentures and to evaluate the effectiveness and prevention of candidiasis treatment. Methods: 100 patients with oral candidiasis of various age groups from 45 to 65 years were observed. Of these, 60 patients with removable plate prostheses; 40 patients with partially removable prostheses. Results and Discussion: Chronic forms of candidiasis were diagnosed in 40 patients and with exacerbation of chronic forms of candidiasis-60 people. The number of untreated carious cavities and poor hygienic condition of the oral cavity directly affects the severity of candidiasis. Acute forms of candidiasis were observed mainly in patients with high DMF and PMA indices. The severity of candidiasis depends on the degree and duration of wearing dentures and hygienic conditions - the most severe forms of invasive candidiasis were observed in the presence of removable plate prostheses, the complete absence of teeth, and the use of a prosthesis for more than 10-15 years. A combined lesion of the oral mucosa and the red border of the lips was observed mainly in patients older than 60 years. Conclusions: The presence of candidiasis in the oral cavity in patients with removable plate prostheses leads to a statistically significant change in the indicators of local immunity of the oral cavity: an increase in the concentration of serum IgG and IgA and the values of the coefficient of the balance of local immunity factors.