Characteristics of the phagocyte effector indexes and effect of local cytokine therapy on their parameters in inflammatory diseases of the maxillofacial region

Abstract

Odontogenic inflammatory diseases and injuries take a leading place in the structure of surgical dental pathology. They often proceed with inflammatory complications. The aim of the present work was to analyze the effector indexes of phagocytic cells at the local area of inflammation (secretions from purulent wounds, tooth socket and mixed saliva), and to evaluate the effect of topical cytokine therapy on the studied parameters in patients with inflammatory dental diseases (chronic periodontitis, odontogenic phlegmon) complicated by mandibular fractures. As a part of a two-stage research, 236 people were comprehensively examined, divided into groups depending on their clinical disease and method of treatment. This group included 74 patients (classified as K 04.5 K 04.9), divided into subgroups by the types of periodontitis (chronic fibrous, granulating and granulomatous form); 102 patients with phlegmon (classified as L03.2, K12.2), who, at the second stage of basic therapy, received topical cytokine treatment with betaleukin (recombinant IL- 1) and roncoleukin (recombinant IL-2). Fifty patients with fractures of the lower jaw (classified as S 02.6) underwent immunotherapy with betaleukin at the second stage of treatment. Examination of patients with inflammatory dental diseases at the first stage of study and analysis of the effector indexes of neutrophilic granulocytes and macrophages from the local inflammatory foci revealed some immunological predictive signs of lacking efficiency of the inflammatory response, manifesting as aberrant functional activity of phagocytes, e.g., inhibition of all studied parameters along with sufficiently reduced functional reserve of phagocytic cells in the patients with phlegmon; high ability to produce reactive oxygen species with a decreased functional reserve of neutrophils in the patients with fractures, and signs of activated chronic inflammation in the patients with periapical lesions. The second stage of our research associated with topical therapy with recombinant cytokines and analysis of the obtained data, ebabled us to detect different effects of drugs on the studied parameters and register the integral effect of immunotherapy, which represents normalization of altered functional indexes. Hence, the data obtained may indicate that, in patients with inflammatory processes in the maxillofacial region, a higher adaptive effector potential of phagocytes was formed at the affected focus following the topical cytokine therapy.