РОЛЬ ИЗУЧЕНИЯ МЕСТНОГО ИММУНИТЕТА У ДЕТЕЙ С ВРОЖДЕННОЙ РАСКИЛЬИНОЙ ГУБЫ И НЕБА

Аннотация

of the oral cavity [1,6]. Despite the large number of surgical methods for In addition, the issue of preoperative preparation and eliminating defects of the palate, the authors note the postoperative care remains a controversial issue to this day. development of anatomical and functional disorders in the Improvement of existing and development of new methods future. Surgical intervention on the tissues of the hard and of treatment, which would be highly effective and at the soft palate leads to the disruption of the existing barrier - same time economically acceptable, is required. protective complex of the oral cavity. Saliva contains specifi c Congenital cleft of the upper lip and palate is an and non-specifi c defense factors. Immunoglobulins, T - and anatomical defect that affects one of the important protective В -lymphocytes act as factors of specifi c protection. Factors functions of the immune system, especially if the child of non-specifi c protection are represented by: interferons; is prone to diseases of otorinolaringologi organs and the lysozyme; lactoferrin; macrophages, neutrophils, etc. The upper respiratory tract [4,15]. Normal lymphopharyngeal oral cavity has a powerful system of humoral immunity, ring from the moment of birth protects the child from which contains secretory immunoglobulin A, which has a respiratory viruses, bacteria, fungi. One of the fi rst wide spectrum of protective action. scientists who formulated and advanced the theory of the 49 STOMATOLOGIYA importance of local immunity of the oral cavity in 1925 the normal microfl ora, contributes to the development of was A.M. Frequently. He emphasized the independence of infl ammatory diseases of the skin and mucous membranes the mechanisms of local immunity from systemic and the of the upper respiratory tract. Children with cleft palate fall importance of local immune mechanisms of the oral mucosa into the category of frequently ill children, as they begin in the development of infectious diseases. Normally, oral to suffer from respiratory diseases almost from the fi rst cavity contains conditionally pathogenic (gram-positive and months of life. Diseases such as SARS, acute respiratory gram-negative) microorganisms, their number is of great infections, rhinitis, bronchitis, starting from birth, occur in importance. The oral cavity in a child performs a number waves until the operation period. In frequently ill children, of inalienable functions: sucking, swallowing, digestive, violations in the interferon production system (IFN) are respiratory, salivary [1,10]. The main and necessary also also detected. In a study conducted by a group of authors, includes maintaining the normal state of the oral mucosa. in frequently ill children, 80% of cases showed a 2-fold Saliva contains specifi c and non-specifi c defense factors. reduction in the ability of cells to synthesize gamma-IFN Immunoglobulins, T - and V-lymphocytes act as factors of compared to infrequently ill children. Given the defect of specifi c protection. The barrier function of immunoglobulins local protection, it can be assumed that the presence of is manifested by: ensuring the binding and neutralization pathogenic microfl ora, especially Gram-negative, will be of microorganisms on the surface of mucous membranes; important in the development of frequent infl ammatory inhibiting the adhesion of pathogens and reducing the risk diseases of the roto-and nasopharynx in this group of of penetration into the body; binding of the complement and children. preventing the development of infl ammation; the interaction In children with congenital isolated cleft lip and palate, of antigen-binding centers of antibodies with epitopes of microbiological studies of pharyngeal smears were antigens; potentiation of the activity of non-specifi c defense performed to select a rational antibiotic therapy. It was factors. Factors of nonspecifi c protection are represented by: revealed the predominance of gram-negative microfl ora in interferons (increase antiviral protection of epithelial cells the oral cavity. To prevent the development of intercurrent and activate natural killer cells and macrophages); lysozyme diseases and postoperative complications, according to the (has a bactericidal effect, eliminates pathogens, blocks viral results of the study, parenteral cephalosporins of the third particle transcriptase); lactoferrin (reduces the degree of and fourth generation should be used in the preoperative colonization of sideophilic bacteria due to their binding to and postoperative periods, oral cefi xime and protected iron); macrophages, neutrophils, etc. The oral cavity has aminopenicillins should be used [1,4]. a powerful system of humoral immunity, which contains The choice of drugs used to treat diseases of the secretory immunoglobulin A, which has a wide spectrum oral mucosa is great, but not all of them meet the basic of protective action (antimicrobial, antiviral, antitoxic). re