The state of mucosal immunity in pediatric patients with chronic stomatitis

Objective. Studying the state of mucosal immunity, identifying age-related differences depending on the stage of histochemical and physical-immunological development in children with chronic stomatitis.

Materials and methods. The study involved 120 pediatric patients aged 4–18 years, of both sexes. The diagnosis is made on the basis of complaints, anamnesis and clinical examination. First group (n = 42) included patients with chronic stomatitis in the stage of primary formation of the mucous membrane (4–7 years), second group (n = 38) included children with the same pathology in the stage of secondary formation of the mucous membrane (8–18 years). The control groups included healthy children aged 4–7 years (third group, n = 20) and 8–18 years old (fourth group, n = 20). The groups were comparable by gender and age (p > 0,05). Enzyme immunosorbent and biochemical analysis of oral fluid included assessment of the levels of lysozyme, lactoferrin, lactoperoxidase, myeloperoxidase, alpha-amylase, immunoglobulin M and secretory immunoglobulin A.

Results. The study revealed that healthy children aged 4–7 years and 8–18 years had statistically significant differences in the studied indicators. In children aged 4–7 years, the level of myeloperoxidase is higher by 122,91 u/l (p < 0,05) compared to the level of this enzyme in children 8–18 years old. In older children, the levels of lysozyme, lactoferrin, alpha-amylase and secretory immunoglobulin are statistically significantly higher (p < 0,05) compared to children 4–7 years old. When studying the indicators in children with chronic stomatitis and healthy children, it was revealed that in the group of young children the level of lysozyme was 2,19 ng/ml, lactoferrin 11,73 ng/ml, secretory immunoglobulin A 12,46 ng/ml, which was statistically significantly different from children of the control group of the same age (p < 0,05). In the older age group, the level of lactoferrin was 8,85 ng/ml, which was significantly lower than the control group (p < 0,05), and the level of lysozyme was 1,51 [0,78; 5,23] ng/ml, which was statistically significantly different from patients in the control group of the same age (p < 0,01). In both age groups of patients with chronic stomatitis, the level of myeloperoxidase was statistically significantly different from the control group (p < 0,05), so in children aged 4–7 years the level of myeloperoxidase was 361,21 u/l, and in children 8–18 years 431,11 u/l.

Conclusion. When analyzing the obtained indicators of mucoprotective immunity in chronic stomatitis in different age groups, changes were revealed that reflected the dysfunction of local immunity. However, the nature of the changes does not always coincide in children 4–7 years old and 8–18 years old. For example, the change in lysozyme had statistically significant differences in both age groups from the control groups, however, in young children there was an increase, while in 8–18 years old there was a decrease in this factor relative to the control group. At the same time, in healthy children 8–18 years old, this figure is significantly higher than in the control group 4–7 years old, which is probably due to the development of the immune system, a change in the stages of histochemical and physicoimmunological development, and an improvement in the functions of mucosal immunity with age.

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