RU2572696C1 - Method for prediction of manifestations of stomatitis in patients with acute leukaemia shown by change in immunoglobulins a and g anti-transglutaminase antibody content in oral fluid - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: patients with acute leukaemia are examined to measure the concentrations of immunoglobulin A (IgA) anti-transglutaminase antibodies and immunoglobulin G (IgG) anti-transglutaminase antibodies. If the immunoglobulin A (IgA) anti-transglutaminase antibody content decreases to 2.05±0.05 Units/ml, whereas the immunoglobulin G (IgG) anti-transglutaminase antibody content decreases to 3.05±0.05 Units/ml, stomatitis is predicted 5-7 days later. If the immunoglobulin A anti-transglutaminase antibody content decreases to 0.97±0.08 Units/ml and the immunoglobulin G anti-transglutaminase antibody content - to 0.85±0.07 Units/ml, developed stomatitis is diagnosed.

EFFECT: using presented method allows predicting the development of stomatitis in patients with acute leukaemia for the purpose of preliminary prediction and early treatment of stomatitis.

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Description

The invention relates to medicine, in particular to dentistry and biochemistry, to methods for diagnosing and predicting stomatitis in patients with leukemia by studying changes in the content of antibodies to transglutaminase classes of immunoglobulins A and G in the oral fluid.

The aim of this invention is the early diagnosis of stomatitis as a consequence of polychemotherapy in patients with acute leukemia based on a study of oral fluid. In patients with acute leukemia, along with an assessment of the clinical symptoms of the disease, this study helps to additionally monitor the course of the disease, assess the prognosis of lesions of the oral mucosa and the effectiveness of treatment.

Pathological processes that occur in the hematopoietic system in acute leukemia are manifested to one degree or another in all body tissues, but the earliest and most pronounced disorders are determined on the oral mucosa [1].

Oral fluid is subject to fairly rapid changes under the influence of external influences on the oral cavity. At the same time, many saliva composition indicators reflect blood composition. Oral fluid can serve as a marker of pathological conditions not only of the glands themselves, but also of pathology in other organs and systems of the body. The oral fluid is directly connected with the internal environment of the body. It has been established that structural changes in crystallized oral fluid can serve as a diagnostic sign of various diseases [2].

A known method of laboratory diagnosis of diseases of the oral cavity by the elemental composition of saliva. To implement the method, the content of sodium, potassium, calcium and phosphorus in the saliva of the subject is determined. The Ca / P and Na / K ratios are calculated and, with Ca / P values less than 0.3 and Na / K less than 0.2, dental caries is diagnosed. With Ca / P values less than 0.3 and Na / K greater than 0.2, the process of stone formation in the oral cavity is diagnosed. With Ca / P values greater than 0.3, a conclusion is drawn about the normal state of the oral cavity. The use of the invention provides for the identification at a dental appointment of persons at risk of tooth decay and stone formation in the oral cavity based on a laboratory assessment of the condition of the oral cavity [3].

The disadvantages of this method are its narrow focus, the lack of consideration of the nature of nutrition, the rigidity of drinking water.

A known method for the differential diagnosis of inflammatory periodontal diseases according to the state of local factors of non-specific protection of the oral cavity. The goal is achieved in that the concentration of secretory immunoglobulin A (SIg A) and lysozyme is determined in the oral fluid by chemiluminescence [4]. The method allows you to early identify signs of periodontitis of one degree or another, to adjust the ongoing therapy. The disadvantage of this method is the complexity of the implementation, while not taking into account possible changes in the composition of saliva, not associated with the development of periodontal disease. This method is taken as a prototype.

The technical result, the achievement of which the creation of this invention is directed, is to prevent the development of stomatitis in patients with acute leukemia by preliminary prevention and early treatment of stomatitis when it is detected.

The technical result is achieved by the method of enzyme immunoassay in patients with acute leukemia determine the concentration of antibodies to transglutaminase class immunoglobulins A (Ig A) and antibodies to transglutaminase class immunoglobulins G (Ig G), while reducing the content of antibodies to transglutaminase class immunoglobulins A up to 2.05 ± 0.05 U / ml and antibodies to transglutaminase of the class of immunoglobulins G up to 3.05 ± 0.05 U / ml predict the manifestation of stomatitis in 5-7 days; with a decrease in the values of antibodies to transglutaminase of the class of immunoglobulins A to 0.97 ± 0.08 U / ml and antibodies to transglutaminase of the class of immunoglobulins G to 0.85 ± 0.07 Units / ml, the developed stomatitis is diagnosed.

90 people were examined, among which three groups were distinguished: with acute leukemia and developed stomatitis, acute leukemia without ulcerative necrotic manifestations as the effects of polychemotherapy and a control group of somatically healthy people, comparable in age and sex. The average age of the patients was 42 years, sexual ratio - 45% of men, 55% of women. The content of antibodies to transglutaminase of classes of immunoglobulins A and G was analyzed in all subjects. The following was established.

In the group of somatically healthy patients, the content of antibodies to transglutaminase of the classes of immunoglobulins A and G was within 3.25 ± 0.07 U / ml of the class of immunoglobulins A and 5.05 ± 0.07 U / ml of the class of immunoglobulins G, with a decrease in the antibody content to transglutaminase class immunoglobulins A up to 2.05 ± 0.05 U / ml and antibodies to transglutaminase class immunoglobulins G up to 3.05 ± 0.05 U / ml recorded the manifestation of mucositis 5-7 days after sampling in the group of patients with acute leukemia without manifestations on the oral mucosa; a pronounced manifestation of stomatitis was diagnosed with a decrease in the content of antibodies to transglutaminase class immunoglobulins A to 0.97 ± 0.08 U / ml (p <0.05) and antibodies to transglutaminase class immunoglobulins G to 0.85 ± 0.07 (p < 0.05) U / ml in the group of patients with lesions of the oral mucosa in patients with acute leukemia.

The proposed diagnostic method is illustrated by the following clinical examples.

Clinical example. Patient P., medical history number 18543, diagnosis of acute myeloid leukemia. A sample of the oral fluid was taken before the course of chemotherapy. The content of antibodies to transglutaminase class of immunoglobulins A - 1.7 U / ml; the content of antibodies to transglutaminase class of immunoglobulins G - 2.5 IU / ml A course of polychemotherapy was started. On the fifth day after its start, the result of an enzyme-linked immunosorbent assay of the oral fluid showed a sharp decrease in the levels of antibodies to transglutaminase of class A and G immunoglobulins: the content of antibodies to transglutaminase of class A immunoglobulins - 0.95 g / l (p <0.05), antibody content to transglutaminase of the class of immunoglobulins G - 0.84 U / ml (p <0.05). Ulcerative necrotic manifestations appeared on the oral mucosa. With further treatment, this patient is recommended the prophylactic use of antiseptics before starting chemotherapy in order to prevent the development of stomatitis.

After the treatment-and-prophylactic course of treatment, stabilization of the pathological process was noted. The content of antibodies to transglutaminase class of immunoglobulins A at the same time became 1.3 U / ml; the content of antibodies to transglutaminase class of immunoglobulins G - 2.2 IU / ml

The proposed method is easily reproducible in a clinical diagnostic laboratory, and when it is used, the indicated technical result is achieved.

Information sources

1. Dmitrieva B.C., Bury A.V., Avanesov A.M. Clinic and features of treatment of lesions of the oral mucosa in patients with leukemia. M .: Publishing house of Ros. University of Friendship of Peoples, 1994.36 p.

2. G.M. Barer // Ros. a dentist. Journal, 2003. - 1. - S. 33-3.

3. Patent "A method for laboratory diagnosis of diseases of the oral cavity by the elemental composition of saliva" (RU 2367959).

4. Patent No. 2390775 "Method for the differential diagnosis of inflammatory periodontal diseases according to the state of local factors of nonspecific protection of the oral cavity."

Claims (1)

A method for the diagnosis of inflammatory diseases of the oral cavity, including the analysis of oral fluid, characterized in that the prognosis of stomatitis in patients with acute leukemia is carried out by determining the concentration of antibodies to transglutaminase class immunoglobulins A (Ig A) and antibodies to transglutaminase class immunoglobulins G (Ig G), while reducing the content of antibodies to transglutaminase class of immunoglobulins A to 2.05 ± 0.05 U / ml and antibodies to transglutaminase class of immunoglobulins G to 3.05 ± 0.05 U / ml predict the manifestation of stomatitis in 5-7 days; when the values of antibodies to transglutaminase of the class of immunoglobulins A to 0.97 ± 0.08 U / ml and antibodies to transglutaminase of the class of immunoglobulins G to 0.85 ± 0.07 U / ml are reduced, the developed stomatitis is diagnosed.