Chapter 4 the Conclusion

Undoubtedly, atopichesky the dermatitis remains important mediko a-social problem; according to different authors of 15-24 %, and in some ecologically adverse regions about 50 % of the children's population suffers this disease.

The quantitative and qualitative structure of antimicrobial peptides represents special interest and is a subject of intensive studying.

Antimicrobial peptides - factors of congenital immunity, an ancient link of immune protection of live organisms and the plants, existing 2 billion years. Other name of these bonds - endogenous antibiotics. Last two decades researches on synthesising of these bonds in vitro are activly conducted, that can give rise to a new era of antibacterial preparations. Considering escalating resistance of microorganisms to traditional antibacterial preparations, synthesising and introduction of synthetic antimicrobial peptides, in our opinion, is a perspective direction of scientific search.

Participation of antimicrobial peptides in inflammation reactions by present time is conventional; it is established, that they make direct impact on effektornye links of inflammatory process. LL-37 induce synthesis
interlejkinov (SILT) ИЛ-6, ИЛ-10 and chemokines in keratinotsitah, that causes mobilisation of neutrophils, monocytes, T-cages and mast cells. The last at influence LL-37 degranulirujut also liberate mediators, including Histaminum. There is also a feedback - inflammation mediators influence development of antimicrobial peptides. To blast membranes of cells of an organism of the owner with the subsequent necrosis high concentration of antimicrobial peptides are capable. Such effect possesses LL-37 in high concentration. Low concentration LL-37 can lead to death of cells owing to an apoptosis which intensifying is significant at virus infections of a skin, and reduction - at a psoriasis, healing of wounds and reepitelizatsii.

In researches of activity of antimicrobial peptides at atopicheskom a dermatitis accurate dependence between a process current, presence of a secondary infection and depression of level of antimicrobial peptides both in blood serum, and in inflammation sites time and again became perceptible. One of components of a hypersensibility sick atopicheskim a dermatitis to various infectious agents is insufficient development of antimicrobial peptides, and, in particular, katelitsidina LL-37 and a-defenzinov. This fact is surveyed as one of the central links of a pathogenesis atopicheskogo a dermatitis. It was initially supposed, that level LL-37 and and - defenzinov should be high because of presence of a mechanical trauma of a pruritic skin. However at use quantitative polimeraznoj chain reaction in real time both at acute, and at chronic atopicheskom a dermatitis appreciable depression of levels LL-37 and a-defenzinov has been taped.

At research a-defenzinov at patients with atopicheskim a dermatitis depression of their level in comparison with healthy donors also is taped. By data
Yount N. Y. (2005), level depression a-defenzinov can testify to active inflammatory process.

In our work attempt to investigate activity of these antimicrobial peptides in a mouth at children with atopicheskim a dermatitis has been undertaken. It is known, that the basic classes of antimicrobial peptides are developed practically in all biological liquids of an organism, including in a stomatic liquid. That fact is conclusive, that the oral cavity condition, in particular carious lesions of firm tissues of a teeth, lesions parodonta directly is bound to the general somatic status of the child. Considering that atopichesky the dermatitis is often met pathology in which pathogenesis antimicrobial peptides play a basic role, research of antimicrobial peptides of a mouth at children suffering AtD seemed to us interesting and perspective. Simplicity of a fence of a material for research, a small amount of a demanded material, an exception of invasive techniques does the given experiment especially interesting. It is necessary to notice, that saliva collecting caused huge positive interest in children of younger, preschool age, that, undoubtedly, does more attractive the given technique of research. In the literature there are no data about level of antimicrobial peptides of an oral cavity at children with atopicheskim a dermatitis.

For statement ekperimenta sets Human LL-37 ELISA, HNP 1-3 ELISA (Hycult Biotech, Holland) have been used. The given sets are intended for definition of antimicrobial peptides in blood serum and other biological liquids.

60 children took part in research with atopicheskim a dermatitis and children without allergic diseases, without a food allergy. Number of the basic group (children suffering atopicheskim by a dermatitis of various severity level) has made 38 persons; comparison group - 22 persons. All children participating in research have been parted on three age groups: 6-9 years (31 child), 10-12 years (14 children), 13-18 years (15 persons). Level has been defined
Antimicrobial polypeptides of an oral cavity depending on age. Statistically it has not been taped dependences between level of antimicrobial peptides and age of children participating in research.

Average concentration katelitsidina in a saliva - 1,2 ng/ml is established. According to Renchuan Tao, Richard J. (2008) level LL-37 of a stomatic liquid makes 1,72 ng/ml.

Average concentration a-defenzinov a saliva in our research has made 7,19 ng/ml. Data about level HNP 1-3 in a saliva at children in modern publications are not present.

At studying of level of antimicrobial peptides at children with atopicheskim a dermatitis the analysis of the received results has shown, that concentration LL-37 in a saliva has appeared authentically more low in comparison with comparison group. Having studied it is an indicator depending on character of a current atopicheskogo a dermatitis, we have found out, that level katelitsidina in a saliva at patients with AtD did not depend on gravity of disease and was authentic below control value as at serious (0, 7 ng/ml), and at sredenetjazhelom current AtD (0,6 ng/ml).

During research of a stomatic liquid, it is taped that concentration level a-defenzinov at children with AtD has made 6,24 ng/ml, that is authentic below the value of these peptides established by us at children of group of comparison (7,19 ng/ml).

At concentration definition a-defenzinov a stomatic liquid at children with serious (6,99 ng/ml) and srednetjazhelym a current atopicheskogo a dermatitis (6,28 ng/ml) it is not taped statistically authentic change of level a-defenzina in comparison with children without an atopy. Thus, it is possible to assume, that a major factor in development and weighting atopicheskogo a dermatitis is katelitsedin, and a-defenziny play a role «supports, the assistant» LL-37, the presence strengthening action of this peptide. Probably, that concentration and - defenzinov is enlarged in process of concentration increase katelitsidina and there is «a critical point» level LL-37, after which achievement defenziny
Start to accept more active participation in antimicrobic process. The given assumption demands additional, more in-depth studies.

Interesting data have been received at studying of influence of a food allergy on concentration katelitsidina in a saliva. So, at children with an alimentary sensibilization level katelitsidina has appeared authentically more low. It can testify that the current atopicheskogo a dermatitis at children with an alimentary sensibilization reduces indicators of immunologic resistance and can promote generalisation of carious process of an oral cavity. At concentration definition a-defenzinov at children with an alimentary sensibilization and without that essential differences it has not been taped. At comparison of two independent groups (LL-37, a-defenziny) on the basis of presence and absence of a sensibilization of statistical reliability it has not been taped.

At an estimation of the stomatologic status it has been taped, that 52 (86,6 %) from surveyed children had caries of various intensity, from them 36 (60 %) the child, suffering atopicheskim a dermatitis of various severity level, 18 (30 %) children from comparison group. At the analysis of intensity of caries on index KPU at children with AtD, it is taped, that 27 (45 %) children had caries of average and high intensity, 7 (11,6 %) children - caries of low intensity.

At children of group of comparison low level of intensity of caries became perceptible at 5 children. At 13 children it was observed high and an average level of intensity of caries.

Intact teeth had 8 of surveyed children, from them 4 children with atopicheskim a dermatitis of moderate severity level and 4 - children from group

Comparisons.

At statistical processing difference of intensity of caries at children with a basic disease and children of group of comparison is accurately proved.

At studying of level of antimicrobial peptides of a mouth it is taped, that at children with atopicheskim a dermatitis concentration LL-37 and a-defenziny in a saliva tended to depression in process of intensity increase
Carious process. It testifies to authentic dependence of concentration LL-37 and a-defenziov a saliva from intensity of carious process at children suffering atopicheskim by a dermatitis.

Other character of dependence has been received in comparison group. Level katelitsidina in a saliva of children without an atopy raised depending on intensity of carious process and has made at low intensity of caries 0,5 ng/ml, average - 1,2 ng/ml and high - 0, 16 ng/ml. The received results confirm assumptions that at children with atopicheskim a dermatitis immunologic resistance of an oral cavity decreases and conducts to an intensification of carious process. Moreover, high intensity of carious process conducts to an additional sensibilization of an organism and considerably reduces indicators of local immunity.

At level research a-defenzinov at children with atopicheskim a dermatitis the authentic interrelation of concentration of these peptides from intensity of carious process also has been established. At children with average and high intensity of caries concentration a-defenzinov it is authentic more low, than at children with low intensity of caries. At activity studying a-defenzinov a mouth at children of group of comparison, on the contrary, statistical reliability between concentration of these peptides at various intensity of carious process vyjavlenno was not. Dependences between level LL-37 and level a-defenzinov in a stomatic liquid at children of group of comparison with various intensity of carious process it has not been taped (r