INTRODUCTION
Urgency of a theme of the dissertation
Caries, its complicated forms and pathology of a mucosa of an oral cavity often meet at children. The accurate interrelation between a condition of an oral cavity and the general somatic status of the child is proved.
Thereupon revealing of features of a condition of an oral cavity at children with allergic diseases is especially actual. The pathogenesis of the last is bound to numerous changes of the immune answer, in particular, to disturbances of congenital immunity. An allergy debut at children's age is, as a rule, IgE - the mediated food allergy [1, 4, 13] which is most often shown atopicheskim by a dermatitis (AtD). The disease beginning is caused by interaction of contributing genes and trigger factors [4].The susceptibility to trigger factors depends on the immune status of the patient. In the physiological reactions of an organism referred on maintenance of a genetic constancy of internal medium, the most important role is played by factors of congenital immunity, namely natural resistance against microorganisms and the cells infected with intracellular microbes [17]. Congenital immunity is genetically fixed system of protection of metaphytes from any patogenov. It provides recognition and eliminatsiju microorganisms during the first hours their intrusions, development of the signals causing formation
Adaptive immunity. At pozvonochnyh in the course of evolutionary development and mutual relations with microorganisms there were numerous mechanisms of protection against aggressive factors of an environment [3].
The person has some levels of protection against infections, among which: cover tissues (a skin and mucosas), microbicidal ekzosekrety (a stomach hydrochloric acid, bactericidal components of a saliva,
Lytic digestive components of an intestine, etc.) ; Reactions from the vessels, referred on creation of a barrier to penetration of external factors into internal medium (a fast local edema in the damage centre), the cells possessing phagocytic activity, bactericidal peptides of blood serum, a fabric liquid or secrets - complement system, a lysozyme, antimicrobial peptides (AMP), etc. [1,2,15]. Factors of congenital immunity join in protection instantly after overcoming by the originator dermal or mucosas. Their influence proceeds during all period of struggle of an organism with an infection, but is the most effective within first four hours after microbe introduction when congenital immunity is practically unique defender of an organism [17]. System of congenital immunity evoljutsionno more ancient, than system of the got immunity. It reacts not to concrete antigens, and on certain classes of antigens, characteristic for pathogenic organisms (polysaccharides of a cellular wall of bacteria, dvunitevaja RNK some viruses, etc.). One of maloizuchennyh components of system of congenital immunity are antimicrobial polypeptides (AMP) [10,17].
Protection of epithelial surfaces against microorganisms depends on expression AMP. At atopicheskom a dermatitis peptides of an epithelium of a skin, interfere with uncontrollable growth St. aureus. Reduction or absence of production, and also change of activity of antimicrobial peptides conducts to rising of sensitivity of a macroorganism to microorganisms and to disease development [3, 17].
Basic classes AMP ekpressirujutsja as in a mouth (a saliva and an epithelium), and in a skin epithelium.
These and other facts prove studying of a role of antimicrobial peptides of a pathology of an oral cavity at children with atopicheskim a dermatitis [3, 17].Research objective
To define communication of a condition of an oral cavity and concentration of antimicrobial peptides (katelitsidina, a-defenzinov) in a stomatic liquid at children with atopicheskim a dermatitis.
Research problems
1. To estimate a state of health of an oral cavity at children with atopicheskim a dermatitis (firm tissues of a tooth, a condition parodonta).
2. To establish concentration of antimicrobial peptides (a-defenziny, LL-37) in a stomatic liquid at children with atopicheskim a dermatitis.
3. To define level of antimicrobial peptides (a-defenziny, LL-37) in a saliva at children without an atopy.
4. To tap communication of the stomatologic status at children with atopicheskim a dermatitis with concentration of antimicrobial peptides in a stomatic liquid.
Scientific novelty
For the first time concentration of antimicrobial peptides of a stomatic liquid both at children with atopicheskim a dermatitis, and at children without an atopy is defined.
It is proved, that at children with atopicheskim a dermatitis concentration of antimicrobial peptides of a stomatic liquid is lowered. And at increase of intensity of carious process level LL-37 and and - defenzinov decreases.
It is established, that concentration katelitsidina in a saliva of children depends on a sensibilization spectrum.
Connection between level katelitsidina a mouth and a condition parodonta at children with atopicheskim a dermatitis and at children without allergic diseases is established.
The practical importance of work
As a result of the carried out research the important data for practical public health services about necessity of the account of presence at children atopicheskogo a dermatitis and an alimentary sensibilization for the purpose of rendering of the effective stomatologic help, and also working out of methods of preventive maintenance of caries and diseases parodonta (to connect germicides for treatment of diseases parodonta, studying of possibility of stimulation of development of endogenous antimicrobial peptides) are obtained.
Concentration of antimicrobial peptides of a saliva at children with a debrided oral cavity, both without allergic diseases, and at children with an atopy is established.
Concentration of antimicrobial peptides of an oral cavity at children with atopicheskim a dermatitis is established at various gravity of a current of process.
The substantive provisions which are taken out on protection
The modern scientific concept about participation of antimicrobial peptides in development of inflammatory diseases of an oral cavity at children is presented.
The condition of an oral cavity at children depends on concentration of antimicrobial peptides in a stomatic liquid. Presence atopicheskogo a dermatitis and an alimentary sensibilization at children is reflected in depression of level LL-37 in a stomatic liquid.
Intensity of carious process at children is bound to concentration of antimicrobial peptides of a stomatic liquid. And, at children without allergic diseases at increase of intensity of caries the augmentation of level of antimicrobial peptides whereas for children with atopicheskim a dermatitis the return situation is characteristic becomes perceptible.
Dissertation approbation
Dissertation materials are reported, discussed and approved on XI Russian congress «Innovative technologies in pediatrics and children's surgery» (Moscow, 2012), [the diploma of the winner of competition of young scientists]; at VIII scientifically-practical conference with the international participation «Pressing questions of children's stomatology and orthodontics», the chair of stomatology of children's age devoted to the 10 anniversary and orthodontics of the First Moscow State Medical University of a name of I.M.Setchenov (Moscow 2012), [1 place of competition of young scientists]; on HH the Russian national
The congress «the Person and a medicine» (Moscow, 2013), [3 place of competition of the young
Scientists]; at joint meeting of employees of chair of children's therapeutic stomatology, chair of pediatrics GBOU VPO «MGMSU of A.I.Evdokimova» on September, 30th, 2013.
Introduction of results of research
Results of research are introduced in educational process on chair of children's therapeutic stomatology GBOU VPO «MGMSU of A.I.Evdokimova».
The personal contribution of the author
The author had personally been spent inspection of 98 patients, interrogation, survey, a material fence, studying of case histories of patients, processing, ordering and statistical data processing, preparation of the basic publications on the executed work on a dissertation theme.
Publications on a dissertation theme
On a dissertation theme 7 printing works in materials of the domestic and international congresses, 4 of them - in the magazines recommended VAK Minobrnauki the Russian Federation are published.
The list of the published scientific works on a theme of dissertational research in the magazines recommended VAK Minobrnauki the Russian Federation
1. Kulakova E.V.endogenous antimicrobial peptides - factors of nonspecific protection of an organism / E.V.Kulakova, V.M.Yelizarov, A.N.Pampura//the Russian stomatologic magazine. - 2012. - № 6. - S.42-45.
2. Kulakova E.V.concentration katelitsidina a saliva at children with atopicheskim a dermatitis / E.V.Kulakova, V.M.Yelizarov, A.N.Pampura//the Collection of works VIII scientifically - practical conference «Pressing questions of children's stomatology and orthodontics». - 2012. - With. 40 - 42.
3. Kulakova E.V.studying of level of concentration LL-37 of a saliva at children with atopicheskim a dermatitis at various kinds of a sensibilization of an organism /
/ E.V.Kulakova//Scientifically-practical magazine «Dental Forum». - 2012. - № 3 With. 61.
4. Kulakova E.V.role of endogenous peptides (katelitsidina LL-37) in development of caries in children with atopicheskim a dermatitis / E.V.Kulakova, V.M.Yelizarov, A.N.Pampura//Scientifically-practical magazine «Dental Forum».-2012. - № 3 With. 59.
5. A role of endogenous peptides (katelitsidina LL-37) in development of caries in children with atopicheskim a dermatitis / E.V.Kulakova, V.M.Yelizarov, A.N.Pampura, T.V.Vinogradova//treatment and preventive maintenance - 2013.³1 (5), - With. 75 - 79.
Volume and dissertation structure
The dissertation is stated on 95 pages of the typewritten text and consists of introduction, the review of the literature, the description of materials and methods, results of own researches, the conclusion and conclusions. The bibliographic index includes 98 sources, including 16 domestic and 83 foreign authors. The dissertation is illustrated by 18 tables, 19 drawings.
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