State Institution “L.T. Malaya National Institute of Therapy of NAMS of Ukraine”, Kharkiv
Introduction. The priority of modern dentistry is a constant research of pathological changes in oral cavity occurring in patients with (COPD). Today under COPD we understand the growing abuse of lung function that caused lung tissue inflammatory response to stimulation by various agents. We know that more than 55.0 % of COPD cases are comorbid with coronary heart disease (CHD). COPD and CHD are accompanied by the emergence of systemic hypoxia, which in addition to the existing metabolic disorders of oxygen deficiency in periodontal tissues depresses regeneration and reparative processes. Results of clinical studies suggest that fairly simple methods of non-invasive exfoliative cytology allow us to determine the impact of various systems and external factors on the parameters of cells and cellular structures in the presence of various states of gums pathology. Both diseases have direct effect on periodontal tissue manifesting in cell anomalies such as micronucleus, binuklear cells, karioreksis, kariolisis, protrusion, vacuolization, and halo (coylocytosis).
Aim. To find out the frequency and nature of epithelial cell nucleus in patients with COPD comorbid with CHD.
Materials and methods. We examined 239 patients aged 45 to 65 years (157 men and 82 women) with verified diagnosis of COPD and CHD. They were divided into groups depending on the underlying disease: the main group – 130 patients with COPD comorbid with CHD, comparison group N 1 – 38 patients with COPD, and comparison group N 2 – 71 patients diagnosed with CHD. Cytology was performed on the gingival epithelium scrapes using light microscope. Also we used digital videocamera CAM 2800 with light microscopy to take photos of cells. Abnormal cells rate was determined in 1/1000 terms. Statistical analysis was performed with “SPSS 13” computer.
Results. All patients with somatic disorders have significant morphological changes of epithelial cells, increased number of non-nuclear cells, and cells with large nuclei evenly colored. At the same time the nucleus of epithelial cells from healthy donors were small and compact. Patients of the main group showed the highest level with micronuclei cells determined pathological processes and violation of apoptosis. In addition, patients of the main group and the comparison group number 1 had more than 2 times higher rate of binuclear cells in comparison with the control group, and also with group of patients with coronary artery disease. The highest rate of core protrusions was also inherent in the study group, whish frequency in patients with COPD increased significantly and exceeded targets by more than 9 times. COPD and CHD may contribute to the presence of hypoxia, microcirculatory disorders and vascular permeability, increased lipid peroxidation. Most likely is the probability of rise above violations and growth in the epithelium of patients with increased number of cells vacuolization, which is a sign of an early destruction of cells, including destructive changes of cell membranes, reducing their barrier and transport functions.
Conclusions. Results of the study indicate that the most significant changes of cells nucleus were found in patients with comorbid broncho-cardiac pathology and display stereotypical features of chronic inflammation. Thus, we can draw a conclusion about genotoxic impact of physical illness or its treatment of the manifestations of epithelial cell abnormalities on the patients with COPD comorbid with coronary artery disease.
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