Зміни біохімічних та молекулярних показників крові у пацієнтів з хронічним генералізованим пародонтитом при курсовому лікуванні антагоністом рецепторів інтерлейкіну-1

The aim of the study was to conduct a laboratory and biochemical assessment of the complex therapy of chronic generalized periodontitis (CGP) with the inclusion of an IL-1 receptor antagonist (Anakinra) in the therapy. Materials and methods. Examination and treatment of 60 patients with CGP of moderate severity and 30 patients with intact periodontium aged 40 to 65 years (35 women and 25 men) were conducted. Patients were divided into 2 groups: main and control, 30 people in each. Examination and treatment were carried out with the consent of the patients in accordance with GCP standards (1996) and the principles of the Declaration of Helsinki (World Medical Association – WMA, 2013). Patients with CGP of both groups received standard complex therapy for 30 days, which included oral hygiene; vector therapy; curettage; fixation of teeth in the correct position with specialized materials; anti-inflammatory and antiseptic medications. In addition, patients in the main group were prescribed Anakinra (1 mg/day) in the form of intraoral transgingival electrophoresis on both jaws (5 sessions). Biochemical studies included monitoring of the activity of lactate dehydrogenase (LDH), succinate dehydrogenase (SDH), glutathione peroxidase (GPx), glutathione reductase (GR); enzyme immunoassay of endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), nitrotyrosine and metalloproteinase-2 (MPP-2) in the blood of patients of the control and main groups before treatment and after 30 days of treatment. Statistical processing of the results was performed using the software package Statistica for Windows 13 (StatSoft Inc., No. JPZ804I382130ARCN10-J), as well as “SPSS 16.0”, “Microsoft Excel 2003”. Results. It was found that the additional inclusion of Anakinra in the complex treatment of CGP potentiated the anti-inflammatory effect of the therapy that was manifested in a more pronounced, compared to the control group, decrease in the level of MMP-2, and clinical signs (depth of periodontal pockets, bleeding, tooth mobility, etc.); enhanced antioxidant action, which was confirmed by a more pronounced decrease in nitrotyrosine level, an increase in GR and GPx activity (p < 0.05) compared to similar indicators in patients in the control group. The inclusion of Anakinra enhanced the anti-ischemic effect of complex therapy that was manifested in a decrease in LDH levels and an increase in SDH concentration (p < 0.05); and also contributed to a decrease in iNOS expression and an increase in eNOS expression (p < 0.05) compared to similar indicators of patients in the control group. Conclusions. The results obtained demonstrate a promising strategy of pharmacological blockade of IL-1β receptors, which may have new prospects for the treatment of patients with CGP.