Karolewska Ewa, Konopka Tomasz, Pupek Małgorzata, Chybicka Alicja, Mendak Magdalena
Department of Oral Pathology, Wroclaw Medical University, Wroclaw, Poland.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Jun;105(6):739-44. doi: 10.1016/j.tripleo.2007.10.010. Epub 2008 Mar 10.
The objectives of this study were to evaluate the local oral defense mechanisms during the course of leukemia, and to define the correlation between the activity of salivary antibacterial factors and the oral clinical findings.
A total of 44 children with newly diagnosed acute leukemia participated in the study. The control group consisted of 23 healthy children. The examination took place at the time of the diagnosis, and during and at the end of the chemotherapy treatment course. During the collection of resting mixed saliva samples the salivary flow rate was measured. In the saliva's supernatant the following parameters were determined: total protein, peroxidase, myeloperoxidase, lysozyme, lactoferrin, and secretory immunoglobulin A.
The introduction of chemotherapy caused a slight decrease of salivary secretion rate (P < .05), as well as the decrease of S-IgA concentration (P < .01), which remained at the same level after the end of chemotherapy (P < .001). Patients with aplasia had decreased levels of peroxidase (P = .014) and myeloperoxidase (P = .013). Patients with oral mucositis presented with lower myeloperoxidase (P = .026) and peroxidase (P = .003) activity levels as well as the drop of S-IgA (P = .000) concentration compared with subjects with no mucositis.
Antileukemic treatment contributes to the compromise of salivary defense mechanisms, therefore it is reasonable to support pharmacologically the saliva's antibacterial potential of leukemic patients to impede the development of local infection.
本研究的目的是评估白血病病程中的局部口腔防御机制，并确定唾液抗菌因子活性与口腔临床发现之间的相关性。
共有44名新诊断的急性白血病儿童参与了本研究。对照组由23名健康儿童组成。检查在诊断时、化疗疗程期间及结束时进行。在采集静息混合唾液样本时测量唾液流速。在唾液上清液中测定以下参数：总蛋白、过氧化物酶、髓过氧化物酶、溶菌酶、乳铁蛋白和分泌型免疫球蛋白A。
化疗的引入导致唾液分泌率略有下降（P <.05），以及分泌型免疫球蛋白A浓度下降（P <.01），化疗结束后仍维持在同一水平（P <.001）。再生障碍性贫血患者的过氧化物酶（P =.014）和髓过氧化物酶（P =.013）水平降低。与无口腔炎的受试者相比，口腔炎患者的髓过氧化物酶（P =.026）和过氧化物酶（P =.003）活性水平较低，且分泌型免疫球蛋白A浓度下降（P =.000）。
抗白血病治疗会导致唾液防御机制受损，因此合理地从药理学上支持白血病患者唾液的抗菌潜力以阻止局部感染的发展是合理的。
