Pels Elżbieta
Chair and Department of Paedodontics, Medical University, Lublin, Karmelicka 7 St., 20-081, Lublin, Poland,
Cancer Chemother Pharmacol. 2015 Jul;76(1):205-10. doi: 10.1007/s00280-015-2750-7. Epub 2015 May 16.
Subjects undergoing chemotherapy often develop disorders in salivation and changes in salivary composition. Therefore, a tendency to inflammatory states developing within oral mucosa is often observed. The objective of the study was to assess the effect of disturbed immunity on the gum condition in children with acute lymphoblastic leukaemia (ALL) during anti-tumour treatment and to compare saliva interleukin-2 (IL-2) concentration in relation to the condition of gums oral mucositis-must be removed in children with ALL.
The study included 78 children with ALL in followed three examinations and a control group included 78 healthy children. Dental examination of the children with ALL and the control group included the evaluation of gingival condition by gingival index (GI). Children's unstimulated saliva samples were taken, and IL-2 concentration was determined by Human IL-2 EIA.
Mean GI higher than 1 was observed in 3.17 % children with ALL. The results found higher frequency of gingival inflammations in children with ALL on chemotherapy compared with the healthy controls. A comparison of results for a given patient during anti-tumour therapy with regard to salivary IL-2 showed significant differences between examination 2 and examination 3. The results indicated that IL-2 level in saliva was twice higher in a patient during chemotherapy.
An increase in salivary level of the proinflammatory IL-2 cytokine in ALL children during chemotherapy may cause pathological changes in the condition of the gums. An increase in salivary IL-2 level most probably results from a micro-injury of oral mucosa following administration of cytostatics, which in turn may cause oral mucositis in children with ALL.
接受化疗的患者常出现唾液分泌紊乱和唾液成分变化。因此,常观察到口腔黏膜出现炎症状态的倾向。本研究的目的是评估抗肿瘤治疗期间急性淋巴细胞白血病(ALL)患儿免疫功能紊乱对牙龈状况的影响,并比较唾液白细胞介素-2(IL-2)浓度与牙龈状况的关系——ALL患儿必须排除口腔黏膜炎。
该研究纳入了78例ALL患儿,进行了三次检查,对照组包括78名健康儿童。对ALL患儿和对照组儿童进行牙科检查,包括通过牙龈指数(GI)评估牙龈状况。采集儿童非刺激性唾液样本,采用人IL-2酶联免疫吸附测定法测定IL-2浓度。
在3.17%的ALL患儿中观察到平均GI高于1。结果发现,与健康对照组相比,接受化疗的ALL患儿牙龈炎症的发生率更高。对给定患者在抗肿瘤治疗期间唾液IL-2的结果进行比较,发现检查2和检查3之间存在显著差异。结果表明,化疗期间患者唾液中的IL-2水平高出两倍。
化疗期间ALL患儿促炎细胞因子IL-2的唾液水平升高可能导致牙龈状况发生病理变化。唾液IL-2水平升高很可能是由于使用细胞抑制剂后口腔黏膜受到微损伤所致,这反过来可能导致ALL患儿发生口腔黏膜炎。