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The purpose of the study was to study the relationship between the state of the oral cavity microbiocenosis and the level of local immunity in children and adolescents with chronic liver diseases. Materials and methods. 45 children aged 10 to 16 years, who were treated in the public utility "City Children's Clinical Dental Hospital of the Poltava City Council" were examined. All children were divided into 2 groups: the main group – children and adolescents with chronic hepatitis (n = 26) with diseases of concomitant oral mucosa and periodontal disease; control group – children of the same age without concomitant somatic pathology (n = 20). In all observation groups, the state of oral hygiene was recorded using the simplified oral hygiene index (Green-Vermillion, 1964) and the intensity of the inflammatory process in the periodontal tissues, which was assessed by the papillary-marginal-alveolar index modified by Parma (1960). The degree of dysbiosis in the oral cavity was determined using the enzymatic method of A. P. Levitsky by the ratio of the relative activity of urease and lysozyme. The state of local immunity was investigated by the level of immunoglobulins IgA, IgM, IgG and secretory immunoglobulin sIgA. Results and discussion. It was found that the majority of patients with chronic hepatitis had an unsatisfactory and even poor state of oral hygiene, according to the Green-Vermillion simplified oral hygiene index, in combination with moderate and severe gingivitis (according to the papillary-marginal-alveolar index). The most negative results were registered in children 9-13 years old. The effect of the low level of oral hygiene in children and adolescents with chronic liver diseases, which is accompanied by increased dysbiosis, was studied, which indicates a drop in the level of antimicrobial protection, suppression of local mucosal immunity, a decrease in lysozyme activity and a decrease in the content of secretory sIgA in the oral fluid. The mediated mechanism of sIgA action through the phagocyte activation system with subsequent lysis of pathogenic microorganisms is considered. Conclusion. Chronic liver diseases reliably lead to changes in the body's immunobiological reactivity, and also cause suppression of the protective mechanisms of the oral cavity and its local immunity, characterized by a decrease in the activity of lysozyme and secretory IgA in the oral fluid of sick children and adolescents

Microbiocenoses and the State of Local Mucosal Immunity of the Oral Cavity of Children and Adolescents with Liver Diseases