ANALYSIS OF LYSOZYME LEVELS IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE DEPENDING ON THE PRESENCE OF PERIODONTAL PATHOLOGY

Abstract

Introduction. Muramidase is a component of saliva that coats the mucous membranes of the mouth, providing the protective function of saliva and aiding the food bolus in passing through the gastrointestinal tract from the external environment. The structure of lysozyme, in addition to the oral cavity, is found in various sections of the small intestine, where it contributes to the protection of this part of the human body. Based on the specific mechanism of action of the studied enzyme on the peptidoglycan (murein) layer of bacteria, it can be concluded that it indirectly participates in the formation of the immune response. Objective – to determine and analyze possible changes in lysozyme levels in saliva depending on the form of gastroesophageal reflux disease, taking into account the condition of the oral mucosa and periodontal tissues. Materials and Methods. To determine lysozyme activity in saliva, test tubes were filled with 4.0 ml of a 0.5% NaCl solution and 1 ml of the studied material. To the mixture, a suspension of 1 billion M. lyzodecticus cells was added, mixed, and incubated in a thermostat at 37 °C for 3 hours. The optical density of the samples was measured before and after incubation using a photoelectrocolorimeter (FEC-M) at a wavelength of 540 nm. The enzyme activity in saliva was calculated using the formula: L=Do - D1/ Do × 100%, where: L – lysozyme activity (in %), Do – optical density before incubation, D1 – optical density after incubation. Results. Comparing the concentrations of the mucolytic enzyme in saliva, a significant decrease in lysozyme levels was observed, accompanied by changes in periodontal tissues. Specifically, in the group with gingivitis on the background of erosive gastroesophageal reflux disease, the indicator was significantly lower than in the groups with gingivitis in the non-erosive form (p < 0.05) and with intact periodontium (p < 0.05). As destructive-inflammatory processes in the periodontal tissues became more active, the numerical indicator of enzyme activity increased compared to that in gingivitis (p < 0.05). Conclusions. The progression of the inflammatory process in the esophageal tissues leads to a decrease in the activity of nonspecific protective factors, which is manifested by a reduction in lysozyme activity in the oral cavity and, subsequently, contributes to the progression of destructive-inflammatory processes in the periodontium. Evidence for this statement is the compensatory increase of 5.1% in enzyme activity in saliva (p < 0.05).