Comparison of oral microflora in selective IgA deficiency and x linked agammaglobulinemia cases with control group

Abstract

Aim: X linked agammaglobulinemia and selective IgA deficiency are predominantly antibody deficiency syndromes Recurrent sinopulmonary infections are common problems observed in both diseases IgG IgM and salivary IgA which are present especially in gingival crevice are involved in the defense of the oral cavity The aim of our study was to investigate oral mucosa dental health and variation in the microflora in selective IgA deficiency and XLA patients by comparison with the healthy group Material and Method: We reviewed 18 selective IgA deficient subjects 12 66 7 boys and 6 33 3 girls 12 patients with Bruton rsquo;s disease and 31 age matched healthy children aged 2 18 years with normal leucocyte and immunoglobuline levels Oral mucosal investigation dental caries plaque and gingival indices were assessed and all patients were evaluated for S mutans Lactobacillus and yeast colonization in İstanbul University Faculty of Dentistry Results: No significant differences were detected between the groups in terms of high MS level and other parameters Significantly higher lactobacillus and yeast levels were found in XLA patients compared to the selective IgA deficient subjects and healthy group respectively High lactobacillus and yeast levels were correlated with frequent consumption of starch rich food Presence of dental caries was correlated with high plaque and gingival indices Conclusions: The higher frequency of Lactobacillus and yeast colonization in XLA patients indicates that antibodies have a major influence on oral microbiota and antibacterial defense The similar frequency of dental caries and oral mucosal lesions among the groups suggests the importance of neutrophils and antibacterial substances taking part in innate immunity Turk Arch Ped 2013; 48: 204 209

Keywords

• Dental caries, selective IgA deficiency, oral microbiota, X linked agammaglobulinemia

Selektif IgA eksikliği ve X’e bağlı agammaglobülinemi olgularında ağız mikroflorasının sağlam grupla karşılaştırılması

Öz

Amaç: X rsquo;e bağlı agammaglobülinemi ve selektif IgA eksikliği antikor eksikliklerine örnek iki hastalıktır ve yineleyen sinopulmoner enfeksiyonlar hastalığın tanımlayıcı bulgularıdır Ağız boşluğunda özellikle diş eti ceplerinde bulunan salgısal IgA immünglobülin G ve M diş sağlığının korunmasında önemli etmenlerdir Biz bu çalışmada selektif IgA eksikliği ve X rsquo;e bağlı agammaglobülinemi tanılı hastaların ağız diş sağlığını ve ağız mikroflorasındaki değişimi araştırmayı amaçladık.

Gereç ve Yöntem: Çalışmamıza Selektif IgA eksikliği tanısıyla izlenen 12 rsquo;si 66 7 erkek altısı 33 3 kız toplam 18 hasta ve X rsquo;e bağlı agammaglobülinemi Bruton Hastalığı tanısıyla izlenen 12 erkek hasta alındı Kontrol grubu olarak 2 18 yaş arası lökosit ve yaşa göre immünglobülin değerleri normal sınırlarda olan hasta grubuna benzer yaşta 31 hasta alındı Hastalar İstanbul Üniversitesi Diş Hekimliği Fakültesi rsquo;nde diş çürükleri plak ve diş eti indeksleri mutant streptokok laktobasil ve maya düzeyleri açısından değerlendirildi.

Bulgular: Gruplar arasında ağız içi lezyon ve diş çürükleri karşılaştırıldığında istatistiksel anlamlı fark saptanmadı X rsquo;e bağlı agammaglobülinemide selektif IgA eksikliğine göre laktobasil düzeyi kontrol grubuna göre maya varlığı anlamlı olarak yüksek bulundu Yüksek maya ve laktobasil düzeyleri sık nişastalı gıda tüketimiyle diş çürükleri yüksek plak ve diş eti indeksleriyle ilişkili bulundu.

Çıkarımlar: X rsquo;e bağlı agammaglobülinemi hastalarında saptanan yüksek maya ve laktobasil düzeyleri antikorların ağız mikroflorasının oluşumu ve antibakteriyel savunmada önemli yer aldığının göstergesidir Selektif IgA eksikliği ve X rsquo;e bağlı agammaglobülinemi hastalarının ağız içi lezyon ve diş çürüğü sıklığında sağlam gruba göre fark saptanmaması antikorlar dışında nötrofiller ve doğal immün sistemde yer alan diğer antibakteriyel etmenlerin etkili olduğunu düşündürmüştür.

Anahtar Kelimeler

• Ağız içi mikroflora
• diş çürüğü
• selektif IgA eksikliği
• X’e bağlı agammaglobülinemi

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