CURRENT ASPECTS OF THE ROLE OF GLYCOSAMINOGLYCANS OF THE EXTRACELLULAR MATRIX IN THE DEVELOPMENT OF GENERALIZED PERIODONTITIS AND THE COURSE OF REPAIR PROCESSES

Abstract

The prevalence of periodontal disease, in particular of generalized periodontitis, has increased up to 98.5% over the past decades. The topical issue of modern dentistry is to fi nd the cause-effect relations of the development of infl ammatory and dystrophic infl ammatory periodontal diseases. It has been established that sulfated and non-sulfated glycosaminoglycans (GAGs) support the structure of periodontal tissues. The group of sulfated glycosaminoglycans (sGAGs) is represented in the bone tissue of the alveolar ridges by chondroitin sulfates, dermatan sulfate, keratan sulfate and heparan sulfate. Hyaluronic acid, which belongs to non-sulfated glycosaminoglycans, is present in a small amount. The role of biofi lm proteinase is important in the pathogenesis of gingivitis and periodontitis, when the activity of acidic and faintly acid proteinases of dental deposits and gum tissues increases 4-5 times. This process is accompanied by degradation of glycoproteins and other proteins of periodontal tissues. The enzymes of beta-glucuronidase, hyaluronidase, beta-NAcetylhexosaminidase and chondroitin sulfatase are actively involved in the cleavage of acid glycosaminoglycans and glycoproteins of the intercellular substance, periodontal cell membranes, and thus the destruction of circular ligament and periodontal tissues in general. Healing, as a complex dynamic process, is implemented with the inclusion of soluble mediators, blood cells, components of the extracellular matrix and resistant cells involved in recovery and tissue integration. Therefore, the role of GAGs in the processes of periodontal healing is active: 1. Inhibition of synthesis of lipids; 2. Inhibition of activity of proteolytic enzymes; 3. Inhibition of synergistic effect of enzymes and oxygen radicals; 4. Reduction of biosynthesis of infl ammation mediators due to masking of secondary antigenic determinants and inhibition of chemotaxis; 5. Inhibition of apoptosis; 6. Construction of collagen fi bers; 7. Regulation of cell proliferation; 8. Regulation of biosynthesis of the intercellular matrix components; 9. Improvement of microcirculation processes; 10. Rearrangement in structures of proteoglycans; 11. Regulation of chondro- and osteogenesis. The references present a generalized formulation of the main mechanisms of effect of periodontal structures glycosaminoglycans, which is relevant and requires further studying.

Keywords

• periodontal tissue, components of intercellular substance, healing