Медицинская иммунология (Jan 2018)
TRYPTASE OF ORAL LIQUID AND IgE-ANTIBODIES AS A MARKER OF ALLERGIC INFLAMMATION IN THE ORAL MUCOSA
Abstract
The goal of present study was to determine the levels of mast cell tryptase (MCT) in whole saliva, and blood serum IgE antibodies in patients with intolerance for dental prosthetic materials (IDM) before and after removal of prosthetic constructs. We have conducted examination of the patients suffering from the IDM symptoms, who were divided into 2 groups depending on the time span between the end of prosthetic treatment and emergence of pathological symptoms: group 1 (n = 19), 1 to 14 days (symptoms emerged immediately after treatment); group 2, (n = 18), IDM symptoms occuring 6 months to 5 years later; group 3 (n = 16), controls without complaints for IDM. Whole saliva (WS) samples were collected before removal of prosthetic constructs and 1 month later. In group 1, salivary MCT was detected in 16 subjects (84.2%) before removal of prosthetic constructs, while 1 month after MCT not detectable in saliva (p < 0.001). Salivary MCT in control group was not detected both before and after removal of prosthetic constructions. Hence, mast cell tryptase in whole saliva could be a diagnostic marker for intolerance to dental materials. In group 1 of the patients, we detected IgE antibodies to Ni-HSA in 78.9% of patients, IgE antibodies to Cr-HSA in 68.4% of patients and IgE to Co-HSA in 52.6% of patients. Salivary MCT levels strongly correlated with IgE levels to Ni-HSA (Rspearman = 0.9; p < 0.05), showing moderate correlation with Cr-HSA (Rspearman = 0.7; p < 0.05). The data obtained suggest some prevalence of immediate type immune reaction against dental materials. Notable local increase of MCT level could be an important diagnostic marker of local inflammatory process initiation. MCT in whole saliva was found only in 3 patients (16.7%) from group 2; those had IgE antibodies to metal ions in blood serum, thus indicating IgE-dependent reaction type. Other patients from group 2 were likely to develop a different type of allergic reaction, e. g. delayed or granulocyte-mediated response. To perform reliable diagnostics of allergy to the components of dental materials, it is reasonable to measure salivary MCT before and after removal of prosthetic constructs. Salivary MCT level monitoring allows to confirm a role of prosthetic constructs in IDM emergence, and a need for their replacement.
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