The role of endothelium dysfunction of vessels of the periodontal microvasculature in development and progression of generalized periodontitis was studied and estimated due to comprehensive clinical, immunological and electron-microscopic researches. Development of pathological process in patients with generalized periodontitis is accompanied by the increased concentration of endothelium dysfunction markers: vasoconstrictor endothelin-1, pro-inflammatory cytokines – IL-1β, IL-6, TNF-α in periodontal blood and mouth liquid. Pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) enhance expression of molecules adhesion, stimulate the activity of endothelium, disrupt the lipids metabolism that has influence upon the change of the endothelial function and increased secretion of endothelin-1. These factors contribute to violation of periodontal hemodynamics stipulated by the increased vascular tone and reactivity, and retardation of capillary blood flow. The increase of imbalance between the formation of vasodilators and vasoconstrictors is a manifestation of endothelial dysfunction of the periodontal microvasculature and leads to the progression of generalized periodontitis. Due to excessive secretion of endothelial-dependent vasoconstrictor endothelin-1 and pro-inflammatory cytokines – IL-1β, IL-6, TNF-α there is blood stasis, adhesion and intracapillary erythrocytes hemolysis. The violation of the blood capillaries ultrastructure in case of generalized periodontitis manifests itself in the form of endothelial cells hyperplasia, organelles destruction and swelling of pericapillary space. The number of agglutinated thrombocytes and erythrocytes increases with the subsequent hemolysis phenomena, diapedesis of blood cells into the pericapillary space enhanced, microthromboses formed. Besides, there is a loosening, easing and violation of the integrity of the basement membrane of blood capillaries and postcapillary venules, the destruction of pericytes. The above-mentioned changes provoke the endothelium hypertrophy, slow down the microhemodynamics, blood cells aggregation and apoptosis of endothelial cells. Authors suggest that apoptosis of endothelial cells could be influenced by endothelin-1, pro-inflammatory cytokines – IL-1β, IL-6, TNF-α, free radicals. Monocytes and lymphocytes often overlap the narrowing of the microvasculature. By secreting the endotelin-1 and pro-inflammatory cytokines they could provoke the exacerbation and progression of generalized periodontitis. All aforesaid data testify to considerable disturbances in periodontal microhemodynamics in patients with generalized periodontitis and demand timely complex correction of these periodontal disorders with the help of capillaries protector, antioxidants and vitamins usage. Authors suggest to employ the obtained research results of the endothelial dysfunction markers indices concentration in mouth liquid and periodontal blood as a diagnostic test for evaluation of the inflammatory process and efficacy of treatment of patients with generalized periodontitis.
generalized periodontitis, endothelium dysfunction, endothelin-1, pro-inflammatory cytokines, ultrastructure of blood capillaries
«Bulletin of problems biology and medicine» Issue 2 part 2 (108), 2014 year, 115-120 pages, index UDK (616-007. 15+616-092); 616. 314. 17-008
