Resistance to antibacterial therapy requires the discovery of new methods for the treatment of infectious diseases. Lactoferrin (LTF) is a well-known naïve first-line defense protein. In the present study, we suggested the use of an adenoviral vector (Ad5) carrying the human gene encoding LTF for direct and cell-mediated gene therapy of maxillofacial area phlegmon in rats. Abscesses were developed by injection of the purulent peritoneal exudate in the molar region of the medial surface of the mandible. At 3–4 days after phlegmon maturation, all rats received ceftriaxone and afterward were subcutaneously injected around the phlegmon with: (1) Ad5 carrying reporter gfp gene encoding green fluorescent protein (Ad5-GFP control group), (2) Ad5 carrying LTF gene (Ad5-LTF group), (3) human umbilical cord blood mononuclear cells (UCBC) transduced with Ad5-GFP (UCBC + Ad5-GFP group), and (4) UCBC transduced with Ad5-LTF (UCBC + Ad5-LTF group). Control rats developed symptoms considered to be related to systemic inflammation and were euthanized at 4–5 days from the beginning of the treatment. Rats from therapeutic groups demonstrated wound healing and recovery from the fifth to seventh day based on the type of therapy. Histological investigation of cervical lymph nodes revealed purulent lymphadenitis in control rats and activated lymphatic tissue in rats from the UCBC + Ad5-LTF group. Our results propose that both approaches of LTF gene delivery are efficient for maxillofacial area phlegmon recovery in rats. However, earlier wound healing and better outcomes in cervical lymph node remodeling in the UCBC + Ad5-LTF group, as well as the lack of direct exposure of the viral vector to the organism, which may cause toxic and immunogenic effects, suggest the benefit of cell-mediated gene therapy.

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Subject. A review of the literature on the topical problem of dentistry — the etiology and pathogenesis of acute odontogenic purulent-inflammatory diseases is presented. The purpose of the research is to study the materials of publications. dedicated to the etiopathogenetic aspects of acute odontogenic infection. Methodology. The etiology and pathogenesis of acute odontogenic purulent-inflammatory diseases are described in detail, in the light of modern concepts. Results. The unfavorable factors influencing the increase in the frequency of acute odontogenic purulent-inflammatory diseases and the worsening of the clinical course are presented. It is noted that these diseases are explained by the effect of microbial associations, one of the frequent representatives of which are anaerobic bacteria, which significantly worsen the clinical picture of the disease. All theories of the pathogenesis of jaw osteomyelitis (vascular, allergic and neuro-trophic) are considered. At the same time, it was noted that the vascular, allergic and neuro-reflex components in the emergence and development of osteomyelitis of the jaws are realized against the background of a decrease in the level of general immunological and specific reactivity of the whole organism, as well as the failure of local immunity. Particular importance is attached to disorders of the systems of neuroregulation and microcirculation. It is noted that sensitization and neuroreflex effects on the inflammation focus are factors contributing to the transition of the reversible phase of inflammation (osteitis) to the irreversible one (osteomyelitis), and microcirculation disorders in the inflammation focus are characterized as the main stage in the chain of pathophysiological processes leading to irreversible changes. Attention is drawn to the fact that in recent years, great importance in maintaining homeostasis in acute odontogenic pyoinflammatory diseases has been given to the antioxidant system, which is directly involved in the regulation of the molecular mechanisms of nonspecific resistance of the organism to the damaging action of various pathogenic factors. Findings. The results of the review indicate that knowledge of the peculiarities of the etiology and pathogenesis of acute odontogenic pyoinflammatory diseases is necessary for correct diagnosis, timely and adequate treatment, prognosis and prevention of complications. However, it should be recognized that this problem continues to remain relevant to this day due to the complexity of its study.