The aim of the study was to determine the changes in the qualitative and quantitative composition of the microbiota in the neck part of the teeth in the gingival margin of the oral cavity of rats under experimental opioid exposure, its cancellation and comprehensive drug correction using an antibacterial drug. The use of the antibiotic ceftriaxone under conditions of two- and six-week administration of the opioid analgesic nalbuphine, caused the elimination or reduction of the quantitative composition of opportunistic and pathogenic bacterial species, in contrast to the identified changes in the microbiocenosis in the studied microbiotope. antibiotic therapy in the experiment.

Background. The prevalence of metabolic syndrome (MS), a cluster of risk factors for type 2 diabetes mellitus (DM) and coronary artery disease (CAD), is increasing annually. MS is associated with an almost 2-fold increase in the risk of cardiovascular complications and 1.5-fold increase in all-cause mortality. Systemic inflammation is considered to be one of the pathogenetic links in the development of MS. The study of alpha defensins as inducers of inflammation with antimicrobial properties in patients with MS is increasing. However, changes in the serum level of alpha defensin in MS, with or without type 2 DM and CAD, remain insufficiently studied that determines the feasibility of conducting this study. The objective: to evaluate serum levels of alpha defensin in individuals with metabolic syndrome, type 2 diabetes mellitus and coronary artery disease. Materials and methods. Fifty-four patients (27 women, 27 men) with MS, type 2 DM and CAD were examined. The research was carried out at the Lviv Regional State Clinical Medical and Diagnostic Endocrinology Center and Lviv Territorial Medical Association “Clini­cal Hospital of Planned Treatment, Rehabilitation and Palliative Care”, Lviv City Clinical Hospital 5. Patients with MS were divided into 3 subgroups, depending on the presence of type 2 DM and CAD. The first subgroup included 18 individuals with MS without type 2 DM and CAD, the second — 18 people with MS and type 2 DM, the third — 18 patients with MS, type 2 DM and CAD. The control group consisted of 16 healthy people (8 men, 8 women), the employees of the Lviv Territorial Medical Association “Clinical Hospital of Planned Treatment, Rehabilitation and Palliative Care”, Lviv City Clinical Hospital 5. In patients, the level of alpha defensin was determined, as well as blood lipids (high-density lipoproteins (HDL), very low-density lipoproteins (VLDL)), and the correlations between the above values were investigated. Results. The level of alpha defensin and blood lipids were examined in patients with MS, type 2 DM and CAD. The content of alpha defensin in all participants with MS, both with and without type 2 DM and CAD (18.40 ± 0.89, 24.4 ± 1.2, and 29.1 ± 1.1 ng/ml), was significantly increased and exceeded the control indicators (3.72 ± 0.36 ng/ml) by 4.95, 6.56, 7.82 times (p < 0.05). The highest parameters of alpha defensin were detec­ted in MS combined with type 2 DM and CAD — 29.1 ± 1.1 ng/ml that significantly exceeded the parameters in patients with MS and type 2 DM (24.4 ± 1.2 ng/ml) and group of MS without type 2 DM and CAD (18.40 ± 0.89 ng/ml; p < 0.05). Values of HDL cholesterol in patients with MS (1.12 ± 0.08 ng/ml), MS and type 2 DM (1.01 ± 0.07 ng/ml), MS, type 2 DM and CAD (0.95 ± 0.05 ng/ml) significantly reduced compared to those in the group of healthy individuals (1.40 ± 0.14 ng/ml; р < 0.05), but no significant difference was found between individual subgroups (p > 0.5). The parameters of VLDL cholesterol were hig­hest in patients with combination of MS, type 2 DM and CAD (1.32 ± 0.05 ng/ml), and significantly exceeded those in patients both with MS and type 2 DM (0.87 ± 0.10 ng/ml), and with MS (0.73 ± 0.06 ng/ml; p > 0.05). Comparative analysis was carried out for alpha defensin and blood lipids. A direct strong correlation (r = 0.72; р < 0.5) was found between alpha defensin and VLDL cholesterol in MS patients. In people with MS, type 2 DM and CAD, a direct strong correlation was also found between alpha defensin and VLDL cholesterol (r = 0.65; р < 0.5). In the group of MS and type 2 DM, a weak correlation was revealed (r = 0.1; р < 0.5). Only weak correlations were found between the levels of alpha defensin and HDL cholesterol (r = –0.15, r = –0.11, r = –0.16; р < 0.5). Conclusions. A significant increase in the le­vel of alpha defensin was detected in patients with metabolic syndrome, type 2 diabetes mellitus and coronary artery disease. HDL cholesterol values are significantly reduced in all patients with metabolic syndrome, regardless of the presence or absence of type 2 diabetes mellitus and coronary artery disease. VLDL cholesterol parameters, depending on combined pathology, were highest in patients with metabolic syndrome, type 2 diabetes mellitus, and coronary artery disease, and significantly exceeded the levels of VLDL cholesterol in patients with both MS and type 2 diabetes mellitus, and with metabolic syndrome. Correlations were found between alpha defensin indicators and VLDL cholesterol, they were especially expressed in the presence of coronary artery di­sease and metabolic syndrome.

The aim of the study was to investigate the microbiota in the cervical part of the teeth in the gingival margin of the oral cavity of rats at the end of the second, fourth and sixth weeks of the experimental action of the opioid analgesic nalbuphine. Under the action of opioids for six weeks, changes in the microbiocenosis in the studied subbiotope of the oral cavity of animals were found, which manifested themselves in the early stages by the appearance of gram-negative anaerobes, gradual increase in opportunistic pathogens, formation of dental biofilm experiment.

The aim: To study the relationship between the degree severity of changes in the tunica mucosa of the rats gums and the composition of the microbiota of tooth surface in the gingival margin under the ten-week action of the opioid. Materials and methods: The study was performed on 34 male rats, weighing 160 - 255 g, aged 4.5 - 7 months. Animals were administered nalbuphine for 10 weeks, gradually increasing the dose (0.212 - 0.283 mg/kg). The research of the bacterial from the microbiotope of tooth surface in the gingival margin of rats was performed using statistical analysis of quantitative results. Results: The 4 stages of development of the pathological process and changes in the qualitative and quantitative composition of the microbiocenosis in the gingival margin of the oral mucosa are determined. Depending on the severity of pathological changes in the mucous membrane of the gums of rats under the long-term action of the opioid, a significant increase in the quantitative indicators of bacterial species of pathogenic and opportunistic microbiota at degree IV of the process compared with degree I. The appearance of potential pathogens of purulent-inflammatory processes - Klebsiella and Pseudomonas aeruginosa was noted. Conclusions: The relationship between the quantitative and qualitative characteristics of the microbiocenosis of tooth surface in the gingival margin and the severity of changes in the mucous membrane of the of rats gums under the ten-week action of the opioid was determined, indicating bacterial associations of dental biopellicle as an etiological factor.

The aim is to investigate changes in the microbiota of dental biofilm at the end of the eighth, tenth and twelfth weeks of experimental opioid exposure. Materials and methods: The study was performed on 36 white outbred adult male rats, which were injected with the opioid analgesic nalbuphine in increasing doses (0,212 – 0,3 mg / kg) during 8, 10 and 12 weeks. Qualitative and quantitative composition of microbiota of dental biofilm was studied using statistical analysis. Results: After eight weeks of opioid exposure, changes in microbiocenosis of dental biofilm of rats were caused by a significant increase in saprophytic and opportunistic microbiota and an appearance of pathogenic species of indicator microbiota with potential periodontopathogenic action. At the end of the tenth week, a significant increase in the quantitative indicators of certain species of opportunistic microbiota and increase in the quantitative composition of pathogenic bacteria were determined. After twelve week of opioid exposure, a significant increase in the quantitative indicators of pathogenic microbiota of dental biofilm was detected. Conclusions: Changes in the qualitative and quantitative composition of the microbiocenosis of the dental biofilm at the end of 8, 10 and 12 weeks of opioid exposure were established, they were manifested by a significant increase in the quantitative indicators of certain species of opportunistic microorganisms and a significant increase in pathogenic microbiota in the dynamics, which led to the progression of dysbiotic changes and purulent-inflammatory process in the oral cavity of rats.