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The presented article is devoted to the problem of the relationship between the microflora of the oral cavity and oral mucositis (OM) induced by systemic antitumor therapy in patients with malignant neoplasms (ZNO). The article highlights modern ideas about the composition of the normal microbiota of the oral cavity, its changes during chemotherapeutic treatment. It has been shown that the normal oral microbiota includes representatives of such genera as Actinomyces, Corynebacterium, Fusobacterium, Leptotrichia, Neisseria, Prevotella, Streptococcus, Veillonella, etc. At the same time, it is emphasized that, even despite the existence of modern molecular genetic techniques and the formation of a database of oral microbiota, it is still difficult to determine the role of individual taxonomic units in oral homeostasis. Existing studies of changes in the qualitative and quantitative composition of oral microflora against the background of drug antitumor therapy have demonstrated that treatment is associated with significant changes in the microbiological landscape of the oral cavity. There is an increase in the number of Gram-negative anaerobic opportunistic flora and a decrease in the representation of protective commensal flora. It has been demonstrated that the components of a bacterial cell can modulate local reactions of a macroorganism through a system of Toll-like receptors, while acting in different directions. A number of unresolved fundamental issues related to the place of oral microbiota in the pathogenesis of OM are also highlighted.
The presented article is devoted to the problem of the relationship between the microflora of the oral cavity and oral mucositis (OM) induced by systemic antitumor therapy in patients with malignant neoplasms (ZNO). The article highlights modern ideas about the composition of the normal microbiota of the oral cavity, its changes during chemotherapeutic treatment. It has been shown that the normal oral microbiota includes representatives of such genera as Actinomyces, Corynebacterium, Fusobacterium, Leptotrichia, Neisseria, Prevotella, Streptococcus, Veillonella, etc. At the same time, it is emphasized that, even despite the existence of modern molecular genetic techniques and the formation of a database of oral microbiota, it is still difficult to determine the role of individual taxonomic units in oral homeostasis. Existing studies of changes in the qualitative and quantitative composition of oral microflora against the background of drug antitumor therapy have demonstrated that treatment is associated with significant changes in the microbiological landscape of the oral cavity. There is an increase in the number of Gram-negative anaerobic opportunistic flora and a decrease in the representation of protective commensal flora. It has been demonstrated that the components of a bacterial cell can modulate local reactions of a macroorganism through a system of Toll-like receptors, while acting in different directions. A number of unresolved fundamental issues related to the place of oral microbiota in the pathogenesis of OM are also highlighted.
Cancer therapy is accompanied by a wide range of systemic manifestations, including dental ones, including xerostomia, mucositis, muscle trism, osteoradionecrosis, caries, opportunistic infections, dysphagia, hypogeusia, dysgeusia and hyposalivation. The dentist is the most qualified specialist in the field of diagnosis and treatment of diseases of the oral cavity, as well as preventive measures to monitor its condition in cancer patients undergoing radiation or chemotherapy. The purpose of the review is to analyze the domestic and foreign literature on the main dental consequences that may arise as a result of cancer therapy, emphasizing the importance of dental care to improve the quality of life of such patients, as well as to provide practical recommendations for eliminating these consequences. The primary sources were searched in the electronic databases PubMed, eLibrary and Google Scholar. In the end, 55 primary sources were included in this review. Damage to the oral cavity during antitumor therapy, which includes conditions such as mucositis, infections, hyposalivation, taste changes and pain, can be significant. These manifestations are potentially capable of disrupting many aspects of the functioning of the oral cavity and oropharynx, affecting taste sensations, causing dry mouth, difficulty chewing and swallowing and, as a result, affecting nutrition. Moreover, they can negatively affect speech function, the ability to maintain oral hygiene, dental prosthetics and a person's appearance, which can affect oral health, social and emotional well-being. These side effects can also affect adherence to planned anticancer therapy, potentially affecting the outcome of treatment, overall health, and cost of treatment. When examining cancer patients, the dentist should take into account the therapy received by the patient, it is also important to pay attention to possible long-term effects similar to those that may occur in patients receiving bisphosphonates. Thus, the cancer patient will not stop receiving proper medical care, and any new problem will be diagnosed at an early stage.
Background. The oropharyngeal microbiota is involved in the development of colonization resistance, affecting viral adhesion and metabolism. Any deviations in the stability of the environmental microbial niches of the oropharynx alter the local immune response and can trigger severe chronic somatic disorders. Aim. To compare the composition of the microbiota of children during an episode of respiratory infection and healthy volunteers examined in different periods of convalescence. The obtained data can be used to predict the course of the disease, analyze the risk of complications, and assess the frequency of the diseases in the future. Materials and methods. From 20.01.2022 to 23.12.2022, an open-label prospective single-center randomized comparative study was conducted, which included 120 children aged 5-10 who presented with symptoms of acute respiratory infection. The control group consisted of 15 asymptomatic children examined at different periods of convalescence. The study compared changes in the oral microbiota composition of patients and healthy children. The evaluation was performed using complete 16S rRNA gene sequencing on the Oxford Nanopore platform. Taxonometric analysis at the species and genera level was performed using the Knomics-Biota platform. The R programming language was used for statistical processing. In addition, the parameters of α- and β-diversity of the microbiota were assessed. The Chao1 and Shannon indices were calculated to assess α-diversity (diversity within one community). The Chao1 index is based on the number of species found in the sample and also rare species that are found only 1 or 2 times, thus preventing underestimation of diversity. The Shannon index includes both the number of species and their uniformity in the community. A change in the index indicates the dominance of one or more species. The following indicators were used to assess the β-diversity describing the differences between two microbiota samples at the species and genera level: Bray–Curtis dissimilarity (characterizing the ratios of common and different microorganisms between the samples) and the Aitchison distance (reflecting the differences in the proportions of microorganisms). In addition, the balance between the two groups of microorganisms was evaluated using the NearesBalance method, which characterizes the differences between the microbiota of the main and control groups. Results. The results of our study show that during respiratory infection, the state of the oropharyngeal microbiota is characterized by an increase in α-diversity, which is associated with an increase in the proportion of species of Streptococcus salivarius, Streptococcus pneumoniae, Streptococcus pseudopneumoniae, Streptococcus pyogenes, Streptococcus thermophilus and A12 versus the proportion of Streptococcus mitis, Streptococcus oralis, Streptococcus gwangjuense, Streptococcus sanguinis, Streptococcus gordonii and FDAARGOS_192. In the control group, the oropharyngeal microbiota was divided into two clusters. The dominance of streptococci was observed in the first group (control), while the second group had a more uniform representation. Analysis of the changes in microbial communities in the main and control groups can show the stages of oral microbiota recovery after an acute respiratory infection episode. Conclusion. More research is needed in the field of the oropharyngeal microbiome on a larger sample of healthy children, to standardize the communities of the oropharyngeal microbiota, to study the interaction within communities and with the body as a whole. Analysis of the impact of the microbiota on the frequency and course of respiratory infections and the rate of complications opens up new prospects in treating, rehabilitating, and preventing diseases. These research areas can contribute to improving children's health and quality of life and introducing new approaches into clinical practice.
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