Ulyanov A. Clinicoimmunological haracteristic and treatment of patients with oral lichen ruber planus

Dissertation is dedicated to the study of clinical pathogenetic specificity of lichen ruber planus in oral mucosa (OM LRP). 125 patients with inflammatory destructive processes in OM were examined and in 42, 4 % cases chronic pathology of non-virus genesis in hepatobiliary system (HBS) was detected. Immunologic disturbances in patients with OM LRP at the stage of exacerbation were characterized by decreasing of indicators of monocyte phagocytic activity, mainly by digestion index, which characterizes the incompletion of digestion processes. Increasing of concentration of circulating immune complexes (CIC) was observed, mainly due to the most toxigenic mid- and fine-molecular fractions. Also it was detected the imbalance in the system of erferonogenesis, such as considerable increase of serum interferon (SIF) level against the background of ?- and ?-interferon decrease, especially in patients with severe inflammatory destructive processes in OM. In examined patients it was observed the increase of leukocyte number, the decrease of number of cells with signs of keratinization, which reflects the insufficiency of epithelium defense reaction, and also the growth of phagocyte number in mucosal imprints. During LRP exacerbation period the decrease of ?- and ?-interferon and lysozyme concentration and also derangements of microhemodynamics (CIgeneral >10) occurred. By the time regular incident of inflammatory destructive process has finished in patient's OM, particularly the one with chronic pathology of HBS, there still are clinical biochemical signs of exacerbation of chronic pathologic process in liver and gallbladder (GB). In this group of patients heightened level of "middle molecules" in blood lasts for a long time, and in clinical aspect an evident asthenoneurotic syndrome is noticed. In treatment of inflammatory destructive process in OM it was developed еру rational approach with use of immunoactive agent lavomax combined with modern enterosorbent white charcoal (silicone dioxide). MO LRP patients with chronic pathology of HBS are recommended to undergo the combined therapy providing strong clinical remission in disease of liver and bile passages with use of antral hepatoprotector, which favors the restoration of immune and metabolic homeostasis. Examination of in-patients with LRP treated as usual afflicted persons allows to detect the tendency of formation of severe inflammatory destructive processes in MO among part of the patients. Inclusion of alfagin, which has vegetable origin and immunocorrection ability, into immunorehabilitation drug complex, favors the restoration of immune indicators and in clinical aspect it stimulates the achievement of strong remission of the disease.