MANIFESTATION OF BURNING MOUTH SYNDROME AGAINST THE BACKGROUND OF THE USE OF INHALED HORMONAL SUBSTANCES IN PATIENTS WITH BRONCHIAL ASTHMA

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Relevance. Over the past years, the number of patients suffering from bronchial asthma has increased significantly, to which doctors from all over the world pay great attention to this disease. Its prevalence, which ranges from 4 to 10%, is constantly growing under the influence of a number of factors: not following a healthy lifestyle, the type and quality of food, as well as the abuse of harmful substances, as well as drugs, among other things, change the body's response. The relevance lies in the fact that the main substances for the treatment of bronchial asthma, many authors consider inhaled hormonal agents, which are taken by patients on an ongoing basis for a long time. However, there are side effects that cause a number of different complications in the oral cavity.
Target. To study the consequences of the use of inhaled hormonal drugs on the part of the oral cavity, as well as to determine their relationship associated with impaired perception of the oral mucosa (OM).
Materials and methods. For the study, a group of people (20-70 years old) with bronchial asthma at different levels of severity was taken and three subgroups were made, each of which differed in the period of use of hormonal inhalation drugs.
The 1st subgroup was 1-3 years (15 patients 21.42%), the 2nd subgroup included from 3 to 5 years (25 patients 35.72%), and the 3rd subgroup was more than 5 years (30 patients 42, 85%). Each patient was examined according to a single plan, in addition to the main methods of examination, various indices were used (KPU, Green-Vermilion, Mulemman and TEP tests), and an examination was also carried out from the side of metabolic activity to determine the state of saliva pH. ORM scrapings were directly taken and microscopically examined to determine the sign of the presence of the Candida fungus in each patient who used ICS, and as a result, round-shaped cells of the yeast nature of this fungus were identified. One of the most important values ​​in the study in recent years is the immune status, as it shows the state of the immune system of the human body during the examination period. During the study period, the activity of lysozyme was detected in saliva, as well as the concentration of interleukins.

Research results. The most common complaints in patients treated with inhaled corticosteroids are dry mouth, paresthesia (in almost all subjects), as well as changes in taste sensations (in more than half of the subjects). Most patients complained of pain in the mouth during the study period, regardless of the state of mobility of the oral region.
One of the important indicators in describing his condition in the oral cavity, the patient indicated a burning sensation not only in the tongue, but also in other parts of the oral region, such as the larynx, pharynx.
When considering the pH of saliva in different study groups, no significant differences were found.
The results of the 1st subgroup of patients revealed the presence of mycelial filaments and active growth of the fungus of the genus Candida, which is characteristic of candidiasis.
The results of the 2nd group of patients also showed the presence of the above fungi. In 100% of the subgroup, the sowing of a diploid fungus was observed, the development of which leads to oral candidiasis. Also, in most cases, there is a white coating with a characteristic manifestation on the root of the tongue. Patients complained of dry mouth, less often pain and burning.
Considering the last subgroup, 90% of patients were diagnosed with oral candidiasis, with the most pronounced signs of the disease, which is the main complication.
In the examined patients, a decrease in the indicator of lysozyme activity was observed, the last subgroup, where the duration of ICS use was 5 years, was especially low in activity.
When studying saliva in patients for the level of cytokine-1, various indicators were identified depending on the duration of taking ICS. The most elevated level was observed in the last subgroup of subjects, where the indicator exceeded the result of the control group by more than 5 times. If we talk about the 1st and 2nd subgroups, then the indicators were increased by almost 3 times.
Discussion. Patients with bronchial asthma who use hormonal inhalation drugs for a long period of time have a reduced level of lysozyme, which is an antibacterial enzyme. Therefore, by the level of lysozyme activity, it is possible to identify patients who use ICS for a long period of time. Summarizing, we obtain a direct dependence of the period of taking these drugs with the frequency of detection of oral candidasis in patients with BA.
Conclusion. The considered clinical signs and symptoms of paresthesia of the oral mucosa reflect the underlying disease - bronchial asthma. The effect of inhaled hormonal drugs on paresthesia of the oral cavity directly depends on the duration of their use. Patients are recommended to undergo a comprehensive examination, including a consultation with a dentist and a pulmonologist, in order to draw up a competent pathogenetic, etiotropic and systematic treatment.

About the authors

Kristina Konstantinovna Bogacheva

Military Medical Academy. S. M. Kirova

Author for correspondence.
Email: k.bogacheva29@gmail.com
ORCID iD: 0000-0002-2754-8186

Student

Russian Federation, 194044, Russia, St. Petersburg, st. Academician Lebedeva, 6Zh

Anzhelika Sergeevna Zhukova

Military Medical Academy. S. M. Kirova

Email: lika.zhukova.1999@bk.ru
ORCID iD: 0000-0001-5607-308X

Student

Russian Federation, 194044, Russia, St. Petersburg, st. Academician Lebedeva, 6Zh

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