ASSESSMENT OF LEUKOCYTES FUNCTION IN PERIPHERAL BLOOD IN PATIENTS WITH MEDICINAL JAWS OSTEONEKROSIS

The aim of the study was to assess the functional activity of peripheral blood phagocytes in patients with drug-induced osteonecrosis of the jaws to develop a new approach to treatment. A total of 35 people were examined, including: 10 healthy individuals, 8 with purulent-inflammatory diseases of the maxillofacial region (GVZ ChLO), 17 patients with medical osteonecrosis of the jaws (MRONJ). Among patients with MRONJ, there were 10 men and 7 women, aged from 54 to 73 years, with a mean age of 62 years. She had a history of cancer (prostate cancer, breast cancer). In connection with the presence of metastases, the patients took bisphosphonates - the drug Zometa (zoledronic acid) in injections of 4 mg intravenously 1 time per month. Phagocytic activity of peripheral blood leukocytes was determined by flow cytometry. The examination of the patients was carried out before and on the 14th day after the surgical treatment, osteonecrectomy. In patients with MRONJ and HVD, the phagocytic activity of leukocytes was reduced by 30-40% compared with healthy individuals (p<0.05). Low phagocytic activity was confirmed by the indicators of stimulation of E. coli leukocytes and the stimulation index (oxidative burst). On the 14th day after surgical treatment in patients with BRONJ, the leukocyte phagocytosis indices did not normalize. The dysfunction of macrophage cells is more pronounced in cancer patients treated with bisphosphonates than in patients with HVD ChLH. A low level of indices of innate immunity factors contributes to the recurrence of osteonecrosis.