Beriashvili Sesili Davidovna
 Postdoc; Georgian David the Builder University    
Mantskava Maia Mikhailovna
Associate Prof.; Beritashvili Biomedical Experimental Center, Tbilisi
Momtselidze Nana Gogievna
 Associate Prof.; Beritashvili Biomedical Experimental Center, Tbilisi
Nikolaishvuli Marina
 Associate Prof.; Beritashvili Biomedical Experimental Center, Tbilisi
Tupinashvili Tamar Nodarovna
 Postdoc; Georgian David the Builder University, Tbilisi
Tamasidze Nino Archilovna
Postdoc; Georgian David the Builder University, Tbilisi

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Blood is not a homogeneous (Newtonian) liquid and it is a suspension having suspended particles, it has exceptional features and it is studied by hemorheology. Blood hemorheology plays a significant role in blood circulation and ensuring its trophic function. Changes in rheological properties of blood may cause a slowdown in the flow, establishment of stasis, therefore tissue hypoxia, which is accompanied by a multi-disease and vice versa, the particular structure of blood depends on a local hematocrit, axial flow of erythrocytes and the existence of plasma layer, blood flow structure changes leads to a disorders of its rheological properties.[/su_animate]

The rheological features of blood are mainly determined by the erythrocytes, as the volume of leukocytes is much smaller (800 times), than the number of erythrocytes and platelet (however they are numerous than erythrocytes, they are of a significantly small size). The volume of the platelet composes only 1/10 of the volume of erythrocytes. Therefore, the rheological properties of blood is determined by erythrocytes and the features of its actions (resilience, agglutination, movement, etc.) [9].

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According to the concept of our research group, erythrocytes value the microcirculation and homorheologic condition, so called homorhelogical status.

We were interested in how the hemorheological status has been changing in adults during the dysfunction of thyroid, the second stage of periodontitis and the parallel development of the thyroid gland and periodontitis. If we take into consideration that according to the epidemiplogical data in children and adults throughout the world the thyroid disease is spreading and increasing from 10 to 15 years of age, the changes in characteristic of periodontitis is far more common in children [15,16].

Our research is very important for fundamental research as well as for practical biomedicine. This approach is gaining more relevance in research, as it is for the first time that we are connecting these two pathologies and estimate rheological status.

Materials and Methods. We investigated 75 patients (30 boys and 45 girls) 11 – 15 years old. Group I – patients with thyroid dysfunction, n=25,  maen age =11,9±2,0   without treatment; group II – patients with II stage periodontitis, n=25, mean age = 12,5±1,6 with out treatment; group III – patients with nozological, wheare parallel development of hyroid dysfunction and periodontitis n=25, mean age = 12,8±1,3 with out treatment; group IV – control subjects group, n=10, mean age = 12,4±2,0.

The following rheological status were examined erythrocytes aggregability, which represents aggregated erythrocytes area ratio against whole area of the erythrocytes [7]. Erythrocyte aggregation was evaluated with the recently developed “Georgian technique” [8,10] providing us with direct and quantitative data. Blood samples (4ml) from the cubital veins were centrifuged and about 0.1 ml blood was diluted 1:200 in own plasma in the Thoma pipettes preliminary rinsed with 5% sodium citrate solution without addition of any other anticoagulants to the blood under study. Following standard mixing the diluted blood was placed into a glass chamber 0.1 mm high. The quantitative index of erythrocyte aggregation, which was assessed with a special program at the Texture Analysis System (TAS-plus, “Leitz, Germany), represented itself the relationship of the aggregated and unaggregated red cells.

Data are presented as mean ±SD. Comparison of data were evaluated by Student’s paired t-test, while data from the patients’ study were evaluated by Student’s unpaired t-test. Differences between groups were considered statistically if P<0.001.

Studies conducted charges according the Declaration of Helsinki [14].

Results. Rheologiocal status in Group I 30,0±2,5. Rheological status in Group II 25,8±2,6. Rheologiocal status in Group III 32,2±2,0. Rheologiocal status in control  – 22,4±2,0.

Discussion. According to the obtained results it turned out that during periodontitis the rheological features are disordered compared to the control (status deteriorated by 15%). The rheological features are far more disordered during dysfunction of thyroid (status deteriorated by 30%). The children who had periodontitis and the dysfunction of thyroid at the same time have been examined. In the given case the rheological status was far from the normal rheological situation for 40% (the targets of our research were the primary patients who weren’t provided with hormonal treatment).

From our point of view periodontitis and the dysfunction of the thyroid developed in parallel. It is known that without an adequate blood supply the normal functioning of the tissue and organ is impossible. The provision of the abovementioned is made by the normal flow of micro circular network, which itself depends on the rheological features of the blood. Micro circulation is important during each physiological process and far more important during the development of pathological processes. Pathology causes the disorder of micro circulation, hemorhelogical changes and the latter strengthens the pathological processes [8,9].

Thus we can conclude that thyroid disorders are contributing factors to the development of periodontitis. Despite the lack of works [1,4,5], where hemorhelogical, the dysfunction unity of calcium and phosphorus homeostasis gland, are discussed, our data also confirms the truth of this statement. We believe that the microcirculation disorder is caused by the mineralization imbalance as a result of parathormonis not only locally, but also in every organ and tissue. The development of periodontitis, cardiovascular problems and risks, as well as memory and other neuro- and neurogenic risk factors are derived from the above mentioned [1,2,3].

Local trans capillary metabolism cause hemorhelogical changes. On one hand hemorhelogical disorders cause illness and on the other hand microcirculation disorder develops pathologies. The more microcirculation is damaged the more actively the rheological status is changed and the more heavily organs and tissues are damaged, which in turn do not function normally and even more damage the microcirculation network by excess or small amounts of a hormone excretion or exudation of other substances [6].

The issue is very relevant, having a practical applied side. It was concluded that one of the reasons of the development of periodontitis in the adults is the changes in the functional state of the thyroid.[/su_spoiler]

The enlargement of the thyroid gland is promoted by some harmful social and cultural habits, poor living conditions, lack of micronutrients in food, but the main role is implemented by the iodine deficiency. Compensatory response to exogenous lack of iodine in the thyroid gland is that: hyperplasia provides the secretion of the required amount of the thyroid hormone. It is also noteworthy that during the 1st and 2nd degrees of periodontitis more often hygiene, viral effects, mineral misbalance of the tooth paste and etc. are named as a main causing factors [11,12,13]. Only in the long term or in rare cases, children are prescribed thyroid test. Based on this work the adults are recommended to be provided with the thyroid examination and/or examination of rheological status, which indicates clinicians on a treatment and choosing the tactics for management. Our data will assist in the correct classification of the 1st and 2nd degrees of periodontitis, which has a fundamental significance for physiology and pathophysiology apart from the practical meaning.

All the planning and performance of the research, which will promote the reduction of the ratio of periodontitis and the monitoring of thyroid function is very important. All the above mentioned allow us to broaden our research.
 

Reference

1.    Carallo C., Franceschi M., Tripolino C. et al. Common carotid and bronhial artery hemodinamic alterations in periodontal disease. J. Clin. Periodontal. 2013. 40 (5), p. 431-436.[su_spoiler title=”Develop”]

2.    Chekmareva S.E. Prognostic an assessment of a functional condition of the blood circulatory system at diseases of a thyroid gland. Avtoreferat.  Krasnodar, 2003. – 48 p.

3.    Jaftha A., Holmes H. Periodontitis and cardiovascular  disease. SADJ 2013, 68(2), p.62-63.

4.    Konoplia  E.E., Danilova L.I., Kremko L.M. Stomatologic status in exchanges tireoidny and calcium at the people with an autoimmune thyreoidit living on it is radioactive the polluted territories. J. Stomat. 2000. 1, p.35-8.

5.     Latypova V. N. A state of health of children and teenagers with thyreopatya. Children's health care of Russia: development strategy: materials IX of congress of pediatricians of Russia. 2000. p.342-343.

6.    Machill K., Scholz G. Dependence of hemodynamic changes in hypothyroidism on age of patients and etiology of hyperthyroidism. Book: Heart and thyroid.  Ed L.E. Braverman. O. Eber, W. Langsteger.-Wien. 1994. p.203-211.

7.    Mantskava M.M., Momtselidze N.G., Davlianidze L.Sh. DOI:https://dx.doi.org/10.15360/1813-9779-2014-5-27-32.

8.    Mchedlishvili G. Basic factors determining the hemorheological disorders in the microcirculation. Clin. Hemorheol. Microcirc. 2004. 30, p.179-80.

9.    Mchedlishvili G. Local RBC aggregation disturbing blood fluidity and causing stasis in microvessels.     Clin. Hemorheol. Microcirc. 2002. 26, p.99-106.

10.    Mchedlishvili, G., Beritashvili N., Lominadze D., and Tsinamdzvrishvili B.  Technique for Direct and Quantitative-Evaluation of Erythrocyte Aggregability. J. Biorheology. 1993. 30, p.153–161.

11.    Nikolaishvili M., Beriashvili S., Franchuk K., Tupinashvili T., Vashakidze I., Zenaishvili S. Crystallization of a saliva at teenagers at dysfunction of a thyroid gland. J. Experimental and clinical Medicine. 2014. 4, p.29-33.

12.    Pestov A. Regularities of relationship of a biocenosis and physical and chemical properties of oral liquid at caries. Avtoreferat.  Volgograd: 2012. p.29.

13.    Sovtsova K.E. Clinic-biochemistry researches of oral liquid at patients with a periodontal disease, Congress of health and education in the XXI century. Moscow: 2008. 460-461.

14.    https://www.ub.edu/recerca/Bioetica/doc/Declaracio_Helsinki_2013.pdf.

15.     https://www.who.int/entity/bulletin/volumes/90/8/12-040812.[/su_spoiler]

16.    https://www.who.int/mediacentre/factsheets/fs318.