Role of pathogenic and mentally pathogenic microflora, which are localized in the orotopharynx in the ethiopathogenesis of secondary osteoarthrosis

ABSTRACT. Much attention is paid to the problem of secondary osteoarthritis caused by various microorganisms and fungi of the genus S. albicans, associated with their significant growth and prevalence throughout the world among the population of various age groups, high temporary and permanent disability. At the same time, the problem of immunopathology in the pathogenesis of secondary osteoarthritis is being actively studied. The developed immunopathological process induced by pathogenic and opportunistic microflora in articular cartilage and synovial membrane is the main factor in the degenerative destruction of articular cartilage. Goal. to determine the role of pathogenic and opportunistic microflora localized in the oropharynx in the etiopathogenesis of secondary osteoarthritis. Research materials and methods. 65 patients aged from 19 to 45 years, who were undergoing inpatient treatment at Artz Klinic, Kharkiv, were examined for secondary osteoarthritis of the knee joint. The diagnosis was established according to the International Classification of Diseases of the 10th revision (ICD-10) - M18.1. Patients with a history of a high frequency of accompanying pathologies of the oropharynx were selected for the study: chronic tonsillitis - 48 (73.8%), tonsillitis - 32 (49.2%), pharyngitis - 34 (52.3%), sinusitis - 13 (20) %), otitis – 9 (13.8%) the etiology of which is determined by gram-positive and gram-negative microorganisms. All patients underwent microbiological examination of throat swabs, and 24 patients underwent microbiological examination of synovial fluid, which was taken for examination before intra-articular therapy. The obtained data were statistically processed by calculating the arithmetic mean and its error. The results. Presented modern ideas about secondary osteoarthritis caused by etiologically significant macroflora persisting in the oropharynx and as a result of organotropy due to the inclusion in its structure of mimicking antigens of articular cartilage play a leading role in the degradation of articular cartilage and articular bag, transferring the pathological process to an autoimmune basis. This approach makes it possible to develop early immunodiagnostics, prognosis of the disease, and immunocorrective therapy. Conclusions. Pathogenic and conditionally pathogenic microflora persisting in the oropharynx is characterized by organotropy (community of lipopolysaccharides and glycoproids), is identical to the cell-tissue structures of articular cartilage and synovial membrane in the causative agent and modulates the immune response through mimicking antigens.