hygiene level and composition of oral microbiota in patents with pemphigus vulgaris during the periods of exacerbat ion and remission

Vulgar pemphigus is a rare autoimmune disease characterized by the development of blisters and erosions on visually unchanged skin and mucous membranes due to acantholysis. It is the most common type of pemphigus, accounting for 70% of all pemphigus cases in the world. The main therapeutic goal is to decrease the inflammatory response and production of autoantibodies. No specific treatment for vulgar pemphigus is currently developed, and corticosteroids and immunosuppressants are widely used for the treatment. Long-term intake of corticosteroids leads to the alterations in protein and mineral metabolism which may manifest as the decrease of both systemic and local host response and the progression of dental diseases such as caries, gingivitis, and periodontitis.
Thirty consent patients aged 18-75 years were recruited for the study, 16 females (53 %) and 14 males (47%). The main age was 50±14 years, 49±17 years and 51±9 years for female and male patients, respectively. The diagnosis of pemphigus vulgaris (ICD-10: L.10.0) was confirmed by primary and secondary immunofluorescence. The level of individual oral hygiene (plaque index, PI, Russel A., 1956) and the composition of oral microbiota (real-time PCR ) were compared during the remission and exacerbation phases.
The level of individual oral hygiene was significanly higher in remission (p<0.001, effect size = 0.20). The log bacterial counts of P.intermedia, T.denticola, T.forsythensis, and P.gingivalis determined by PCR were significantly lower during the period of exacerbation compared with the period of remission (p = 0.028, 0,047, 0.026, and 0.022, respectively). In contrast, the log viral counts of Epstein-Bar virus were significantly greater in exacerbation period (p = 0.007)