**3.2 Features of peripheral blood response in slow consolidation of the mandible**

In this group of patients, before surgery, differences in immunological parameters from data obtained on the bone consolidation without complicating osteomyelitis were revealed. The number of monocytes (**Table 2**) was lower, than in the group with the slow regeneration of bone tissue by 59.3% (p < 0.05). There was a significant attenuation of the bactericidal activity of mechanisms: the level of lactoferrin was reduced 3.5 times (p < 0.05) was only 33.6% compared with the normal values. The same can be mentioned for complement activity-30.2% of the lower limit of normal and below 4.2 times (p < 0.05) than in the group with normal bone regeneration. Increased concentration of 37.4% IgM (p < 0.05) in peripheral blood also exceeded 49.0% and the normal values (**Table 2**). There was increased functional activity of CD45<sup>+</sup> CD3<sup>+</sup> -cells and it was more than 3.5 times (p < 0.05) differences in the recorded response of leukocyte migration inhibition (**Table 2**). Serum lysozyme was reduced by 5.8 times. Interestingly, the concentration of the receptor antagonist of IL-1ra concentration was lower for IL-1α (**Table 2**) that was not observed in patients with normal bone consolidation. IL-8 levels were reduced by 1.8-fold (p < 0.05) (**Table 2**) in comparison with patients with the other group.

The postoperative period was characterized by leukocytogenesis activation: leukocytosis was marked with the change in the ratio of group cells to the segmented cells. On day 3, a reduction in the number of T cells was shown (according to the dynamics of CD45<sup>+</sup> CD3<sup>+</sup> -cells) 40.8% (p < 0.05), confirming previously published data [60]. Recovery of these cell populations occurred in 10 days (**Table 2**). Perhaps this change in the amount of T cells in the early postoperative period resulting, ultimately, in disruption of bone regeneration, because it is known that both by generating INF-γ, and through prostaglandin mechanism of these cells involved in suppressing bone destruction and the formation of osteoclasts. Decrease in the relative number of B cells (based on dynamics of CD45<sup>+</sup> CD19<sup>+</sup> -cells) by 55.6% (p < 0.05) was observed later, on day 10 (**Table 2**).

Important changes were noted by the indicators characterizing the phagocytic activity of neutrophils. Amplification reactions were detected at 3 days after surgery when the spontaneous and stimulated superoxide radical production by neutrophils'superior control values was in the subgroup of 1.6- to 1.7-fold (p < 0.05). It can be assumed that the changes in neutrophil phagocyte system in the blood reflect the processes occurring in bone tissue. Of interest for the study was the dynamics of the content of lactoferrin at the stages of bone tissue consolidation (**Table 2**). As noted earlier, prior to the operation, its level was significantly reduced. Due to the fact that lactoferrin causes proliferation of osteoblasts and bone growth, it is not excluded that lowering the level of lactoferrin in the blood is also one of the reasons for slow regeneration of bone tissue. Later, after the operation, the lactoferrin content was always significantly lower in patients with delayed bone formation compared with patients who have bone fusion that took place at the usual time.

Slow bone formation was accompanied by significant increase (72.0%) in IgM levels (**Table 2**). The revealed changes were statistically significant differences between these patients with normal bone tissue regeneration. Inflammatory response was characterized by pronounced dynamics of slow-reacting acute-phase proteins. Specifically, on day 3, after surgery, ceruloplasmin concentration was higher by 1.9-fold (p < 0.05) than in patients with normal bone regeneration. The functional activity of T cells throughout the observation period was 2.0- to 3.3-fold higher (p < 0.05) than in patients with normal consolidation, while it exceeds the normal value of 1.5 times (**Table 1**). Active cationic proteins and myeloperoxidase neutrophilic granulocytes were higher than in patients with complication of osteogenesis, respectively, by 33.6% (p < 0.05) and 3.1-fold (p < 0.05).


**Laboratory**

**167**

TNF-α, pg/ml

IL-8, pg/ml

IL-10, pg/ml Ceruloplasmin,

C-reactive protein, mg/l

*\**

*p < 0.05 compared with preoperative*

*#*

*р < 0.05 compared with* 

**Table 2.**

*Immunological*

 *parameters*

 *of peripheral*

 *blood at slowing bone formation.*

 *levels.*

*uncomplicated*

 *osteogenesis.*

 g/l

 **parameters**

**Normal**

**Before**

**3 days**

 **10 days**

 **1 month**

 **3 months**

**surgery**

**values**

0–50

0–50

<1.0

0.24–0.42

0–8

 9.09

0.22

 6.01

1.12\*

0.14

0.03\*,#

0.12

0.03\*,#

0.14

0.04\*,#

*Immunological Monitoring of Osteogenesis Disorder DOI: http://dx.doi.org/10.5772/intechopen.92099*

> 0.50

0.02

 0.75

0.16#

0.66

0.08

 0.51

0.12

 0.99

0.09\*,#

 2.19

0.07

 0.08

0.02\*

0.04

0.01\*

0.04

0.01\*

0.85

0.06\*

 24.15

4.78#

90.32

3.66\*,#

180.74

14.85\*,#

55.41

6.74\*,#

41.65

8.97\*

 22.65

6.58

 62.50

11.54\*,#

75.12

9.67\*,#

100.33

9.89\*,#

102.61

10.24\*,#


**Table 2.**

*Immunological parameters of peripheral blood at slowing bone formation.*
