Development and application of a multicomponent film biocoating based on sodium carboxymethylcellulose to study the antibacterial activity of microflora in the oral fluid of patients with pemphigus vulgaris in vitro

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Abstract
BACKGROUND: A special place among dermatological diseases is occupied by dermatoses affecting the oral mucosa, in particular pemphigus vulgaris. Constant damage to the mucous membrane, combined with the presence of abundant microflora in the oral cavity, leads to rapid variability in the primary or pathognomonic manifestations of specific diseases, making them look similar. Erosion and ulcers in the oral cavity are very difficult to treat and are accompanied by severe pain. The role of the oral microflora in the development and progression of pemphigus vulgaris has not been fully studied, however, it is known that the microflora of patients differs significantly from that of healthy individuals. Today, much attention is paid to studying the composition, properties and role of the microflora of the oral mucosa in the manifestation and course of pemphigus vulgaris. AIM: determination of the most effective combination of a three-component film biocoating based on sodium carboxymethylcellulose for patients with pemphigus vulgaris, by assessing and comparatively in vitro comparison of quantitative and qualitative characteristics of the oral microflora, as well as local oral protective factors (lysozyme titer, phagocytosis index neutrophils and the level of the secretory fraction of immunoglobulin class A) MATERIALS AND METHODS: A cross-sectional single-center study was performed among patients with pemphigus vulgaris (n=12). Oral fluid was collected by washing (rinsing) 4.5 ml of physiological solution from the oral mucosa. Subsequently, in the laboratory, a series of serial dilutions were prepared, some of which were inoculated by quantitative sectoral sowing on media intended for the cultivation of aerobic and anaerobic microbes. Microbiological and immunological sensitivity to films with different concentrations of mometasone furoate (20–40–80 mg) and propolis (2.5–5–7.5–10%) was determined. RESULTS: The most pronounced antibacterial activity was observed in the following 2-component forms (gel film and propolis at a concentration of 7.5%; gel film and mometasone furoate in an amount of 20 mg) and in 3-component gel films (gel film, propolis at a concentration of 5% and mometasone furoate 20 mg). According to the results of a comparative quantitative assessment of local factors protecting the oral cavity in patients with pemphigus vulgaris, their positive dynamics, characterized by the restoration of immunodeficiency, were most influenced by the three-component composition, including a gel film, propolis 5% and mometasone furoate 80 mg. CONCLUSION: The three-component composition of the film biocoating based on carboxymethylcellulose significantly reduces the quantitative and improves the qualitative indicators of microorganisms in the oral cavity, thereby having a positive effect on the treatment process for patients with pemphigus vulgaris.

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