MARKERS OF INFLAMMATORY RESPONSE IN PATIENTS WITH DRUG RESISTANCE OF MYCOBACTERIUM TUBERCULOSIS

Objective: to study inflammatory response in patients with drug-resistant Mycobacterium tuberculosis. Materials and methods. 56 patients were examined. The first group consisted of (n=38) patients with extensively drug-resistant pathogen (23 men and 15 women) from 17,0 to 63,0 years old, the second group (n=18) – patients with multi-drug resistant pathogen (12 men and 6 women) from 16,0 to 69,0 years old. Reference group – 30 practically healthy donors. Were examined: level of ceruloplasmin, haptoglobin, α1acid glycoprotein, activity of α1-proteasome inhibitor, α2macroglobulin, activity of adenosine deaminase and elastase. Statistical data processing was performed using Statistica 7.0. Results. In both groups average level of haptoglobin exceeded the upper limit of normal range 2,5 times; grade depended on clinical form of tuberculosis. Level of α1-acid glycoprotein in both groups was increased on average 1,5 times (p<0.01). Low activity of α2-macroglobulin and normal values of α1-proteasome inhibitor were observed in both groups. Activity of elastase in both groups was within the limits of normal ranges. Elevated values of ceruloplasmin were observed in 39% and 50% correspondently in both groups. Level of ceruloplasmin above X+σ was detected more frequently in patients with fibro-cavernous tuberculosis than with infiltrative (76,0% vs. 10.0 percent, p=0,001, respectively), in patients with polycavernosive process compared to patients with presence of single cavities (p=0,003) and with cavities of destruction more than 4,0 cm (100,0%, p=0,0004). Increase of adenosine desaminase was observed only in patients with extensive drug-resistant pathogen (p=0,038). Conclusion. In both groups the most expressed changes were observed in levels of haptoglobin, α1-acid glycoprotein and α2-macroglobulin. Activity of adenosine desaminase may reflect tension of immune response with extensive drug resistance of the pathogen and probably suggests an adequate response of the organism to ongoing chemotherapy in patients with multidrug-resistant mycobacteria.

: lung tuberculosis, drug resistance of agent, inflammatory response

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