Phthisiology

doi: 10.25005/2074-0581-2019-21-1-110-115
DYNAMICS OF THE INDICATORS OF LUNG DESTRUCTION AND HORMONAL BACKGROUND AS A PREDICTIVE MARKER OF THE EFFECTIVENESS OF MULTIDRUG RESISTANT TUBERCULOSIS TREATMENT

O.S. Shevchenko, I.A. Ovcharenko, O.N. Shvets

Department of Phthisiology and Pulmonology, Kharkiv National Medical University, Kharkiv, Ukraine

Objective: Study of the dynamics of indicators of pulmonary tissue destruction and hormonal background, as a marker for predicting the effectiveness of treatment of multidrug resistant tuberculosis (MDR TB).

Methods: The study involved 84 patients with new cases of MDR TB, which were divided into groups with effective (group I) and ineffective (group II) treatment of tuberculosis. The criteria for the effectiveness of treatment of tuberculosis were the cessation of bacterial excretion and the closed cavity destruction.

Results: It was found that in patients from group I, the levels of free hydroxyproline were lower than in group II during the first two months of treatment: at the beginning of treatment by 60%, after 2 months of treatment – by 29.4%. In both groups, there was an increase in this indicator during the first 2 months of treatment. The level of protein-bound hydroxyproline was higher in group I by 21.7%. The level of aldosterone in the groups at the beginning of treatment was almost the same. After 2 months of treatment, its level decreased in both groups. However, after 2 months of treatment in group I, its content was lower than in group II by 12.7%. In the course of treatment, the insulin resistance index in patients of both groups decreased to the norm, however, it remained higher in patients of group II (2.4±1.1 vs. 1.6±0.8). At the same time the level of insulin secretion in patients with a favorable course of the disease has decreased almost three times in compared with the baseline data (7.4 vs. 20.1 μU/ml), while in the group of patients with an unfavorable course it decreased only in 2 times (10.3 vs. 22.9 μU/ml).

Conclusions: The obtained data allow recommending the study of indicators of carbohydrate metabolism, the reorganization of connective tissue and aldosterone in dynamics as an early marker of effective treatment of MDR TB.

Keywords: Multidrug resistant tuberculosis , oral glucose tolerance test, insulin, protein bound hydroxyproline , free hydroxyproline.

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References
  1. Feshchenko YuI, Melnyk VM, Turchenko LV. Pohlyad na problemu borot’by z tuberkulyozom v Ukraini [A fight with tuberculosis in Ukraine: view on a problem] Ukr. pulmonol. zhurn. 2016;3:5-10.
  2. Melnyk VM, Novozhylova IA, Matusevich VH, Lynnyk MI. Analitichnyy pohlyad na problemu khimiorezystentnogo tuberkulyozu: nynishniy stan, dosiahnennia ta deiaki nevyrisheni pytannia [Аnalytical view on a problem of drug-resistant tuberculosis: current status, achievements and unsolved issues]. Ukr. pulmonol. zhurn. 2012;1:5-7.
  3. Feshchenko YuI, Humeniuk MI, Denysov OS. Antybiotykorezystentnist mikroorhanizmiv. Stan problemy ta shliakhy yii vyrishennia [Antibiotic resistance of microorganisms. state of problem and way of decision]. Ukrainskyi khimioterapevtychnyi zhurnal. 2011;4:41-3.
  4. Feshchenko YuI, Melnyk VM, Turchenko LV. Kontseptualni zasady optymizatsii protytuberkulznykh zakhodiv i reformuvannia protytuberkuloznoi sluzhby Ukrainy [Conceptual basis of optimization of anti-tuberculosis activities and reforming anti-tuberculosis service in the Ukraine] [Elektronnyi resurs]. 2015 [data dostupu 2015 liutyi 05]; Rezhym dostupu: URL ftp://ftp1.ifp.kiev.ua/ original/2015/feschenko2015.pdf.
  5. Tarasova LG, Streltsova EN, Kantemirova BI. Immunogeneticheskie predposylki narusheniya metabolizma kollagena pri tuberkulyoze [Immunogenetic prerequisites for the disturbance of collagen metabolism in tuberculosis]. Tuberkulyoz i bolezni lyogkikh. 2015;11:4-9.
  6. Tarasova LG, Streltsova EN. Reparatsiya lyogochnoy tkani pri tuberkulyoze [Reparation of pulmonary tissue in tuberculosis]. Saint-Petersburg, RF: ElbiSPb; 2010. 136 p.
  7. Filippova OYu. Stan fibrozuvannia u khvorykh na nealkoholnyi steatoz z komorbidnym ozhyrinniam i patolohiieiu biliarnoho traktu [Liver fibrosis development in patients with non-alcoholic steatosis and steatohepatitis against the background of comorbid obesity and pathology of billary tract]. Visnyk VDNZU «Ukrainska medychna stomatolohichna akademiia». Aktualni problemy suchasnoi medytsyny. 2017;17(2):204-9.
  8. Philips L, Visser J, Nel D, Blaauw R. The association between tuberculosis and the development of insulin resistance in adults with pulmonary tuberculosis in the Western sub-district of the Cape Metropole region, South Africa: a combined cross-sectional, cohort study. BMC Infectious Diseases. 2017. Available from: http://dx.doi.org/10.1186/s12879-017-2657-5.
  9. Zaigham S, Nillson PM, Wollmer P, Engström G. The temporal relationship between poor lung function and the risk of diabetes. BMC Pulmonary Medicine. 2016;16:75. Available from: http://dx.doi.org/10.1186/s12890-016-0227-z.
  10. Trinidad RM, Brostrom R, Morello MI, Montgomery D, Thein CC, Gajitos ML, et al. Tuberculosis screening at a diabetes clinic in the Republic of the Marshall Islands. Journal of Clinical Tuberculosis and Other Mycobacterial Diseases. 2016;5:4-7.
  11. Seredyuk V. Role of aldosterone, mutogenic growth factors, apoptosis inducers and pulmonary arterial hypertension in the formation and progression of chronic pulmonary heart disease. The Pharma Innovation Journal. 2013;5(2):36-40.
  12. Kulish MV. Vplyv kortykosteroidiv na funktsiiu kory nadnyrnykiv u khvorykh na vpershe diahnostovanyi destruktyvnyi tuberkuloz lehen [Influence of corticosteroids on adrenal cortex function in patients with the first diagnosed destructive pulmonary tuberculosis]. Problemy ekolohii ta medytsyny. 2013;17(3–4):21-3.
  13. Yareshko AH, Kulish MV, Pos OA. Rol kortykosteroidiv u likuvanni vpershe diahnostovanoho destruktyvnoho tuberkulozu lehen z pervynnoiu rezystentnistiu mikobakterii tuberkulozu [A role of corticosteroids is in treatment of the first diagnosed destructive lung tuberculosis with primary drug-resistant of mycobacterium tuberculosis]. Svit medytsyny ta biolohii. 2012;1:106-9.

Authors informations:

Shevchenko Olga Stanislavna , Doctor of Medical Sciences, Full Professor, Head of the Department of Phthisiology and Pulmonology, Kharkiv National Medical University ORCID ID: 0000-0002-5476-3981

Ovcharenko Irina Anatolyevna , Assistant of the Department of Phthisiology and Pulmonology, Kharkiv National Medical University ORCID ID: 0000-0001-6953-9029

Shvets Olga Nikolaevna , Postgraduate Student of the Department of Phthisiology and Pulmonology, Kharkiv National Medical University ORCID ID: 0000-0002-8371-8258, Researcher ID: D-4703-2019

Address for correspondence:

Ovcharenko Irina Anatolyevna
Assistant of the Department of Phthisiology and Pulmonology, Kharkiv National Medical University

61022, Ukraine, Kharkiv, Science Ave., 4

Tel.: +380 (67) 3247149

E-mail: arlabhf@i.ua

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