Keywords
Abstract
Neopterin (2-amino-4-hydroxy-6-(D-Erythro-1,2,3-trihyd- roxypropane)-pteridine (NEO) is considered as an integral indicator of cytokine-dependent activation of monocytes/ macrophages. NEO is a non-specific marker of cellular im- munity activation and a useful biomarker of disease activity monitoring during treatment in patients with chronic diseases, including pulmonary tuberculosis. NEO level was compared with clinical and bacteriological characteristics of the process, laboratory parameters of activity and severity in 103 of newonset untreated patients with pulmonary tuberculosis (PT) before treatment and after 3 months of adequate intensive care. There were only infiltrates in lungs without cavities. NEO level was high in all patients with PT. Its changes were associated with acutephase reactants (APR) of inflammation (haptoglobin, oro- somucoid, ?1-proteinase inhibitor, ?2-macroglobulin and ceruloplasmin) and with indicator of the process severity - adenosine deaminase (АDА). It is established that its changes are not connected with prevalence of process and with Mycobacterium tuberculosis (Mtb) properties (availability, appearance, drug resistance) and are defined by character of lung tissue reaction. Analysis of therapy effectiveness in three months showed no changes in the level of NEO and АDА, whereas the changes APR were different: their level became normal in patients with fast reparation and declined (not to normal value) in patients with slow reparation. Preservation of the increased level of NEO and АDА after three months of adequate treatment confirms the need to continue specific therapy.