Dynamics of indicators of the functional activity of leukocytes in patients with infiltrative pulmonary tuberculosis

Abstract

In a heterogeneous population of cellular elements involved in the development of an inflammatory response, the phagocyte response to Mycobacterium tuberculosis aggression is recognized as the earliest link in the pathogenesis of inflammation prior to inclusion of other mechanisms responsible ultimately for the clinical outcome. From this point of view, it seems promising to study phagocytes cells involved in the formation of an immune response and an inflammatory reaction in pulmonary tuberculosis. Patients newly diagnosed with untreated infiltrative pulmonary tuberculosis (ITL, n = 106), based on the dynamics of clinical and radiological data, were retrospectively divided into two groups: "significant improvement" - disappearance of symptoms of intoxication, abacillation, closure of decay cavities; "improvement" - elimination of symptoms of intoxication, abacillation, pronounced resolution of focal and infiltrative changes, reduction of cavities of decay. For patients ITL, irrespective of the severity of the clinical and radiological effect, unidirectional but different degrees of severity, changes in the activity of the enzymes of purine metabolism, the level of oxidative and nitrosylating stress of immunocompetent cells, oxygen-independent bactericidal activity of neutrophils are characteristic. The expression level of ecto-ADA-2 depended on the severity of the clinical and radiological effect. The co-operation of mononuclear phagocytes and polymorphonuclear leukocytes, which ensures the functioning of a single phagocytes cellular domain that plays a key role in the elimination of Mtb, is characteristic of a "significant improvement". The remaining high/low indicators of the functional status of leukocytes indicate the preservation of the activity of a specific process, the incompleteness of inflammation, despite the abacillation, and the need for continued treatment.