Seregina V.A., Budritsky A.M.
The criteria of the lung tuberculosis treatment efficacy based on the study of tuberculin-binding monocytes levels
Abstract.
According to the World Health Organization assessment tuberculosis at the present time is a threat to humanity on a global scale (WHO, 2010). Therefore, it is especially important to duly assess the effectiveness of treating tuberculosis, for it largely determines the prognosis and the outcome of the disease. Currently the criteria of clinico-roentgenologic improvement while treating pulmonary tuberculosis are the results of clinical, roentgenologic, laboratory examination methods, indicating the decrease in active pulmonary tuberculosis process. The aim of our study was to find out new criteria to assess the effectiveness of the treatment of pulmonary tuberculosis on the basis of determining the number of tuberculin-binding blood monocytes. The level of tuberculin-binding monocytes in the blood was determined in patients suffering from pulmonary tuberculosis with bacterioexcretion. Fresh heparinized blood of the patients was used in this research. The number of tuberculin-binding monocytes was determined with tuberculin, conjugated with FITC using reagents of lot (SIMFITC.5x2, SRE «RESAN», Belarus) by means of flow cytometry method on the Beckman Coulter FC500 apparatus. Argon laser with emission wave length of 488 nm was used. Statistical processing of the results was performed on the computer with the help of software sets (Statistica-10). Nonparametric analysis (Mann-Whitney test, Wilcoxon, Spearman criterion) was used. The analysis of the number of tuberculin-binding monocytes in patients with the diagnosis of pulmonary tuberculosis being made on the basis of the detection of tuberculosis mycobacteria in the sputum was conducted. It has been found that the effectiveness of treatment of pulmonary tuberculosis depends on the number of tuberculin-binding blood monocytes. Its doubling by the end of the third month of treatment testifies to the effectiveness and relevancy of the conducted therapy; in patients with multiple drug resistance the number of tuberculin-binding blood monocytes during treatment didn’t change; in patients receiving complex treatment with the use of cycloferon in tablets significant increase in the number of tuberculin-binding monocytes was determined one month earlier than in patients who did not take cycloferon, which can testify to the effectiveness of treatment for pulmonary tuberculosis with the use of cycloferon.
Key words: tuberculosis, efficacy of treatment, tuberculin-binding monocytes.
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