External Respiratory Function, Inflammation Markers, and Life Quality Depending on the Volume of Tuberculosis Lung Lesion

Abstract

Tuberculosis is a common disease in many countries, so understanding of its impact on life quality and respiratory function as well as study of correlations of these parameters with biochemical markers of tuberculosis course and treatment effectiveness is important in evaluating new methods of treatment and prevention. Objective — to investigate the relationships between the function of external respiration, the level of Humanbeta-defensin-1, ferritin, interleukin-6, quality of life and the volume of tuberculosis lung lesions. Materials and methods. 100 patients with pulmonary tuberculosis were included in the study. Patients were divided into groups depending on the volume of tuberculous lesions: Group 1 (n = 36) had lesions within one lung, Group 2 (n = 64) had lesions of both lungs. Examination of patients was carried out according to the current standards of providing medical care to tuberculosis patients. In addition, patients underwent determination of ferritin, interleukin-6 (IL-6), and Human-beta-defensin-1 (HBD-1) levels in the blood by ELISA test. Spirography was performed to determine the parameters of the function of external breathing. Interviews were provided using SF-36 questionnaire with the determination of the main indicators of quality of life. Statistical data processing was carried out using the Statistica 8.0. Results and discussion. Comparison of spirometry parameters between groups showed significantly lower respiratory function parameters in patients with bilateral tuberculous lesions compared to patients with unilateral lesions. A decrease in external respiratory function indicators was accompanied by a corresponding significant decrease in the quality of life, which was more pronounced in Group 2. The described changes occurred against the background of a significant increase in the studied biochemical markers in Group 2 compared to Group 1. Thus, the level of HBD-1 in Group 1 was (8.11 ± 1.78) pg/ml, in Group 2 it was (30.14 ± 3.89) pg/ml (p < 0.05). Ferritin level in Group 1 was (94.19 ± 1.18) ng/ml, in Group 2 — (113.45 ± 4.77) ng/ml (p < 0.05). The level of IL-6 in Group 1 was (81.43 ± 1.14) pg/ml, in Group 2 — (103.34 ± 3.46) pg/ml (p < 0.05). When investigating the correlations between the levels of HBD-1, ferritin, IL-6 and quality of life indicators according to the SF-36 scale, reliable inverse relationships were found between all quality of life parameters and the levels of HBD-1 and ferritin. When investigating the correlations between the levels of HBD-1, ferritin, IL-6 and parameters of the function of external respiration, it was found that HBD-1 demonstrates negative reliable correlations with both volume and speed indicators (– 0.24…– 0.32). IL-6 shows negative relationships only in FVC (rs = – 0.42) and FEV1 (rs = – 0.41), however, these correlations are stronger compared to HBD-1. Conclusions. An increase in the volume of tuberculous lesions of the lungs leads to a more pronounced violation of the function of external breathing and, as a result, a decrease in the patients life quality. The described changes are accompanied by an increase in the levels of HBD-1, ferritin and IL-6, which makes the studied biomarkers promising predictors of deterioration of external respiratory function and quality of life. HBD-1 and ferritin demonstrated more pronounced correlations with parameters of life quality. The investigated markers have negative correlations with indicators of both restrictive and obstructive ventilation disorders.