Наукові роботи молодих вчених. Кафедра фтизіатрії та пульмонології

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Pro-atherogenic lipid profile in pulmonary tuberculosis patients with concurrent insulin resistance
(Inter Collegas, 2021) Shvets, Olga; Shevchenko, Olha; Piskur, Zoriana; Stepanenko, Hanna; Pohorielova, Olha
Background. The problem of studying lipid metabolism in patients with tuberculosis is of interest to scientists around the world. The purpose of the study was to investigate lipid profile in pulmonary tuberculosis patients with concurrent insulin resistance. Materials and methods. Forty-one patients with pulmonary tuberculosis were examined. Insulin resistance index (HOMA-IR), total cholesterol level (TC), triglycerides (TG) level, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, very-low-density lipoprotein (VLDL) cholesterol and atherogenic index (AI) were measured. The patients were divided into two groups: group 1 – 26 patients with tuberculosis and insulin resistance (HOMA-IR > 2.7); group 2 – 15 patients with tuberculosis without insulin resistance (HOMAIR < 2.7). Results. Group 1 patients had severe course of TB with fever, severe fatigue and weakness, profuse sweating, weight loss, cough and shortness of breath. Median TC indices differed at significant level (p = 0.012): group 1 – 4.82 mmol / L, group 2 – 4.25 mmol / L. TG level was higher in group 1 patients – 1.32 mmol / L than in group 2 patients – 1.28 mmol / L. LDL cholesterol values were higher in group 1 patients – 3.2 mmol / L, vs. group 2: 2.5 mmol / L. The AI was higher in group1 (p = 0.005): 3.9 units against 2.8 units in group 2 patients. Conclusions. Insulin resistance in pulmonary tuberculosis patients was associated with severe course of the disease, severe clinical manifestations and impaired external respiration. Pro-atherogenic disorders of lipid metabolism in pulmonary tuberculosis patients with concurrent insulin resistance can be considered as the degree of endogenous intoxication.
The effect of prescribing a complex of essential amino acids on the level of human-beta-defensin-1 in patients with drug-susceptible and drug-resistant pulmonary tuberculosis
(Deutscher Wissenschaftsherold, 2021) Pohorielova, Olha; Shevchenko, Olga
With the expansion of M. tuberculosis resistance, more and more attention is being paid to alternative pathogenetic therapies that can stimulate the host's immune response. The purpose of the study was to determine the effect of prescribing a complex of essential amino acids on the level of Human-beta-defensin-1 in patients with drug-susceptible and drug-resistant pulmonary tuberculosis. Materials and methods. 50 patients with drug-susceptible tuberculosis (TB) and 50 patients with drugresistant TB (multidrug-resistant and extensively drug resistant TB) were included to the study. The patients with were divided into 3 groups: patients in Group 1 did not receive additional treatment, patients in Group 2 received essential amino acids in tablets for 30 days, patients in Group 3 received injectable essential amino acids for 10 days and after that they received essential amino acids in tablets for 20 days. HBD-1 level was measured in blood serum by ELISA at the treatment onset, after 30 and after 60 days in all the patients. Results. Comparison of the HBD-1 level in patients with susceptible TB after 30 days of treatment showed its highest level in Group 3 (21.59±5.33 μmol/L, median – 17.14 μmol/L), lower level in Group 2 (19.41±3.66 μmol/L, median – 20.17 μmol/L) and the lowest level in Group 1 (9.25±1.95 μmol/L, median – 4.42 μmol/L), p<0.05. After 60 days of treatment, patients with drug susceptible TB showed the opposite results with the highest level of HBD-1 in Group 1 (26.18±2.82 μmol/L, median – 29.17 μmol/L), lower level in Group 2 (16.57±3.95 μmol/L, median – 11.11 μmol/L) and the lowest level in Group 3 (6.32±1.44 μmol/L, median – 3.99 μmol/L). Comparison of the HBD-1 level in patients with drug resistant TB after 30 days of treatment also showed its highest levels in Group 2 (21.65±3.27 μmol/L, median – 20.19 μmol / L) and Group 3 (20.98±7.91 μmol/L, median – 11.01 μmol/L), and significantly lower level in Group 1 (10.79±2.91 μmol/L, median – 4.09 μmol/L), p<0.05. After 60 days of drug resistant TB treatment, the highest HBD-1 level was observed in Group 1 (63.24±9.73 μmol/L, median – 58.15 μmol / L), its lower level was in Group 2 (18.99±2.09 μmol/L, median – 20.26 μmol/L) and the lowest level was in Group 3 (13.86±3.63 μmol/L, median – 13.97 μmol/L), p<0, 05. Conclusions. The appointment of the complex of essential amino acids in the pathogenetic therapy of tuberculosis allows to increase the production of Human-beta-defensin-1 in both patients with drug susceptible and drug resistant tuberculosis, which leads to a more balanced immune response and an increase in the effectiveness of anti-tuberculosis therapy. Key words: tuberculosis, amino acids, MDR-TB, treatment
Эффективность HAIN MTDR в определении устойчивости M.tuberculosis к противотуберкулезным препаратам
(2019) Шевченко, Ольга Станиславна; Новохатская, Мария Федоровна; Погорелова, Ольга Александровна
Interleukin-10 gene polymorphism is associated with patients on multi-drug resistant tuberculosis during the intensive phase of standard chemotherapy
(2017-02-25) Butov, Dmytro; Kuzhko, Mykhailo; Butova, Tetiana
Background and objective. To study interleukin-10 (IL-10) gene polymorphism is associated with patients on multi-drug resistant tuberculosis (MDR TB) during the intensive phase of standard chemotherapy. Methods. The study comprised 170 individuals in Kharkiv region of Ukraine including 74 patients with pulmonary MDR TB (group1), 66 patients without – MDR TB (group 2) and 30 healthy donors (group 3). Serum level of IL-10 was evaluated by ELISA (pg/L). Measurements on serum samples of patients were conducted prior or during first days after admission to the hospital and after 2 months on therapy. Investigations of gene polymorphism of IL-10 were performed using restriction analysis of the amplification products of specific regions of the genome. The method of investigation (for the sets real-time) — an allele-specific PCR using intercalating coloring Sybr Green. G1082A — IL-10 rs1800896 were genotyped with amplification-refractory mutation system-polymerase chain reaction. Results. In the 1stgroup, the level of IL-10 was (38.01±0.78), 2nd – (43.88±0.70) while in the 3rd group this value was (50.25±1.26) (p<0.05 between the groups). In patients with MDR TB the heterozygous GA genotype (75.68±4.99 % (N=56) ) was higher than: 14.86±4.14 % (N=11) of patients who had homozygote AA and GG (9.46±3.40 % (N=7)) genotype. In patients of the 2nd group, the homozygote AA genotype (62.12±5.97 % (N=41)) was higher than: 25.76±5.38 % (N=17) of patients who had heterozygous GA and homozygote GG genotype who had 12.12±4.02 % (N=8). In contrast, most of healthy donors had homozygous GG genotype with 56.67±9.05 % (N=17) and a low frequency of heterozygous GA 23.33±7.72 % (N=7) and AA genotype 20.00±7.30 % (N=6) (p<0.05 between the groups). Following a 2 month treatment, there was a significant increase of cytokine levels in the IL-10: 1st group (44.58±0.78) and 2nd group (50.59±0.99) (p<0.05 between the groups), when compared to the beginning of therapy and after 2 months (p<0.001). Conclusion. Compared to healthy control-group, patients with tuberculosis had significantly low level of IL-10. This coincided with a greater frequency of heterozygous GA genotype in the 1stgroup and homozygote АА genotype in the 2ndgroup’s polymorphism G1082A genes of IL-10. Further studies are warranted on whether a higher rate of patients without MDRTB has a causal immunogenetic relationship to polymorphism of genes encoding for IL-10 than patients with MDR TB. Standard 2-month TB therapy results in reversal of inflammation characterized by increase in IL-10 to the level comparable to healthy donors. IL-10 are immune correlates of treatment outcome and can help to identify better strategy for TB management. TB chemotherapy may have immunomodulatory effect of anti-inflammatory nature.
Features of intravenous anti TB therapy in patients with first diagnosed pulmonary TB in the intensive phase of treatment
(2017-09-09) Kuzhko, Mykhailo; Gumeniuk, Mykola; Butov, Dmytro; Tlustova, Tetiana; Denysov, Oleksii; Sprynsian, Tetiana
Background. We determined the effectiveness of intravenous anti-TB drugs compared with their oral administration during the intensive phase of treatment. Methods. 152 patients with newly diagnosed destructive pulmonary TB were randomized into 2 groups: Main (n=65) who received isoniazid (0.3 g), ethambutol (1.2 g) and sodium rifamycin (0.6 g) iv with pyrazinamide (2.0 g) per os and control (n=87) who received standard chemotherapy with the same drugs in the same doses orally. Results. After intensive phase sputum conversion was found in all the patients main group and 71 (81.6±4.1 %) patients control p<0.05. Time of sputum conversion in main group was 1.6±0.1 months and 1.9±0.1 months in control, p>0.05. In patients with destructive TB time to sputum conversion was 1.7±0.1 months in main group and 2.2±0.2 months in control, p<0.05. Time of cavities healing in main group was 2.9±0.2 months and 3.9±0.2 months in the control, p<0.05. Conclusions. Use of iv isoniazid, ethambutol and sodium rifamycin in the intensive phase of chemotherapy resulted in a significant reduction in terms of sputum conversion.
Association between IL-2,IL-4 gene polymorphisms and pulmonary MDRTB
(2017-09-09) Butova, Tetiana; Kuzhko, Mykhailo; Butov, Dmytro; Piriatinskaa, Natalia
Background.To study the association between IL-2,IL-4 gene polymorphisms and pulmonary MDRTB. Methods.The study comprised 170 individuals in Ukraine including 74 patients MDRTB(group1),66 patients without–MDRTB(group2) and 30 healthy donors(group3).Serum levels of cytokines IL-2 and IL-4(pg/L)were evaluated by ELISA.Two polymorphic variants were examined:T-330G promoter region of IL-2 and C-589T–IL-4genes. Results.In the 1 group the levels of IL-4 and IL-2 were 7.96±0.29 and 39.34±1.14,2nd–11.29±0.35 and 36.20±0.89 while in 3rd–29.99±1.27 and 21.60±0.80 respectively(p<0.05).In patients with MDRTB the heterozygous genotype (HeG)(79.73%(N=59) for IL-2 and 71.62%(N=53) for IL-4genes) was higher than: 10.81%(N=8) and 14.86%(N=11) of patients had mutation(MG) and normal homozygote genotype (NHG) had 9.46%(N=7) and 13.51%(N=10) for IL-2 and IL-4 genes, respectively.In patients 2ndgroup the MG(65.15%(N=43) for IL-2 and 69.70%(N=46) for IL-4 gene) was higher than:19.70%(N=13) and 13.64%(N=9) of patients had HeG and NHG had 15.15%(N=10) and 16.67%(N=11) for IL-2 and IL-4 genes, respectively.In contrast, most of healthy donors had NHG with 60.00%(N=18) and low frequency of MG at 16.67%(N=5) and 23.34%(N=7) and HeG at 23.33%(N=7) and 16.67%(N=5) for IL-2 and IL-4genes,respectively(p<0.05). Conclusion.Compared to healthy controls patients with tuberculosis had significantly lower levels of serum IL-4 and high - IL-2. This coincided with greater frequency of HeG in 1group and MG in 2group polymorphisms C-589T and T-330G genes of IL-4 and IL-2. Further studies are warranted whether higher rate of MDRTB has a causal immunogenetic relationship to polymorphism of genes encoding for IL-2 and IL-4 than patients without MDRTB.
Changes in nitric oxide synthase and nitrite and nitrate serum levels in patients with or without mdr-tb undergoing the intensive phase of anti-tuberculosis therapy
(2017-02-25) Butov, Dmytro; Kuzhko, Mykhailo; Butova, Tetiana; Stepanenko, Ganna
Aims and objectives. There is a paucity of published data on the effect of TB chemotherapy on nitric oxide (NO) synthesis and metabolism in newly diagnosed and relapsed patients with or without multi-drug resistant TB(MDR-TB). Methods. The pattern of NO response in 140 patients with pulmonary TB, including 74 with MDR-TB (1stgroup) and 66 without MDR-TB (2ndgroup) has been studied and compared to the NO status of 30 healthy donors (3rdgroup). Patients comprised those with newly diagnosed TB (NDPTB)(Subgroups 1B,2B) and recurrent or relapsed TB(Subgroup 1A,2A). The NO status was assessed by measuring inducible NO synthase (iNOS), nitrites and nitrates levels. This was measured prior to treatment initiation and two months after the prescribed chemotherapy. Results. Increased levels of NO indices were found in patients with TB when compared (1st group (iNOS-231.6±6.65pmole/min/mgB, nitrites-5.626±0.15μmol/L and nitrates-62.89±1.42μmol/L) Subgroups 1A(iNOS-208.40±8.26pmole/min/mgB, nitrites-5.027±0.17μmol/L and nitrates-59.29±1.79μmol/L) and Subgroups 1B(iNOS-260.4±8.56pmole/min/mgB, nitrites-6.371±0.19μmol/L and nitrates- 67.36±2.03μmol/L)) and 2nd group (iNOS-286.3±5.92pmole/min/mgB, nitrites-6.747±0.17μmol/L and nitrates-72.02±1.43μmol/L) Subgroups 2A(iNOS-260.9±14.12pmole/min/mgB, nitrites-5.686±0.20 μmol/L and nitrates-66.26±1.89μmol/L) and Subgroups 2B (iNOS-293.7±6.13pmole/min/mgB, nitrites-7.059±0.19μmol/L and nitrates-73.72±1.71μmol/L))) to healthy controls (iNOS-81.03±2.36 pmole/min/mgB, nitrites-3.83±0.093μmol/L and nitrates- 37.98±1.30μmol/L). After two months of chemotherapy a significant decrease in NO indicators was observed in the patients with TB, particularly in those without MDR-TB(1st group (iNOS-114.9±3.2 pmole/min/mgB, nitrites-4.21±0.13μmol/L and nitrates-46.65±1.04μmol/L) Subgroups 1A(iNOS-125.3±4.5pmole/min/mgB, nitrites-4.42±0.14μmol/L and nitrates-49.38±1.30μmol/L) and Subgroups 1B(iNOS-102±3.53pmole/min/mgB, nitrites-3.93±0.13μmol/L and nitrates-43.26±1.50μmol/L)) and 2nd group (iNOS-91.4±2.53 pmole/min/mgB, nitrites-3.67±0.09 μmol/L and nitrates-35.65±1.06μmol/L) Subgroups 2A(iNOS-106.7±5.2pmole/min/mgB, nitrites-4.04±0.19 μmol/L and nitrates-40.53±1.83 μmol/L) and Subgroups 2B(iNOS-86.7±2.59 pmole/min/mgB, nitrites-3.56±0.1μmol/L and nitrates-34.22±1.19μmol/L))).The decline in NO activity was less prominent in patients with recurrent TB and MDR-TB, which suggests lower level of immunologic and reparative processes in such patients. Conclusion.In patients with pulmonary TB, significantly higher levels of NO activity were observed as compared with the levels in healthy individuals. In patients with recurrent TB and MDRTB, significantly lower levels of NO indicators were observed by comparison with patients with newly diagnosed pulmonary TB. After two months on chemotherapy, a significant decrease in iNOS activity and NO metabolites was observed in patients with pulmonary TB, but the decrease of NO indicators was manifested mostly in the NDPTB patients and patients without MDR-TB as opposed to patients with recurrent TB and MDR-TB, which suggests lower levels of immunologic and reparative processes in such patients. Therefore, the levels of nitrites and nitrates aswell as iNOS activity may serve as additional diagnostic criteria to differentiate MDR-TB from non-resistant TB in patients with relapsed and newly diagnosed TB. Easily assessed NO-related markers can also serve as predictors of treatment outcome since patients with drug-susceptible strains had lower NO output approaching levels found in controls.
Efficacy and safety of quercetin and polyvinylpyrrolidone in treatment of patients with newly diagnosed destructive pulmonary tuberculosis in comparison with standard antimycobacterial therapy
(2017-02-25) Butov, Dmytro; Zaitseva, Svitlana; Butova, Tetiana
The objective/background of this work was to study the efficacy and safety of quercetin and polyvinylpyrrolidone (QP) in the treatment of patients with newly diagnosed destructive pulmonary tuberculosis in comparison with standard antimycobacterial therapy. Materials and methods: The study involved 124 patients aged between 20 years and 70 years with newly diagnosed destructive pulmonary tuberculosis. Patients were allocated to two groups. The first (control) group of patients received standard antimycobacterial and pathogenetic therapy and included 31 (25.00±3.89 %) patients. The second (main) group of patients received QP therapy in addition to chemotherapy and included 93 (75.00±3.89%) patients. All patients received standard chemotherapy, consisting of orally administered isoniazid (0.3 g), rifampicin (0.6 g), pyrazinamide (2 g), ethambutol (1.2 g), and/or an intramuscular injection of streptomycin (1 g) with a dose reduction after the intensive phase of the therapy. Theanti-TB drugs were procured through the Ukraine’s centralized national supply system. QP was used in a dose of 0.5 g in 100 mL of 0.9% sodium chloride solution intravenously once per day for 10 days starting on admission to the hospital. Results: Intoxication symptoms in the second group were reduced following 1.33±0.15 months, whereas in the first group intoxication symptoms were reduced following 2.64 ± 0.20 months, p < .001. Moreover, respiratory symptoms regression in the second group was observed following (1.43±0.30) months, whereas in the first group – following (2.33±0.30) months, p<0.05. Bacillary excretion period evaluated within 3 months was reduced, as it was shown by (97.67±1.63%) in the main group compared to (72.41±8.45%), p<0.05, in the control group. In addition, period of cavities healing was reduced to (2.86±0.15) months in the main group compared to (3.43±0.20) months, p<0.05, in the control group. Residual radiological lung damage findings (mild or slight or even no signs) were observed in 84 (90.32±3.07 %) patients of the main group versus 22 (70.97±8.15 %) patients in the control group. Significant residual radiological lung damage findings were observed in 9 (9.68±3.07 %) patients of the main group and in 9 (29.03±8.15 %) patients of the control group, p<0.05. In addition, QP provides anti-TB drugs tolerance increase by 20.42% and has immunomodulatory effect. Conclusion: Administration of QP combined with chemotherapy in patients with newly diagnosed destructive pulmonary tuberculosis resulted in a comparatively quick reduction of disease manifestation.
Intravenous application of rifampicin and ethambutol in patients with TB treatment failure and impaired suction function of the small intestine
(2017-10-11) Kuzhko, Mykhailo; Gumeniuk, Mykola; Todoriko, Liliia; Butov, Dmytro; Tlustova, Tetiana
Background: The purpose of our work was to study the peculiarities of intravenous application of rifampicin and ethambutol in TB patients with failure of treatment and impaired function of the small intestine. Methods: We observed 49 TB patients with treatment failure and impaired intestinal penetration (IIP). Patients were divided into two groups: Main group (MG) inclu¬ded 20 patients who received intravenously ethambutol (E) (10 ml - 10%) and rifampicin (R) (0.6 g) and orally pyrazinamide (Z, 2 g), isoniazid (H, 0.3 g) in standard doses; Control group (n= 29) received oral standard che¬motherapy - H (0.3 g), R (0.6 g), Z (2 g) and E (1.2 g); 3rd group included 20 relatively healthy individuals. All the patients were with drug-sensitive tuberculosis. The severity of IIP was determined by the concentration of lactulose and mannitol (lactulose-manitol test) in the urine. H, R, E concentration in blood serum was deter¬mined by liquid chromatography. The concentration of anti-tuberculosis drugs (ATDs) was determined in 2,4 and 6 hours after administration. Results: We detected violations of IIP in all the pati¬ents observed, while in Group 3 we did not observe the¬se changes. In the Control group the concentration of ATDs was significantly lower than the average therapeu¬tic concentration, and significant lower than in the Main group (Tab.1) (p < 0.05). The indices regarding the num¬ber of patients who took H were not significant between the Main and Control groups (p> 0.05). Conclusions: In TB patients with treatment failure, vio¬lations of IIP are determined, which leads to a decrease in the concentration of major ATDs in serum and inef¬fective treatment, especially with R and E. To increase the effectiveness of chemotherapy in drug-sensitive TB patients with treatment failure and violation of IIP in¬travenous administration of R and E lead to improve the effectiveness of treatment.
Efficacy and safety of parenteral anti-tuberculosis therapy of patients with TB meningitis compared to standard treatment
(2017-10-11) Kuzhko, Mykhailo; Gumeniuk, Mykola; Butov, Dmytro; Tlustova, Tetiana; Sprynsian, Tetiana; Denysov, Oleksii
Background: The objective of this work was to study the efficacy and safety of parenteral anti-TB therapy in treatment of patients with TB meningitis in comparison with standard antimycobacterial therapy. Methods: The study involved 44 patients with TB me¬ningitis. Patients were allocated to two groups. The first (control) group (n=31) received standard anti-TB the¬rapy (isoniazid 0.3 g), rifampicin (0.6 g), pyrazinamide (2 g) and ethambutol (1.2 g) - per os. The 2nd (main) group (n=13) received parenteral anti-TB therapy (iso¬niazid 0.5 g) - i/m, rifampicin (0.6 g) - i/v, ethambutol (1.0 g) - i/v and pyrazinamide (2 g) - per os. Results: After a week of chemotherapy 5 (16.1±6.6%) patients from 1st group and 10 (79.9±12.1%) patients from 2nd group had a positive dynamics: a decrease in the severity of cerebral symptoms, a decrease in focal neurological symptoms, liquorological and liquorody¬namic changes (19.3±3.8%), pleocytosis (22.9±7.2%) and cerebrospinal pressure to (210±30) mm.v.st.) and intoxication syndrome (p< 0.05). After two weeks of anti-tuberculosis the¬rapy, improvement of these parameters was observed in 10 (32.2±8.4%) patients of the 1st group and 11 (84.6±10.4%) - 2nd groups (p< 0.05). The mortality rate was significantly lower in the 2nd group (1 patient (7.6±7.6%)) compared to 8 patients of the 1st group (25.8±7.8%),p < 0.05. In addition, parenteral anti-TB therapy provided reduction of side effects by 23%. Conclusions: Administration of parenteral anti-TB the¬rapy in patients with TB meningitis resulted in a com¬paratively quick reduction of disease manifestation and reduce mortality.
Efficiency of treatment in patients with newly diagnosed destructive pulmonary tuberculosis using intravenous chemotherapy
(2017-02-16) Kuzhko, Mykhailo; Gumeniuk, Mykola; Butov, Dmytro; Tlustova, Tetiana; Denysov, Oleksii; Sprynsian, Tetiana
Background. The aim of research was to determine the effectiveness of chemotherapy using intravenous antituberculosis drugs compared with their oral administration during the intensive phase of treatment. Methods. 152 tuberculosis patients were randomized into 2 groups: Main (n=65) who received isoniazid, ethambutol and sodium rifamycin intravenous with pyrazinamide (2.0 g) per os and control (n=87) who received standard chemotherapy, consisting of orally administered isoniazid (0.3 g), rifampicin (0.6 g), pyrazinamide (2.0 g), ethambutol (1.2 g) with a dose reduction after the intensive phase of the therapy. Results. After 2 weeks of treatment symptoms of intoxication disappeared in 59 (90.7±3.59 %) of patients of the main group and 60 (68.9±4.9 %) patients in the control group, p<0.05. The mean duration of symptoms of intoxication in patients main group was 9.6±0.7 days, in control group – 13.7±0.9 days. After completing intensive phase sputum conversion was found in all the patients main group and 71 (81.6±4.1 %) patients control group p<0.05. The average time of sputum conversion in main group was 1.6±0.1 months and 1.9±0.1 months in control group, p>0.05. In patients with destructive pulmonary tuberculosis time to sputum conversion was 1.7±0.1 months in main group and 2.2±0.2 months in control group, p<0.05. The average time of cavities healing in main group was 2.9±0.2 months and 3.9±0.2 months in the control group, p<0.05. Conclusions. In patients with newly diagnosed destructive pulmonary tuberculosis use of isoniazid, ethambutol and sodium rifamycin intravenous in the intensive phase of chemotherapy resulted in a significant reduction in terms of the disappearance of symptoms of intoxication and sputum conversion.
Efficacy and safety of inhaled nebulized chemotherapy in treatment of patients with newly diagnosed pulmonary tuberculosis in comparison to standard antimycobacterial therapy
(2017-02-16) Kuzhko, Mykhailo; Gumeniuk, Mykola; Butov, Dmytro; Tlustova, Tetiana; Denysov, Oleksii; Sprynsian, Tetiana
The objective/background of this work was to study the efficacy and safety of inhaled nebulized chemotherapy in the treatment of patients with newly diagnosed pulmonary tuberculosis in comparison with standard antimycobacterial therapy. Materials and methods. The study involved 68 patients aged between 20 years and 70 years with newly diagnosed pulmonary tuberculosis. Patients were allocated to two groups. The first (main, n=21) group of patients received standard chemotherapy and further 0.15 g of isoniazid and rifampicin 0.15 g inhaled through a nebulizer, also they received salmeterol 50 mcg + fluticasone propionate 250 mcg at 2 breaths twice a day for 2 months. The second (control, n=47) group of patients received standard chemotherapy, consisting of orally administered isoniazid (0.3 g), rifampicin (0.6 g), pyrazinamide (2 g), ethambutol (1.2 g) with a dose reduction after the intensive phase of the therapy. Theanti-TB drugs were procured through the Ukraine’s centralized national supply system. Results. Intoxication symptoms in the first group were reduced following 1.39±0.18 months, whereas in the second group intoxication symptoms were reduced following 2.7 ± 0.1 months, p<.001. Moreover, respiratory symptoms regression in the first group was observed following (1.6±0.2) months, whereas in the second group – following (2.5±0.2) months, p<0.05. Bacillary excretion period evaluated within 1 month was reduced, as it was shown by (66.6±10.5 %) in the main group compared to (27.6±6.5%), p<0.05, in the control group. In addition, period of cavities healing was reduced to (2.9±0.2) months in the main group compared to (3.7±0.1) months, p<0.05, in the control group. Residual radiological lung damage findings (large residual changes) were observed in 22 (23.8±9.5 %) patients of the main group versus 24 (51.0±7.2 %) patients in the control group, p<0.05. After completion of treatment scar stenosis of the bronchi II-III art. diagnosed in 3 (14.2±7.8 %) patients main group and 17 (68.0±6.8 %) - control group, p<0.05. The duration of hospital treatment was 2.4±0.4 months in main group and 4.1±0.4 months in control group, p<0.05. Conclusion. Administration of of inhaled nebulized chemotherapy in patients with newly diagnosed pulmonary tuberculosis resulted in a comparatively quick reduction of disease manifestation.
The effectiveness of treatment in patients with destructive pulmonary tuberculosis depending on the mode of administration of antimtuberculosis drugs
(2017-01-14) Kuzhko, Mykhailo; Gumeniuk, Mykola; Butov, Dmytro; Tlustova, Tetiana; Denysov, Oleksii; Sprynsian, Tetiana
Background and objective. The aim of research was to determine the effectiveness of chemotherapy using intravenous (i/v) antimtuberculosis drugs compared with their oral administration during the intensive phase (IP) of treatment in patients with destructive pulmonary tuberculosis (TB). Methods. 130 TB patients were randomized into 2 groups: Main (n=65) who received isoniazid, ethambutol and sodium rifamycin i/v + pyrazinamide per os and control (n=65) who received all the drugs (isoniazid, rifampicin, ethambutol, pyrazinamide) orally. Results. After 2 weeks of treatment symptoms of intoxication disappeared in 90.7% of patients of the main group (MG) and 75.0% patients in the control group (CG), p<0.05. The mean duration of symptoms of intoxication in patients MG was 9,6±0,7 days, in CG -13.4±1.2 days. After completing IP sputum conversion was found in all the patients MG and 43 (95.7%) patients CG. The average time of sputum conversion in MG was 1.6±0.1 months and 1.8±0.1 months in CG, p>0.05. In patients with destructive pulmonary TB time to sputum conversion was 1.7±0.1 months in MG and 2.1±0.1 months in CG, p<0.05. The average time of cavities healing in MG was 2.9±0.2 months and 3.7±0.3 months in the CG, p<0.05. Conclusions. In patients with destructive pulmonary TB use of isoniazid, ethambutol and sodium rifamycin i/v in the intensive phase of chemotherapy resulted in a significant reduction in terms of the disappearance of symptoms of intoxication and sputum conversion. Funding acknowledgement: the study was supported by the National Academy of Medical Sciences of Ukraine.
Association of interleukin-2 gene polymorphisms with patients on multi-drug resistant tuberculosis
(2017-01-14) Butov, Dmytro; Kuzhko, Mykhailo; Butova, Tetiana; Piriatinskaa, Nataliya
Background and objective: To study association of IL-2 gene polymorphisms with patients on MDRTB. Methods: The study comprised 170 individuals in Kharkiv region of Ukraine including 74patients pulmonary MDRTB (group 1), 66 patients without-MDRTB (group2) and 30healthy donors (group3).Serum level of IL-2 was evaluated by ELISA(pg/L).Polymorphic variant were examined: T-330G region of IL-2gene. Results: In the 1st group the level of IL-2 was 39.34±1.14, 2nd -36.20±0.89 while in 3rd group this value was 21.60±0.80(p<0.05 between the groups).In patients with MDR TB the heterozygous TG genotype (79.73±4.67%(N=59)) was higher than: 10.81±3.61%(N=8) of patients had homozygote GG and ТТ (9.46±3.40% (N=7)) genotype. In patients 2nd group the homozygote GG genotype (65.15±5.87%(N=43)) was higher than: 19.70±4.90%(N=13) of patients had heterozygous TG and homozygote ТТ genotype had 15.15±4.41%(N=10).In contrast, most of healthy donors had homozygous ТТ genotype with 60.00±8.94%(N=18) and low frequency of heterozygous TG 16.67±6.80%(N=5) and GG genotype 23.34±7.72%(N=7) (p<0.05 between the groups). Following a 2 month treatment, there was a significant reduction of cytokine levels in the IL2: 1stgroup (32.85±1.11) and 2nd group (25.27±0.65) (p<0.05 between the groups), when compared to the beginning of therapy and after 2 months (p<0.001). Conclusion: Compared to healthy controls patients with tuberculosis had significantly high level of IL-2.This coincided with greater frequency of heterozygous TG genotype in 1st group and homozygote GG genotype in 2nd group polymorphism T-330G genes of IL-2. Further studies are warranted whether higher rate of MDRTB has a causal immunogenetic relationship to polymorphism of genes encoding for IL-2 than patients without MDRTB. Standard 2-month TB therapy results in reversal of inflammation characterized by decrease in IL-2 to the level comparable to healthy donors. IL-2 are immune correlates of treatment outcome and can help to identify better strategy for TB management. TB chemotherapy may have immunomodulatory effect of anti-inflammatory nature.
Уперше діагностований туберкульоз легень у вагітних
(Lublin, Republic of Poland, 2017-04) Григорова, Марина Вікторівна; Сокол, О.О.; Степаненко, Г.Л.
Clinical presentation of TB amoung patients who have risk factors of TB
(KhNMU, 2016-05) Ghosh, Somdipa
Динаміка профілактичних заходів серед дітей Харківської області за останні п'ять років
(ХНМУ, 2017-01) Гарлиєва, Катерина Борисівна
Стигмация больных туберкулезом
(ХНМУ, 2017-01) Гольник, Ярослав Викторович; Золотарь, Анна Александровна; Литивин, Николай Иванович
Что харьковчане знают о туберкулезе
(2016-05) Семенюк, Мария Александровна
Thyroid state in cases of pulmonary tuberculosis
(KhNMU, 2016-05) Ilyukha, Sergey; Parkhomenko, J.

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