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Peripheral blood leucocytes specific stability depending on different lung tuberculosis duration PDF Печать E-mail
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19.12.10 14:17
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Raphael M.T.
Kursk State Medical University
Pthysiopulmonology department
(Head of the department MD, professor Kolomiyets V.M.)
Scientific instructor associated professor Lebedev Yu. I.


In multidimensional researches, touching the problem of tuberculosis activity estimation, it is discussed a lot of different clinical, X-ray, immunological indices, for accurate diagnosis establishment and necessary treatment. Meanwhile we have not been found the clear determination of an activity phenomenon in the accessible literature.

Adding up obtained information, we would like to present the generalized interpretation of activity as such tubercular inflammatory process state, that can be described the phases of infiltration, disintegration, scattering and incomplete resolution in obedience to the last tuberculosis classification, accepted in Russia. All these phases are developing with taking part of leucocytes rich in enzymes and actively reactive on a specific allergen – tuberculin. Previously only the lytic damaging effect of tuberculin on leucocytes was investigated [2]. However in the light of the last numerous works, devoted to the cancer cells drug resistance there is a question about probability of the same phenomenon with the host cells of tuberculosis patient to the tuberculin on a background of his protracted chronic contact with the body cells in vivo [1,3,4,5 ].

To study in vitro specific leucocytes stability depending on the disease duration 31 patients including 18 men and 13 women, in the age from 20 to 60, with pulmonary tuberculosis (6 focal, 12 disseminated, 13 infiltrated forms) were investigated. Activity of tuberculosis inflammation was well-proven after clinical, X-ray, laboratory research, including the estimation of the leucocytes stability according to the licence №1673061. All patients were parted on 2 groups. Patients, having an above one year disease duration and clear signs of pulmonary sclerosis (lung pattern deformation, local emphysema, mediastinum deviation , pulmonary tissue shrinkage) were included in the first group (16 persons),. New cases were included in the second group (15 persons). They had not clear signs of sclerosis in the pulmonary tissue. Correlation of the patients according to a sex, age and tuberculosis forms was approximately identical in the supervision groups. Besides 11 tuberculin positive healthy persons in the age of 20-60 were examined as a control group.

More clear changes of in vitro leucocytes stability were detected in the patients with tuberculosis in comparison with the healthy persons. In the healthy persons absence of reaction were found out in 5, lysis lesion in 1, increase of cellular stability in 4 persons. At the same time in the patients with tuberculosis analogical correlation of cells reaction on tuberculin was accordingly 3, 16 and 12 men (P<0.05). Besides specific cells stability was recognized more frequently among the patients with more than 1 year protracted course of tuberculosis. So, in the 1st group it was observed in 9 persons, against 2 persons in the 2nd group (P<0,05).
Probably, an active long tubercular process in the lung with mycobacteria vegetation in the body provoke intoxication and natural tuberculins' irritation of the host cells which step by step acquire host-associated resistance according to a common law of the cell drug resistance [5,6]. This phenomenon can be detected in blood incubation with a purify protein derivative (PPD) in vitro. It is dramaticaly demonstrated in the tuberculosis cases with a long way of a disease and it is needed in further investigation.

Conclusions

1.With an active tubercular process in the lung stability of peripheral blood cells to a tuberculin is changed, it can both go down and rise that should be taken into account at tuberculosis activity diagnostics.
2. At the persons, being ill more than 1 year, the peripheral blood leucocytes are more stable to the tuberculin in vitro, in comparison with new cases in comparison with new cases and that points to a long duration of a disease.
3.In vitro specific leucocytes stability is often recognized in the tuberculous patients, having signs of pulmonary sclerosis that should be taken into consideration at nosotropic therapy recommendation.

Literature

1.Ерохина М.В. Белки-транспортеры соматических клеток организма и их влияние на эффективность противотуберкулезной терапии (обзор литературы) // Пробл. туберкулеза и болезней легких. – 2004. - №8. – С.11-15.
2.Фрадкин В.А. Диагностика аллергии реакциями нейтрофилов крови. – М., 1985. – C. 121.
3.Golay J, Zaffaroni L, Vaccari T, et al. Biologic response of B lymphoma cells to anti-CD20 monoclonal antibody rituximab in vitro: CD55 and CD59 regulate complement-mediated cell lysis // Blood. - 2000.- Vol. 95, P. 3900–3908.
4.Hammerschmidt R. Host cell death and onset of systemic aquired resistiance: old observation // Physiological and Molecular Plant Pathology. – 2003. – Vol. 62, Issue 6. – P. 315-316.
5.Smith MR. Rituximab (monoclonal anti-CD20 antibody): mechanisms of action and resistance. Oncogene // 2003. - V.22, P. 7359–7368.
6.Voso MT, Pantel G, Rutella S, et al. Effector cell-mediated mechanisms play the dominant role in the cytotoxicity of rituximab on human peripheral blood B cells from normal donors and patients with chronic lymphocytic leukemia // Blood. - 2000. - Vol.96, P.338a.


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