RESUMEN
The aim of this study was to examine the relationship between serum levels of parameters of the system metalloproteinase (MMP)/inhibitors with severity of infiltrative pulmonary tuberculosis (ITL), changes in examined parameters during the intensive phase treatment (IPT), as well as possibility of their use for prediction of IPT effectiveness, along with acute-phase proteins (AFP). The study included ITL patients which were subdivided into two groups (I and II) with different rates of reparative changes. It was shown that: 1) ITL is characterized by impairements in the system MMP/inhibitors: the levels of MMP-1, -9 increased, MMP-3, -8, TIMP-1 remained at the reference values and a 2-macroglobulin was low. 2) Changes of the parameters of the system MMP/inhibitors were associated with markers of severity and activity of the process: MMP-1, with the presence of destruction and sensitivity of the pathogen (Mycobacterium tuberculosis; MBT) to anti-TB drugs, MMP-9, with the volume of destruction, MMP-8 - with activity of tuberculosis. 3) TIMP-1 and MMP-9 concentrations decreased during treatment in groups with different rates of reparative process, whereas proMMP-1, MMP-3,-8 remained unchanged. 4) Before and after IPT, the level of TIMP-1 was higher in the group of patients with slower rate of reparative processes. 5) After IPT the imbalance in the system MMP/inhibitor preserved thus suggesting continuation of the reparative process. 6) Use of combination of MMP and AFR is more informative in predicting efficacy of IPT.
Asunto(s)
Colagenasas/sangre , Tuberculosis Pulmonar/sangre , Proteínas de Fase Aguda/metabolismo , Adolescente , Adulto , Antituberculosos/administración & dosificación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Inhibidor Tisular de Metaloproteinasa-1/sangre , Tuberculosis Pulmonar/tratamiento farmacológicoRESUMEN
The paper sets forth the stages of design and introduction of the new Russian tuberculosis (TB) drug perchlozon registered in the Russian Federation in 2012. Based on the results of Phases I-III clinical trials, the authors evaluate the efficacy and safety of the agent and consider the adverse effects of its treatment for respiratory TB. The use of perchlozon as a component of combination therapy versus standard chemotherapy regimens significantly reduces abacillation time in pulmonary TB caused by its drug-resistant pathogen. In terms of the higher prevalence of TB induced by its pathogen resistant to many drugs (with multiple and broad-spectrum drug resistance), perchlozon is an essential drug that has antituberculous activity mainly against multidrug-resistant Mycobacterium tuberculosis strains and gives patients with the severest and epidemiologically poor form of TB the chance to recover.
Asunto(s)
Antituberculosos/farmacología , Ensayos Clínicos como Asunto , Descubrimiento de Drogas , Evaluación de Medicamentos , Farmacorresistencia Microbiana , Tuberculosis Pulmonar/tratamiento farmacológico , Antituberculosos/efectos adversos , HumanosRESUMEN
The paper gives the results of studies to determine blood bacteriostatic activity (BBA) in the use of a patient's autostrain and semiliquid medium versus the clinical and laboratory parameters of the course of a process in 101 patients with pulmonary tuberculosis. There is evidence for the relationship of the BBA to the sensitivity to isoniazid and the structure of drug resistance. The zero values of BBA correspond to the severest course of the disease. The efficiency of treatment is much higher in patients with high and moderate BBA. The latter's determination using the semiliquid medium permits an objective evaluation of the efficiency of chemotherapy, identification of patients with a poor prognosis, and then choice of an individual treatment regimen on day 7 after the test just before obtaining the data on drug sensitivity.
Asunto(s)
Antituberculosos/uso terapéutico , Isoniazida/uso terapéutico , Mycobacterium tuberculosis/efectos de los fármacos , Prueba Bactericida de Suero/métodos , Tuberculosis Pulmonar/sangre , Estudios de Seguimiento , Humanos , Mycobacterium tuberculosis/aislamiento & purificación , Estudios Retrospectivos , Resultado del Tratamiento , Tuberculosis Pulmonar/tratamiento farmacológico , Tuberculosis Pulmonar/microbiologíaRESUMEN
Clinical Mycobacterium tuberculosis (MBT) strains (their genotype, drug resistance, and virulence) and the characteristics of their caused processes were studied. More than a half the studied MBT isolates belonged to the genetic family Beijing. As compared with mycobacteria of individual genotypes, they showed a significantly higher rate of multidrug resistance, polyresistance, and a high virulescence and caused more common and frequently progressive pulmonary lesions requiring the use of large-dose isoniazid and second-line drugs and early surgical treatment.
Asunto(s)
Antibióticos Antituberculosos/uso terapéutico , Mycobacterium tuberculosis/aislamiento & purificación , Tuberculosis Pulmonar/tratamiento farmacológico , Tuberculosis Pulmonar/microbiología , Genotipo , Humanos , Mycobacterium tuberculosis/genética , Polimorfismo Genético/genética , Tuberculosis Pulmonar/genéticaRESUMEN
The progress and efficiency of different therapy regimens for respiratory tuberculosis and the genotyping of Mycobacterium tuberculosis (MBT) were clinically analyzed in 46 adolescents. The pathogen of the disease was MBT of the Beijing family in 20 patients and the individual genotype of MBT in 22 patients. It has been ascertained that MBT of the Beijing genotype (80%) was more commonly recorded in secondary tuberculosis, both MBT of the Beijing family (59.0%) and the individual genotype of the pathogen (41%) were in primary tuberculosis. When MBT of the Beijing family had been infected, progression was diagnosed as being 3 times more frequently [n = 12 (54.5%)] family than that with individual genotype infection [n = 3 (13.6%)]. Therapy regimens have been developed by taking into account drug resistance and the genotype of MBT, the degree of inactivation of GINK and bacteriostatic blood activity, their clinical efficiency proved.
Asunto(s)
Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Mycobacterium tuberculosis/efectos de los fármacos , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Tuberculosis Pulmonar/tratamiento farmacológico , Adolescente , Genotipo , Humanos , Isoniazida/farmacología , Isoniazida/uso terapéutico , Kanamicina/farmacología , Kanamicina/uso terapéutico , Mycobacterium tuberculosis/genética , Rifampin/farmacología , Rifampin/uso terapéutico , Estreptomicina/farmacología , Estreptomicina/uso terapéuticoRESUMEN
A relationship of the clinical picture of destructive pulmonary tuberculosis to the genotype, drug resistance, and virulence of Mycobacterium tuberculosis (MBT) strains was studied. As compared with the processes induced by individual genotypes, pulmonary tuberculosis caused by MBT from the family Beijing was found to be characterized by more marked clinical symptoms, multisegmental lung tissue lesions with multiple decay cavities, by low bacteriostatic blood activity, abundant bacterial isolation, and progression. MBT of the Beijing genotype were characterized by higher rates of resistance to antituberculous drugs and their combinations than were the strains of individual genotypes; they have a high virulence, which is likely to enhance their transmissibility and to determine the poor course of a specific process.
Asunto(s)
Mycobacterium tuberculosis/genética , Tuberculosis Pulmonar/microbiología , Adolescente , Adulto , Animales , Antituberculosos/farmacología , ADN Bacteriano/análisis , Modelos Animales de Enfermedad , Farmacorresistencia Bacteriana , Femenino , Genotipo , Humanos , Masculino , Ratones , Persona de Mediana Edad , Modelos Teóricos , Mycobacterium tuberculosis/efectos de los fármacos , Mycobacterium tuberculosis/aislamiento & purificación , Mycobacterium tuberculosis/patogenicidad , Polimorfismo Genético , Radiografía Torácica , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/diagnóstico por imagen , VirulenciaRESUMEN
The virulence of 43 Mycobacteria tuberculosis strains isolated from 21 patients with new cases of pulmonary tuberculosis and from 20 patients with chronic destructive pulmonary tuberculosis (CDPT) was studied in non-inbred albino mice. Twenty four (56%) and 19 (44%) M. tuberculosis strains belonged to the Beijing and individual genotypes, respectively. The virulence of isolates from the new cases of pulmonary tuberculosis was higher than that from CDPT patients. The M. tuberculosis strains studied showed no correlation between the virulence, viability, and affiliation to a certain genotype. However, there was a lower rate of decreased virulence in multidrug-resistant strains of the Beijing genotype than in the isolates of individual genotypes. This is likely to be a factor of the high transmissible capacity of M. tuberculosis strains of the Beijing family.
Asunto(s)
Mycobacterium tuberculosis/patogenicidad , Tuberculosis Pulmonar/microbiología , Animales , Genotipo , Ratones , Mycobacterium tuberculosis/genética , Polimorfismo de Longitud del Fragmento de Restricción , Tuberculosis Pulmonar/genéticaRESUMEN
Due to the fact that there were difficulties in interpreting the cardiac scintigrams after 99mTC pyrophosphate had been given to patients with coronary heart disease without acute myocardial infarction, an experimental study was undertaken. The scintigraphic characteristics were examined in 10 cats following ligation of the interventricular artery at its middle third for more than 20 min, followed by myocardial reperfusion, histochemical and electron microscopic studies. Cat interventricular artery occlusion for a more than 20 min was found to be followed by specific ischemic changes in ECG and myocardial accumulation of 99mTc pyrophosphate. The histochemical and electron microscopic studies indicated that there were both reversible and irreversible cardiomyocyte lesions. Reversible myocardial changes were detected not only in the ischemic area, but in the other myocardial regions away from the basin of the ligated artery. If occlusion was short, the rate of myocardial tracer accumulation rapidly became lower; with long-term occlusion or profound myocardial damage caused by reperfusion, tracer accumulation became higher. There is experimental evidence for applying 99mTc-pyrophosphate scintigraphy in the clinical setting to reveal reversible myocardial changes that are most common in chronic coronary heart disease.