The effect of a systemic inflammatory response on adaptive mechanisms and the state of homeostasis in patients with respiratory tuberculosis in combination with chronic obstructive pulmonary disease

Abstract

The influence of the systemic inflammatory response on the adaptive mechanisms and the state of homeostasis of the body in patients with respiratory tuberculosis against the background of chronic obstructive pulmonary disease is considered. It has been established that respiratory tuberculosis and chronic obstructive pulmonary disease are widespread among the population and are important causes of bronchopulmonary morbidity and mortality. Chronic obstructive pulmonary disease is determined in one third of newly diagnosed patients with respiratory tuberculosis. The combined course of respiratory tuberculosis and chronic obstructive pulmonary disease is a mutually aggravating condition. Comorbid pathology is much more difficult, accompanied by severe intoxication, disintegration of lung tissue and bacterial excretion. Biomarkers and the severity of the systemic inflammatory response are of great clinical and diagnostic value in chronic obstructive pulmonary disease. It was determined that the systemic inflammatory response in chronic obstructive pulmonary disease is characterized by endothelial dysfunction of the vascular wall, significant changes in white blood cells, changes in the protein spectrum of the blood, and lipid metabolism disorders. The manifestations of systemic inflammation and endothelial dysfunction, characteristic of chronic obstructive pulmonary disease, in patients with respiratory tuberculosis, aggravate the course of both diseases. The comorbid state is also characterized by a change in the lipid profile of patients, an increase in the content of total cholesterol and atherogenic fractions. These changes are interrelated with the state of adaptive mechanisms, homeostasis and reactivity of the organism. The state of homeostasis largely determines the development, course and outcome of pathological processes characteristic of tuberculous inflammation and inflammation in chronic obstructive pulmonary disease, and the increase in the effectiveness of the treatment is closely related to the restoration of homeostatic balance and reactivity of the body. The availability of methods for determining the homeostatic balance of the body in clinical practice, with their high information content, allows a personalized approach to the management of patients with comorbidity.

Keywords

tuberculosis of the respiratory system / chronic obstructive pulmonary disease / systemic inflammatory response / homeostatic balance of the organism / reactivity of the organism / lipid profile / C-reactive protein / protein fractions / entropy and redundancy

References

[1] Авдеев, С.Н. Системные эффекты у больных ХОБЛ / С.Н. Авдеев // Врач. – 2006. – № 12. – С. 3–8.

[2] Ахминеева, А.Х. Нарушение гомеостаза при хронической обструктивной болезни легких / А.Х. Ахминеева, О.С. Полунина, И.В. Севостьянова // Курский науч.-практ. вестн. «Человек и его здоровье». – 2016. – № 4. – С. 34–39.

[3] Браженко, Н.А. Туберкулез: гомеостаз организма и эффективность лечения / Н.А. Браженко, О.Н. Браженко. -Васильева, И.А. Заболеваемость, смертность и распространенность как показатели бремени туберкулеза в регионах ВОЗ, странах мира и в Российской Федерации / И.А. Васильева [и др.] // Туберкулез и болезни легких. – 2017. – Т. 95, № 6. – С. 9-Колб, В.Г. Использование теории информации в вопросах реактивности / В.Г. Колб // Биофизические аспекты реактивности организма при туберкулезе. – Минск: Беларусь, 1974. – С. 20–39.

[4] Мордык, А.В. Распространенность хронической обструктивной болезни легких и отдельных вариантов заболевания среди впервые выявленных больных туберкулезом / А.В. Мордык [и др.] // Мед. альманах. – 2017. – № 4 (49). – С. 120–123.

[5] Моткина, Е. В. Функциональное состояние эндотелия и хроническое воспаление при хронической обструктивной болезни легких / Е.В. Моткина, В.А. Невзорова // Тихоокеанский мед. журн. – 2005. – № 2 (20). – С. 34–37.

[6] Никитин, В.А. Комплексный анализ факторов риска, влияющих на прогрессирование хронической обструкивной болезни легких / В.А. Никитин [и др.] // Терапевт. архив. – 2018. – Т. 90, № 1. – С. 27–30.

[7] Шпрыков, А.С. Клиника и эффективность лечения туберкулеза и бактериальных заболеваний легких в условиях хронической табачной интоксикации (экспериментальные и клинические исследования): дис. … д-ра мед. наук / Шпырков А.С. – М., 2011. – 313 с.

[8] Эргешов, А.Э. Туберкулез с множественной и широкой лекарственной устойчивостью микобактерий туберкулеза в Российской Федерации // А.Э. Эргешов [и др.] // Вестн. Авиценны. – 2018. – Т. 20, № 2–3. – С. 314–319.

[9] Jain, N.K. Chronic obstructive pulmonary disease and tuberculosis / N.K. Jain // Lund India. -Kanacia, K.P. High Tobacco Use among Presumptive Tuberculosis Patients, Sought India: Time to integrate Control of two epidemic / K.P. Kanacia [et al.] // Osong. Public. Health Res. Pershect. – 2016. – № 7 (4). – Р. 228–232.

[10] Liu,Y. Tuberculosis – associated mortality and its risk factors in a district of Shanghail, Chaina: retrospective cohort studynt / Y. Liu // J. Tuberc. Lung. Dis. – 2018. – Vol. 22, № 6. – P. 655–660.

[11] Rahman, I. Oxidative stress in pathogenesis of chronic obstructive pulmonary disease: cellular and molecular mechanisms / I. Rahman // Cell Biochem Biophys. – 2005. – № 43. – P. 167–88.

RIGHTS & PERMISSIONS

Katicheva A.V., Brazhenko N.A., Brazhenko O.N., Chuikova A.G., Nikolay A.V., Zheleznyak S.G., Tsygan N.V.