Pathogenically important risk factors for the progression of newly diagnosed infiltrative pulmonary tuberculosis

O.Z. Basieva, Z.K. Dzhagaeva, N.V. Kobesov, B.M. Maliev

North Ossetia State Medical Academy, Vladikavkaz

Aim: to evaluate the role of certain pathogenic factors (i.e., endogenous intoxication, lipid peroxidation, and immune imbalance) in the progression of tuberculosis and the potential tools to manage them.

Patients and Methods: this prospective cohort study included 60 patients aged 25–60 years with newly diagnosed infiltrative pulmonary tuberculosis (TB). All participants were divided into two groups (30 patients each). Comparison group patients (18 women [60%], mean age 47.2±3.6 years) received standard anti-TB treatment. Study group patients (16 women [53.3%], mean age 44.7±3.25 years) additionally received Imunofan^® (arginil-α-aspartil-lysil-valil-tyrosil-arginine), an immunoregulatory peptide (two series of 10–15 injections, 50 mg IM). Changes in clinical presentations, radiological findings, CBC parameters, indicators of intoxication, lipid peroxidation, antioxidant system, and immune functions were evaluated. Examinations were performed one and three months after starting treatment.

Results: infiltrative pulmonary TB is associated with significant alterations in homeostasis, e.g., endogenous intoxication, activation of lipid peroxidation and phospholipase, inhibition of antioxidant activity, and immune imbalance. These are important factors of TB progression. In patients with limited lung damage, the intensity of these predictors was minimal compared to patients with advanced disease associated with more severe and persistent impairments. The efficacy of standard anti-TB treatment was inadequate (less significant improvement in lab tests and lung tissue infiltration) .

Conclusions: immunoregulatory peptide as a part of complex treatment of newly diag-nosed infiltrative pulmonary TB at early stages provides a focused and relatively fast effect on pathogenically important alterations of homeostasis. Imunofan^® improves infection course and helps eliminate the pathogen.

Keywords: tuberculosis, endotoxicosis, lipid peroxidation, phospholipase, antioxidant system, immunity.

For citation: Basieva O.Z., Dzhagaeva Z.K., Kobesov N.V., Maliev B.M. Pathogenically important risk factors for the progression of newly diagnosed infiltrative pulmonary tuberculosis. RMJ. 2022;2:11–15.