Bronchial obstructive syndrome in patients with pulmonary tuberculosis or pneumonia: features of cytokine profile

Abstract

The problem of pulmonology in modern conditions is the spread of respiratory diseases, which has led to an increase in morbidity, disability and mortality from this pathology. Such diseases include chronic obstructive pulmonary disease (COPD), bronchial asthma (BA), tuberculosis (TB), pneumonia (PN). At some stage in their development, these diseases have the same symptoms and syndromes, in particular, bronchial obstructive syndrome (BOS). The clinical course of these diseases is accompanied by suppression of immunological reactivity, impaired cytokine content, reduction of general and local adaptation­protective mechanisms of the body.Objective — to study the indices of the cytokine profile of the serum in patients with uncomplicated pulmonary TB or PN with the presence of BOS.Materials and methods. Surveys were conducted in 65 patients with pulmonary TB with symptoms of BOS, 64 patients with PN with BOS. The control group consisted of 27 patients with COPD and 25 patients with BA. Patients of the examined groups determined the serum content of pro­ and anti­inflammatory interleukins.Results and discussion. The level of proinflammatory cytokines IL 1β (3.92 ± 1.4 pg/ml), IL 6 (19.21 ± 1.5 pg/ml), TNF-a (21.4 ± 1.8 pg/ml) in the serum of COPD caused by COPD in patients with TB exceeds similar in healthy donors and in the control group more than 2.4—5.5 times, at the same time, the levels of IL 4 (0.75 ± 0,1 pg/ml) and IL 2 (1.64 ± 0.1 pg/ml) were 2.0 times lower than in healthy donors, approprlately. The level of proinflammatory interleukins (IL 4, IL 6) indicates a high likelihood of adverse course with the probable prolongation of the underlying disease.With COPD caused by COPD or BA, an increase in the content of proinflammatory cytokines in patients with may be a prerequisite for more frequent exacerbations of COPD and the formation, as a consequence, of its complications, and in PN with ALS is a factor in the delayed course of asthma and an increase in the volume of AD.Conclusions. The study of indicators of the interleukin profile in the serum of patients with pulmonary TB or PN with the phenomena of BOS allowed to determine their role in the assessment of the course of the pathological process, the choice of optimal treatment options and the prediction of the frequency of complications.