Comparative characteristics of the proteolytic system (on the example of elastase) in patients with pulmonary tuberculosis and pleural tuberculosis

Abstract

Despite the expanded possibilities of antibacterial therapy with the use of very expensive drugs, the effectiveness of these measures has not yet yielded the desired results. Clarification of the role of pathogenesis, in our opinion, can expand both diagnostic possibilities and possibilities of pathogenetic treatment of various forms of tuberculosis, which, accordingly, will increase its effectiveness. Objective — to study the state of the proteolytic system on the example of serum elastase in various forms of tuberculosis.Materials and methods. Under our supervision there were 111 patients, who were divided into 3 groups. The first group consisted of 66 (59.5 %) persons with pulmonary tuberculosis. Group 2 included 13 (11.7 %) patients with tuberculous pleurisy. The third group consisted of 32 (28.8 %) patients with dual localization of the TB process (pulmonary tuberculosis and pleural tuberculosis).Results and discussion. In patients with tuberculous pleurisy, the level of elastase was (253.2 ± 16.7) nmol/min ⋅ ml, which was 1.4 times higher than when the pleurisy was combined with the pulmonary process (p < 0.01) and 2.5 times higher than in the pulmonary process. The level of leukocytes and neutrophils was highest in pulmonary tuberculosis and lowest in the combination of pulmonary tuberculosis and pleurisy.Conclusions. In pulmonary and extrapulmonary forms of tuberculosis (pulmonary tuberculosis and pleural tuberculosis), the proteolytic system is activated, in particular, the level of elastase. The content of the latter in the serum differs in pulmonary and extrapulmonary forms of tuberculosis, which, according to the authors, can be explained by the prevailing «use» of the enzyme in pulmonary processes. The dependence of the level of elastase on the content of leukocytes and neutrophils has not been established.The level of fluctuations in the content of elastase in pulmonary forms of tuberculosis can be attributed to the duration of the actual existence of pulmonary tuberculosis and its various forms.