The feasibility of immunocorrective therapy in the treatment of children with new tuberculosis cases

Abstract

Aim. To substantiate the expediency of the immunocorrective therapy use in combined treatment by studying the effectiveness of the immunomodulator azoximer bromide aimed at correcting the immunological changes in children with new tuberculosis (TB) cases. Materials and methods. The study on the effectiveness of immunocorrective therapy in the complex treatment of children with new TB cases was conducted at the beginning of antimycobacterial therapy (AMBT) and at the end of the maintenance phase (MF) of AMBT. For this purpose, 51 children with new TB cases and immunologic changes were included in the study and divided into 2 groups: 26 children received immunomodulator azoximer bromide in the combined therapy on the background of AMBT (main group) and 25 children were assigned to receive only AMBT (control group). The groups were identical in age, sex, prescribed AMBT regimens, and severity of the specific process. The children from the main group along with the standard AMBT additionally used azoximer bromide (immunomodulator) to correct immunological changes: for children under 10 years of age – 6 mg twice a day, for children over 10 years – 12 mg twice a day; the treatment course – 14 days. The study results were processed on a personal computer using the statistical package of the licensed program Statistica, version 13 (Copyright 1984–2018 TIBCO Software Inc. All rights reserved, License No. JPZ804I382130ARCN10-J). Results. Given the results obtained, the use of immunomodulator azoximer bromide in the complex treatment for children with new TB cases, alongside normalization of all cytokine profile indicators and the balance in the regulatory system of pro- and anti-inflammatory cytokines, helped to achieve by the end of treatment: a shorter average time to culture conversion by 0.9 (1.5 (1.0; 2.0) months against 2.4 (2.0; 3.0) months; P < 0.01), positive radiological dynamics of 77 % (χ2 = 5.79; P < 0.01), reduced time of destruction healing by 2.1 (1.7 (1.0; 2.0) months against 3.8 (3.0; 4.0) months, P < 0.02), shorter average time of the basic AMBT course by 1.5 (6.2 (5.6; 6.8) months against 7.7 (6.0; 9.3) months; P < 0.01). Combined treatment tolerability was satisfactory in all 100 % of cases. Conclusions. Immunomodulator azoximer bromide as a part of the combined therapy for children with new TB cases can not only restore the body immune reactivity, but also reduce the specific process activity on the background of AMBT, shorten the average time to culture conversion by 0.9 months and destruction healing by 2.1 months, reduce the average duration of the main AMBT course by 1.5 months. In addition, this approach to therapy helps to conduct standard AMBT without changing the treatment regimen.