Efficacy and safety of quercetin and polyvinylpyrrolidone in treatment of patients with newly diagnosed destructive pulmonary tuberculosis in comparison with standard antimycobacterial therapy

Objective/background: The objective/background of this work was to study the efficacy and safety of quercetin and polyvinylpyrrolidone (QP) in the treatment of patients with newly diagnosed destructive pulmonary tuberculosis in comparison with standard antimycobacterial therapy. Materials and methods: The study involved 124 patients aged between 20 years and 70 years with newly diagnosed destructive pulmonary tuberculosis. Patients were allocated to two groups. The first (control) group of patients received standard antimycobacterial and pathogenetic therapy and included 31 (25.00 ± 3.89%) patients. The second (main) group of patients received QP therapy in addition to chemotherapy and included 93 (75.00 ± 3.89%) patients. Results: Intoxication symptoms in the second group were reduced following 1.33 ± 0.15 months, whereas in the first group intoxication symptoms were reduced following 2.64 ± 0.20 months, p < .001. Conclusion: Administration of QP combined with chemotherapy in patients with newly diagnosed destructive pulmonary tuberculosis resulted in a comparatively quick reduction of disease manifestation

Impact of the Russia–Ukraine armed conflict on water resources and water infrastructure

The armed conflict between Ukraine and Russia that began in late February 2022 has far-reaching environmental consequences, especially regarding water resources and management. Here we analysed the multifaceted impacts of the military actions on freshwater resources and water infrastructure during the first three months of the conflict. We identified the nature of the impacts, the kind of pressures imposed on the water sector and the negative consequences for the availability and quality of freshwater resources for the civilian population. Our results showed that many water infrastructures such as dams at reservoirs, water supply and treatment systems and subsurface mines have been impacted or are at risk from military actions. Continuation of the conflict will have multiple negative sustainability implications not only in Ukraine but also on a global scale, hampering achievement of clean water and sanitation, conservation and sustainable use of water resources, and energy and food security

Morphological changes in experimental tuberculosis resulting from treatment with quercetin and polyvinylpyrrolidone

AbstractObjective/BackgroundMorphological study of a mice of tissue necrosis stages in experimental organ-preserving tuberculosis (TB) pharmacotherapy using quercetin and polyvinylpyrrolidone (QP).MethodsA total of 32 laboratory mice of C57BL/6JLacSto strain were used in the experiment. The animals were divided into five groups (Group 1–5), with six to seven mice in each group: Group 1, Mycobacterium tuberculosis (MBT)-uninfected mice; Group 2, MBT-infected mice; Group 3, MBT infected and treated with anti-TB preparation (ATP); Group 4, MBT infected and QP treated; and Group 5, MBT infected and treated with ATP and QP. The mice were infected through caudal vein injection with the MTB H37Rv strain. The QP preparation, which belongs to the capillary-stabilizing-remedy group, was used for the research. The ATP included isoniazid and streptomycin. Thus, the drug doses for the mice contained the following drugs: isoniazid (10%, 5mL), 45mg/kg; streptomycin (1g), 90mg/kg; and QP (0.5g), 45mg/kg of the body weight of a mouse. The medicines used in the experimental studies on the mice were applied as follows: isoniazid and streptomycin, administered intramuscularly once a day; and QP, administered intraperitoneally according to a schedule (on the 5th day after the introduction of the infection every 2h, and then every 12h; on the 6th day and 7th day two times a day every 12h).ResultsQP produced a strict delineation of caseous necrosis from the unaffected parts of the connective tissue with fibrosis in the center and a large number of Langerhans cells, which was not observed in the control groups without QP. The combination of QP and ATP had more pronounced effects. In MBT-infected mice, where QP was not used, unlike the group where QP was used, adipose dystrophy of hepatocytes was observed. Thus, the hepatoprotective effect of QP against TB can be suggested.ConclusionUnder the influence of QP, the separation of caseous necrosis of granulomas from unaffected areas begins through connective tissue with fibrotization in the central part and a large number of Langerhans cells and lymphocytes that are not observed in the control groups. The interaction of QP with anti-TB drugs shows more obvious effects: fast tendency of epithelioid cellular tubercles to fibrotization and separation of TB granulomas through connective tissue. In addition, in the control groups of animals infected with TB, in contrast to the experimental groups, fatty degeneration of hepatocytes is observed. Thus, we have shown the hepatoprotective function of QP against TB

Changes in nitric oxide synthase and nitrite and nitrate serum levels in patients with or without multidrug-resistant tuberculosis undergoing the intensive phase of antituberculosis therapy

Objective/background: There is a paucity of published data on the effect of tuberculosis (TB) chemotherapy on nitric oxide (NO) synthesis and metabolism in newly diagnosed and relapsed patients with or without multidrug-resistant TB (MDR-TB). Methods: The pattern of NO response in 140 patients with pulmonary TB, including 74 with MDR-TB (1st group) and 66 without MDR-TB (2nd group) has been studied and compared with the NO status of 30 healthy donors (3rd group). Patients comprised those with newly diagnosed pulmonary TB (Subgroups 1B and 2B) and recurrent or relapsed TB (Subgroups 1A and 2A). The NO status was assessed by measuring inducible NO synthase (iNOS), nitrites, and nitrates levels. This was measured prior to treatment initiation and 2 months after the prescribed chemotherapy. Results: Increased levels of NO indices were found in patients with TB when compared with healthy controls—1st group: iNOS, 231.6 ± 6.65pmol/min/mgB; nitrites, 5.626 ± 0.15 μmol/L; and nitrates, 62.89 ± 1.42 μmol/L (Subgroup 1A: iNOS, 208.40 ± 8.26pmol/min/mgB; nitrites, 5.027 ± 0.17 μmol/L; and nitrates, 59.29 ± 1.79 μmol/L and Subgroup 1B: iNOS, 260.4 ± 8.56pmol/min/mgB; nitrites, 6.371 ± 0.19 μmol/L; and nitrates, 67.36 ± 2.03 μmol/L); 2nd group: iNOS, 286.3 ± 5.92pmol/min/mgB; nitrites, 6.747 ± 0.17 μmol/L; and nitrates, 72.02 ± 1.43 μmol/L (Subgroup 2A: iNOS, 260.9 ± 14.12pmol/min/mgB; nitrites, 5.686 ± 0.20 μmol/L; and nitrates, 66.26 ± 1.89 μmol/L and Subgroup 2B: iNOS, 293.7 ± 6.13pmol/min/mgB; nitrites, 7.059 ± 0.19 μmol/L; and nitrates, 73.72 ± 1.71 μmol/L) versus healthy controls (iNOS, 81.03 ± 2.36pmol/min/mgB; nitrites, 3.83 ± 0.093 μmol/L; and nitrates, 37.98 ± 1.30 μmol/L). After 2 months of chemotherapy, a significant decrease in NO indicators was observed in the patients with TB, particularly in those without MDR-TB—1st group: iNOS, 114.9 ± 3.2pmol/min/mgB; nitrites, 4.21 ± 0.13 μmol/L; and nitrates, 46.65 ± 1.04 μmol/L (Subgroup 1A: iNOS, 125.3 ± 4.5pmol/min/mgB; nitrites, 4.42 ± 0.14 μmol/L; and nitrates, 49.38 ± 1.30 μmol/L and Subgroup 1B: iNOS, 102 ± 3.53pmol/min/mgB; nitrites, 3.93 ± 0.13 μmol/L; and nitrates, 43.26 ± 1.50 μmol/L) and 2nd group: iNOS, 91.4 ± 2.53pmol/min/mgB; nitrites, 3.67 ± 0.09 μmol/L; and nitrates, 35.65 ± 1.06 μmol/L (Subgroup 2A: iNOS, 106.7 ± 5.2pmol/min/mgB; nitrites, 4.04 ± 0.19 μmol/L; and nitrates-40.53 ± 1.83 μmol/L and Subgroup 2B, iNOS, 86.7 ± 2.59pmol/min/mgB; nitrites, 3.56 ± 0.1 μmol/L; and nitrates, 34.22 ± 1.19 μmol/L). The decline in NO activity was less prominent in patients with recurrent TB and MDR-TB, which suggests lower level of immunologic and reparative processes in such patients. Conclusion: In patients with pulmonary TB, significantly higher levels of NO activity were observed as compared with the levels in healthy individuals. In patients with recurrent TB and MDR-TB, significantly lower levels of NO indicators were observed in comparison with patients with newly diagnosed pulmonary TB. After 2 months on chemotherapy, a significant decrease in iNOS activity and NO metabolites was observed in patients with pulmonary TB, but the decrease in NO indicators was manifested mostly in the newly diagnosed pulmonary TB patients and patients without MDR-TB as opposed to patients with recurrent TB and MDR-TB, which suggests lower levels of immunologic and reparative processes in such patients. Therefore, the levels of nitrites and nitrates as well as iNOS activity may serve as additional diagnostic criteria to differentiate MDR-TB from nonresistant TB in patients with relapsed and newly diagnosed TB. Easily assessed NO-related markers can also serve as predictors of treatment outcome because patients with drug-susceptible strains had lower NO output approaching levels found in controls

Morphological changes in experimental tuberculosis resulting from treatment with quercetin and polyvinylpyrrolidone

Research objective: Morphological study of tissue necrosis stages in experimental organ-preserving tuberculosis pharmacotherapy using Quercetin and Polyvinylpyrrolidone (QP). Background and methods: 32 laboratory mice of C57BL/6JLacSto strain were used in the experiment. The animals were divided into five groups, six to seven mice in each: group 1- Mycobacterium tuberculosis (MBT) uninfected mice; group 2- MBT infected mice; group 3- MBT infected and treated with antituberculosis preparation (ATP); group 4- MBT infected and QP treated; group 5- MBT infected and treated with ATP and QP. The mice were infected through caudal vein injection with MTB H37Rv strain. The preparation QP, which belongs to the capillary-stabilizing-remedy group, was used for the research. The ATP were izoniazid and streptomycin. Results: QP produced a strict delineation of caseous necrosis from the unaffected parts of the connective tissue with fibrosis in the center and a large number of Langerhans cells, which was not observed in the control groups without QP. The combination of QP and ATP had more pronounced effects. In MBT-infected mice, where QP was not used, unlike the group where QP was used, adipose dystrophy of hepatocytes was observed. Thus, the hepatoprotective effect of QP against TB can be suggested. Conclusion: QP produces a clear delineation of caseous necrosis from an uninfected tissue by connective-tissue formation, and by forming fibrotic tissue in the center of epithelioid cells that prevents further TB dissemination by enhancing TB pharmacotherapy