Репарация легочной ткани при впервые выявленном туберкулезе легких как генетически детерминированный процесс

The objective of the study is to assess the effect of rs6707530 polymorphism of the FN1 gene and rs1150754 polymorphism of the TNXB gene on the healing of lung tissue destruction in patients with newly detected pulmonary tuberculosis.Subjects and methods. 82 patients older 18 years with newly diagnosed pulmonary tuberculosis with destruction were enrolled in the study. X-ray data were assessed on the 2nd, 4th and 6th months of the study. Patients were divided into 2 groups depending on the efficacy of chemotherapy intensive phase.Results. In the group of patients with an effective course of chemotherapy, the frequency of carriers of G allele (p < 0.001) and T/G genotype (p = 0.01) in rs6707530 locus of the FN1 gene was higher. While T/T genotype (p = 0.002) and T allele (p < 0.001) prevailed among the patients with persisting destruction of lung tissue after the intensive phase of chemotherapy.Цель исследования: оценить влияние полиморфизма rs6707530 гена FN1 и полиморфизма rs1150754 гена TNXB на динамику заживления деструкции легочной ткани у больных с впервые выявленным туберкулезом легких.Материалы и методы. В исследование включено 82 пациента старше 18 лет с впервые выявленным туберкулезом легких в фазе распада. На 2, 4 и 6-м мес. исследования проводилась оценка рентгенологических данных. Пациенты были разделены на 2 группы в зависимости от эффективности интенсивной фазы химиотерапии.Результаты. В группе пациентов с эффективным курсом химиотерапии чаще встречались носители аллеля G (p < 0,001) и генотипа T/G (p = 0,01) в локусе rs6707530 гена FN1. При этом генотип T/T (p = 0,002) и аллель Т (p < 0,001) доминировали среди пациентов с сохранением деструкции легочной ткани после интенсивной фазы химиотерапии

Пищевой статус и структура потребления макронутриентов у больных туберкулезом с различной лекарственной устойчивостью возбудителя

The objective: to assess the nutritional status and actual nutrition of respiratory tuberculosis patients with various drug resistance patterns.Subjects and methods. The actual nutrition of tuberculosis patients was assessed using a standard questionnaire containing questions about the amount of food and meals consumed at home in the last 30 days preceding the survey. Assessment of anthropometric indicators and the survey were carried out by medical workers when the patients were admitted to hospital. Patients were enrolled from April to August 2018 out of 300 respiratory tuberculosis patients who had a positive result of a sputum test for M. tuberculosis. The multidrug resistant tuberculosis group consisted of 222 patients, while the group of those drug susceptible or having mono- or polyresistance included 78 patients.Results. It was found out that the home diet of patients with active respiratory tuberculosis was imbalanced in respect of basic nutrients and energy. The following was detected: lack of protein in the diet (including the one of animal origin) in 80.6 ± 2.3% with a depth of more than 55.7%; excess unbalanced fat consumption in 66.6 ± 2.7%; insufficient consumption of dietary fiber in 45.0 ± 2.8%. Multidrug resistant tuberculosis patients consumed more energy and macronutrients (proteins, fats, dietary fiber, animal protein, cholesterol, and fatty acids) both in absolute terms and relative to individual needs, but at the same time they had worse nutritional status indicators; 37,2% of them had malnutrition of the 1st to 3rd degree. At the same time, patients with multidrug resistant tuberculosis were significantly more often HIV-positive, they had disseminated and chronic tuberculosis, the treatment of which itself lead to a decrease in appetite, malnutrition, metabolic and digestion disorders.Цель исследования: оценка пищевого статуса и фактического питания больных туберкулезом органов дыхания с различной лекарственной устойчивостью возбудителя.Материалы и методы. Оценка фактического питания больных туберкулезом проводилась с использованием стандартного опросника, содержащего вопросы, характеризующие количество потребляемых пищевых продуктов и блюд в домашних условиях в течение последних 30 дней, предшествовавших опросу. Определение антропометрических показателей и опрос проводили медицинские работники в момент поступления пациентов в стационар. Выборка пациентов сформирована в период с апреля по август 2018 г. из 300 больных туберкулезом органов дыхания, выделявших M. tuberculosis. Группу туберкулеза с множественной лекарственной устойчивостью составили 222 больных, группу с сохраненной чувствительностью M. tuberculosis к противотуберкулезным препаратам, а также с моно/полирезистентностью ‒ 78 пациентов.Результаты. Установлено, что домашнее питание больных активным туберкулезом органов дыхания характеризовалось несбалансированностью основных пищевых веществ и энергии. Выявлены: недостаток белка в рационе (в том числе животного происхождения) ‒ у 80,6 ± 2,3% с глубиной более 55,7%; избыточное несбалансированное потребление жиров ‒ у 66,6 ± 2,7%; недостаточное потребление пищевых волокон ‒ у 45,0 ± 2,8%. Больные туберкулезом с множественной лекарственной устойчивостью потребляли больше энергии и макронутриентов (белков, жиров, пищевых волокон, животного белка, холестерина, жирных кислот) как в абсолютном выражении, так и относительно индивидуальной потребности, но вместе с тем имели худшие показатели пищевого статуса, 37,2% лиц имели недостаточность питания 1-3-й степени. При этом больные туберкулезом с множественной лекарственной устойчивостью значимо чаще имели ВИЧ-положительный статус, распространенный и хронический туберкулез, лечение которого само приводит к снижению аппетита, недоеданию, нарушению обмена и усвоения пищевых веществ.Авторы заявляют об отсутствии у них конфликта интересов

Reparation of lung tissue in newly detected pulmonary tuberculosis as genetically determined process

The objective of the study is to assess the effect of rs6707530 polymorphism of the FN1 gene and rs1150754 polymorphism of the TNXB gene on the healing of lung tissue destruction in patients with newly detected pulmonary tuberculosis.Subjects and methods. 82 patients older 18 years with newly diagnosed pulmonary tuberculosis with destruction were enrolled in the study. X-ray data were assessed on the 2nd, 4th and 6th months of the study. Patients were divided into 2 groups depending on the efficacy of chemotherapy intensive phase.Results. In the group of patients with an effective course of chemotherapy, the frequency of carriers of G allele (p < 0.001) and T/G genotype (p = 0.01) in rs6707530 locus of the FN1 gene was higher. While T/T genotype (p = 0.002) and T allele (p < 0.001) prevailed among the patients with persisting destruction of lung tissue after the intensive phase of chemotherapy

Nutritional status and structure of macronutrient consumption in tuberculosis patients with different drug resistance profiles

The objective: to assess the nutritional status and actual nutrition of respiratory tuberculosis patients with various drug resistance patterns.Subjects and methods. The actual nutrition of tuberculosis patients was assessed using a standard questionnaire containing questions about the amount of food and meals consumed at home in the last 30 days preceding the survey. Assessment of anthropometric indicators and the survey were carried out by medical workers when the patients were admitted to hospital. Patients were enrolled from April to August 2018 out of 300 respiratory tuberculosis patients who had a positive result of a sputum test for M. tuberculosis. The multidrug resistant tuberculosis group consisted of 222 patients, while the group of those drug susceptible or having mono- or polyresistance included 78 patients.Results. It was found out that the home diet of patients with active respiratory tuberculosis was imbalanced in respect of basic nutrients and energy. The following was detected: lack of protein in the diet (including the one of animal origin) in 80.6 ± 2.3% with a depth of more than 55.7%; excess unbalanced fat consumption in 66.6 ± 2.7%; insufficient consumption of dietary fiber in 45.0 ± 2.8%. Multidrug resistant tuberculosis patients consumed more energy and macronutrients (proteins, fats, dietary fiber, animal protein, cholesterol, and fatty acids) both in absolute terms and relative to individual needs, but at the same time they had worse nutritional status indicators; 37,2% of them had malnutrition of the 1st to 3rd degree. At the same time, patients with multidrug resistant tuberculosis were significantly more often HIV-positive, they had disseminated and chronic tuberculosis, the treatment of which itself lead to a decrease in appetite, malnutrition, metabolic and digestion disorders