[Cytokines in tuberculosis]. / Tsitokiny pri tuberkuleze.

The paper presents the data available in the literature and the authors' own findings concerning the production of cytokines, such as interleukins 1, 2, 4, 6, and 8, interferons and tumor necrosis factor, in patients with different stages of tuberculosis. A relationship between the production rate of some cytokines and the stage of the disease, the extent of the process, chemotherapeutical efficiency and other clinically important factors is discussed. The prospects of further investigations in this area are dealt with.

[The blood count of regulatory T-lymphocyte subpopulations in patients with pulmonary tuberculosis]. / Soderzhanie reguliatornykh subpopuliatsii T-limfotsitov v krovi bol'nykh tuberkulezom legkikh.

Important aspects are discussed of clinical evaluation of regulatory subpopulations of T-lymphocytes (T-helpers and T-suppressors) in the blood of patients with pulmonary tuberculosis. Imbalance of these subpopulations in the patients with normal values of E-REG BTR with PHA allows to establish immunity disorders in supplementary group of patients. Subpopulation imbalance is an unfavourable prognostic sign and one of indications to immunomodulating therapy.

[Efficacy of treating patients with disseminated forms of destructive pulmonary tuberculosis using chemical preparations and T-activin]. / Effektivnost' lecheniia khimiopreparatami i T-aktivinom bol'nykh s rasprostranennymi formami destruktivnogo tuberkuleza legkikh.

The use of T-activin in combination with chemical drugs allowed to markedly increase efficacy of the treatment. As a result of the treatment significant improvement was found in 17 (41.5 per cent) out of 41 patients with marked disorders in cellular immunity and severe tuberculosis. At the same time in the patients treated with the chemotherapeutics alone the improvement was stated only in 18.5 per cent of the patients. T-Activin improved the indices of cellular immunity and eliminated imbalance in regulatory subpopulations of T-helper and T-suppressor cells.

[A new method of the evaluation of lymphocytes and monocytes during immune response in patients with tuberculosis and sarcoidosis]. / Novyi metod otsenki sostoianiia limfotsitov i monotsitov v protsesse immunnogo otveta u bol'nykh tuberkulezom i sarkoidozom.

Examination which included 21 patients with tuberculosis, 6 with sarcoidosis and 9 healthy volunteers was aimed at determining the amount and intensity of surface fluorescence of CD+3, CD+4, CD+8 lymphocytes and CD14+, KIM+I monocytes. The findings demonstrate that determination of the fluorescence intensity of lymphocytes and monocytes provides a more exact characterization of the morphofunctional state of cells involved in the immune response. It is shown in particular that tuberculosis and sarcoidosis patients exhibit a varying density of the expressed antigenic markers of lymphocytes, which increases only in sarcoidosis, except a suppressor subpopulation (cytotoxic lymphocytes). Patients with tuberculosis had decreased density of CD9+, CD14+ and KIMI markers on the particular subpopulations.

[Natural killer cells in patients with pulmonary tuberculosis]. / Estestvennye kletki-killery u bol'nykh tuberkulezom legkikh.

In the existent literature the number of works devoted to the subpopulation of natural killer cells (NK) is not significant. The purpose of the present study was to determine the NK content in the blood of pulmonary tuberculosis patients; to establish correlation of the level of their content with the content of the previously studied T-lymphocyte subpopulations; to determine the intensity of the fluorescence of NK, CD3+, CD4+, CD8+ lymphocytes. The data were obtained on the significant increase in the NK mean level in tuberculosis patients (20.37 +/- 1.74) as compared with that in healthy subjects (12.77 +/- 2.56). The NK fluorescence intensity (56.33 +/- 2.28) conditioned by the Fc-receptor expression intensity is significantly lower than the analogous index in healthy volunteers (82.4 +/- 7.69). The NK level in the blood of tuberculosis patients correlates with the content of CD3+, CD8+ lymphocytes as well as with the CD4+/CD8+ index.

[Treatment of immunodeficient conditions caused by viral infection with the Soviet immunomodulator kemantan in patients with pulmonary tuberculosis]. / Lechenie immunodefitsitnykh sostoianii, vyzvannykh perenesennoi virusnoi infektsiei, otechestvennym immunomoduliatorom kemantanom u bol'nykh tuberkulezom legkikh.

Observation of 219 patients with pulmonary tuberculosis was made to study the effect of acute respiratory viral infection (ARVI) on the course of the disease. The affected were divided into 2 groups: 136 subjects who had ARVI and 83 persons who did not have it during their stay at a hospital. Patients with infiltrative pulmonary tuberculosis, and young and middle-aged men were prevalent in both groups. It was found that ARVI promoted the aggravation of a specific process in the lungs in 19.1 per cent of the patients. Keeping in mind a large proportion of aggravations and low immunologic indices as a consequence of ARVI, 14 patients were put on kemantan. Study of the immune status of the patients who had ARVI and received kemantan demonstrated a significant increase in the formation of blasts and the concentration of T cells whose functional activity tended to rise. At the same time the above-mentioned indices remained intact or tended to drop in patients receiving no kemantan. The Soviet immunomodulator kemantan is recommended for a combined treatment of the pulmonary tuberculosis patients who had intercurrent viral infection to stimulate cellular immune defences and prevent an aggravation of the specific process.

[Effectiveness of antitubercular chemotherapy combined with corticosteroids and immunomodulators]. / Effektivnost' protivotuberkuleznoi khimioterapii v sochetanii s kortikosteroidami i immunomoduliatorami.

One hundred forty eight patients with common forms of pulmonary tuberculosis in an outbreak phase and the presence of secondary immunodeficiency were observed. Caverns were found in 80.4% and bacterial excretion, in 87.16% of the cases. Group 1 (71 persons) received chemotherapeutic drugs only; group 2 (21 persons), chemotherapeutic drugs and T-activin; group 3 (33 persons), chemotherapeutic drugs and corticosteroids; and group 4 (23 persons), chemotherapeutic drugs, corticosteroids and T-activin. The bacterial excretion in all the groups was found to be the same. The regression of infiltrative changes in the lungs by the 6-th month of treatment was more significantly registered in the groups of patients on a regimen containing chemotherapeutic drugs, corticosteroids and T-activin. Cavern closure rate appeared to be the lowest in subjects receiving chemotherapeutic drugs and corticosteroids; the addition of T-activin increases the cavern closure index. The combination of chemotherapeutic drugs, corticosteroids and T-activin promotes the normalization of the cellular immunity and increases the efficacy of pulmonary tuberculosis treatment.

[Use of T-activin in patients with sarcoidosis]. / Primenenie taktivina u bol'nykh sarkoidozom.

In sarcoidosis patients, comparison of the outcomes of treatment with corticosteroids alone (n = 142) or in combination with T-activin (n = 20) showed a marked positive effect of T-activin on the improvement of the patients' immunologic status and pronounced regression of changes in the lungs and intrathoracic lymph nodes. Indications for T-activin administration were defined and its treatment regimen was suggested.

La aplicación combinada de las drogas inmunotropicas en el tratamiento de los pacientes con tuberculosis pulmonar

A fin de evaluar la actividad terapéutica combinada de drogas antituberculosas, glucocorticoides y activa T, fue administrada dicha combinación a 53 tuberculosis pulmonares graves, tomando como grupo control a 17 pacientes con igual forma clínica. Se correlacionaron los criterios clínicos y radiológicos de tuberculosis con los índices de células T formadoras de roseras, la transformación blástica de linfocitos T con PHA y la relación R " helper" T "supressor". La administración adicional de activina T marca una tendencia hacia el aumento en la proporción de enfermos con negativización bacteriológica y cierre de las cavernas, lo cual la hace recomendable en el tratamiento combinado de drogas antituberculosas y glucocorticoides para disminuir el efecto inmunosupresor de estos últimos. La asociación de activina T al tratamiento, refuerza la eficacia del mismo en los pacientes con tuberculosis pulmonar grave