New laboratory criteria of the autoimmune inflammation in pulmonary sarcoidosis and tuberculosis.

Sarcoidosis and tuberculosis have many clinical and laboratory similarities, which allowed researchers to assume the presence of common pathogenetic mechanisms in the development of both diseases. Recently, much attention has been paid to investigate the autoimmune origins in these pathologies. The aim of this study is to find out the characteristics of the autoinflammatory immune response in sarcoidosis and tuberculosis. In patients with sarcoidosis (n = 93), tuberculosis (n = 28), and in healthy donors (n = 40), the serum anti-MCV concentration was measured by ELISA, and B cell subpopulations were analyzed by flow cytometry. Based on the results obtained, the formula ([B-naïve%]\[B-memory%]) * ([B-CD38%] + [B-CD5%]) / [anti-MCV] was described. The increase in the calculated index by more than 5 units with a sensitivity of 80.00% and a specificity of 93.10% (AUC = 0.926) suggest the presence of the autoimmune component, which is more typical for sarcoidosis, rather than tuberculosis patients and may serve as a diagnostic criterion.

[Preclinical and clinical trials of the new tuberculosis drug perchlozon].

The paper sets forth the stages of design and introduction of the new Russian tuberculosis (TB) drug perchlozon registered in the Russian Federation in 2012. Based on the results of Phases I-III clinical trials, the authors evaluate the efficacy and safety of the agent and consider the adverse effects of its treatment for respiratory TB. The use of perchlozon as a component of combination therapy versus standard chemotherapy regimens significantly reduces abacillation time in pulmonary TB caused by its drug-resistant pathogen. In terms of the higher prevalence of TB induced by its pathogen resistant to many drugs (with multiple and broad-spectrum drug resistance), perchlozon is an essential drug that has antituberculous activity mainly against multidrug-resistant Mycobacterium tuberculosis strains and gives patients with the severest and epidemiologically poor form of TB the chance to recover.

Tuberculosis and autoimmunity: Common features.

Despite the proven infectious nature of tuberculosis, new data have recently appeared on the autoimmune component in the course of tuberculosis infection. This chapter discusses the currently known signs of autoimmune inflammation in tuberculosis infection, including both clinical and immunological manifestations. Taking into account the available data on the possible triggering effect of M. tuberculosis on the development of the autoimmune process, the correction of these autoimmune complications may be a key moment in prescribing therapy and in predicting the low efficacy of the treatment of the disease.

Diagnostics and management of tuberculosis and COVID-19 in a patient with pneumothorax (clinical case).

The spread of COVID-19 in countries with high and medium incidence of tuberculosis has led to an increased risk of COVID-19 and tuberculosis co-infection, introducing new diagnostic and therapeutic challenges for the clinician. Hereby we describe a first case where tuberculosis and COVID-19 were diagnosed concomitantly in a Russian patient with pneumothorax. We discuss the challenges associated with the diagnosis and treatment of tuberculosis during the COVID-19 pandemic.

Imbalance in B cell and T Follicular Helper Cell Subsets in Pulmonary Sarcoidosis.

Sarcoidosis is a systemic granulomatous disease that develops due to the Th1, Th17 and Treg lymphocytes disturbance. There is an assumption, that B cells and follicular T-helper (Tfh) cells may play an important role in this disorder, as well as in several other autoimmune diseases. The aim of this study was to determine CD19+ B cells subset distribution in the peripheral blood and to define disturbance in the circulating Tfh cells subsets in patients with sarcoidosis. The prospective comparative study was performed in 2016-2018, where peripheral blood B cell subsets and circulating Tfh cell subsets were analyzed in 37 patients with primarily diagnosed sarcoidosis and 35 healthy donors using multicolor flow cytometry. In the results of our study we found the altered distribution of peripheral B cell subsets with a predominance of "naïve" (IgD + CD27-) and activated B cell (Bm2 and Bm2') subsets and a decreased frequency of memory cell (IgD+ CD27+ and IgD- CD27+) in peripheral blood of sarcoidosis patients was demonstrated. Moreover, we found that in sarcoidosis patients there are increased levels of B cell subsets, which were previously shown to display regulatory capacities (CD24+++ CD38+++ and CD5 + CD27-). Next, a significantly higher proportion of CXCR5-expressing CD45RA - CCR7+ Th cells in patients with sarcoidosis in comparison to the healthy controls was revealed, that represents the expansion of this memory Th cell subset in the disease. This is the first study to demonstrate the association between the development of sarcoidosis and imbalance of circulating Tfh cells, especially CCR4- and CXCR3-expressing Tfh subsets. Finally, based on our data we can assume that B cells and Tfh2- and Tfh17-like cells - most effective cell type in supporting B-cell activity, particularly in antibody production - may be involved in the occurrence and development of sarcoidosis and in several other autoimmune conditions. Therefore, we can consider these results as a new evidence of the autoimmune mechanisms in the sarcoidosis development.

[Optimization of chemotherapy regimens in children with primary pulmonary tuberculosis].

The efficiency of treatment was analyzed in 142 children aged 3-14 years who had local forms of primary pulmonary tuberculosis. Therapy was performed according to regimens 3 and 1, by using individual dosage regimens depending on the extent and severity of a specific process, the presence of complications, and age-related features. In minor tuberculosis, solitary calcifications being detected without signs of the activity of tuberculous infection, the basic course of therapy was 6-8 months; it was performed using 2 drugs in individual cases. In disseminated and complicated processes, eliminated intoxication and visible X-ray inflammatory changes were observed in 58.8-61.7% of children by months 3-4 of treatment, which required a longer intensive phase, by administering 3 drugs in the continuation phase till 6-9 months.

[Approach to diagnosing tuberculosis of intrathoracic lymph nodes of a paraaortic group in children].

A hundred and seventeen patients aged 3 to 14 years, with suspected tuberculosis of intrathoracic lymph nodes (ILN) of a paraaortic group in the phase of calcination, were examined at the Clinic of Childhood Pulmonary Tuberculosis, Saint Petersburg Research Institute of Phthisiology. The comprehensive examination made the diagnosis of tuberculosis be cancelled in 35% of cases and confirmed in 65%, by determining the phase and extent of a specific inflammation. In 8.5% the local manifestations of the disease were absent along with the significant symptoms of intoxication and with the activity of tuberculous infection, which gave grounds to establish the diagnosis of tuberculous intoxication. Despite the fact that computed tomography revealed aortic ligament calcification, enlarged mediastinal lymph nodes were detected in 35%. High tuberculous infection activity and mediastinal ILN lesion in different phases of the specific inflammation were found in 15.4%, which was indicative of the chronic course of inflammation. The first detected isolated calcification in the paraaortic group of lymph nodes was diagnosed in 5.9%. The use of the presented complex, the diagnostic efficiency of which was 98%, significantly enhanced the diagnosis and reduced the number of errors in making the diagnosis.

[The pathomorphism and diagnosis of tuberculosis of intrathoracic lymph nodes in children]. / Patomorfoz i diagnostika tuberkuleza vnutrigrudnykh limfaticheskikh uzlov u detei.

In the past decade, the leading form of specific lesion in children is tuberculosis of intrathoracic lymph nodes, whose proportion in the pattern of clinical forms is as high as 85.7%. The period of 1990 to 2002 showed a 3-fold increase in the detection of bilateral lesion involving more than 3 groups of lymph nodes; the specific processes were complicated by 3.5 times more frequently. The proportion of generalized forms of primary tuberculosis increased from 5 to 15%. Inclusion of mediastinal computed tomography into a package of studies significantly evaluates the magnitude of enlargement of lymph nodes. The polymerase chain reaction test for MBT DNA in the diagnosis of tuberculosis of intrathoracic lymph nodes in the absence of bacterial isolation yields a positive result in 73.3% of the children, which is an additional tool in the comprehensive study, which verifies the activity of a tuberculous process.

[Experimental study of the anti-arrhythmia action of unithiol]. / Izuchenie antiaritmicheskogo deistviia unitiola v éksperimente

Tests conducted on 70 rabbits showed that cardiac rhythm disorders produced by introduction of a 10% calcium chloride solution was prevented by the administration of unithiol. With developing arrhythmia in the muscle of the rabbits' heart the level of sulfhydryl groups went down. The introduction of unithiol was followed by a rising content of sulfhydryl groups, especially in the myocardium of the left ventricle.