Possibilities of non-invasive diagnosis of fibrotic phenotype of interstitial lung diseases.

Progressive pulmonary fibrosis is a major problem in respiratory medicine. Currently, there are no reliable biomarkers for early diagnosis of progressive pulmonary fibrosis, which leads to delayed diagnosis. AIM: To determine the role of serum biomarkers CA-19-9 and CA-125 and the possibilities of capillaroscopy of the nail fold in the diagnosis of progressive pulmonary fibrosis. MATERIALS AND METHODS: The study included 43 patients with interstitial changes in the lungs. Based on the presence/absence of signs of progression over the previous 12 months, patients were divided into 2 groups. All patients underwent forced spirometry, body plethysmography, diffusion test, CT, lung ultrasound, capillaroscopy of the nail fold, study of serum concentrations of CA-19-9 and CA-125. RESULTS: In the group of patients with a progressive fibrotic phenotype of Interstitial lung diseases, a greater severity of capillaroscopic changes and a higher level of CA-19-9 were revealed. Correlation of these parameters with changes according to CT scan data (Warrick test) and lung ultrasound was shown. CONCLUSION: The data obtained demonstrate the possibilities of non-invasive diagnosis of progressive fibrosing interstitial lung diseases and require further research and prospective follow-up to assess the diagnostic and prognostic role of the studied biomarkers, as well as to determine their place in clinical practice.

[Effect of surfactant-BL on ventilation and gas exchange function in patients with destructive pulmonary tuberculosis].

The fact that the treatment of pulmonary tuberculosis is a topical problem is beyond question. At present, it is well known that there is dissociation between the time of a negative sputum reaction and later cavernous healing, resolution of inflammatory changes. Therefore, search for new possibilities of pathogenetic action on the course of a tuberculous process, healing of destructive changes, and the maximum recovery of functional disorders are one of the ways of enhancing the efficiency of treatment in patients with destructive pulmonary tuberculosis. Over 70 years' history of the discovery and studies of the pulmonary surfactant system has made it possible to formulate a current concept of surfactant as a multicomponent system of cellular and non-cellular elements that ensure the antiatelectatic, antiedematous, protective, and other functions of the lung. The effects of surfactant preparations as an agent of pathogenetic therapy are being investigated at the Central Research Institute of Tuberculosis, Russian Academy of Medical Sciences. The present paper presents the results of changes in external respiratory function and gas exchange before and after surfactant therapy in 64 patients with established drug-resistant infiltrative pulmonary tuberculosis. Along with the performed antituberculous therapy, the natural agent Surfactant-BL made in Russia was used by taking into account individual sensitivity. The agent was inhalationally administered in a daily dose of 25 mg by the schedule for 8 weeks.

[Lung dysfunction in patients with mild chronic obstructive bronchitis]. / Nuarusheniia funktsii legkikh u bol'nykh s legkim techeniem khronicheskogo obstruktivnogo bronkhita.

VC, FVC, FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75, TCL, TGV, RV, Ravt, Riin, Rex, DLCO-SS, PaO2, and PaO2 were determined in 33 patients with mild chronic obstructive lung disease (FEV1 > 70% of the normal value). All the patients were found to have impaired bronchial patency; most (63.6%) patients had lung volume and capacity changes, almost half (45.5%) the patients had pulmonary gas exchange dysfunction. Impaired bronchial patency mainly appeared as decreased MEF50, MEF15, and FEV1/VC%; altered lung volumes and capacities manifested chiefly by increased RV and decreased VC; pulmonary gas exchange dysfunction showed up primarily as lowered PaO2. The magnitude of the observed functional changes was generally slight. MEF50, MEF75, FEV1/VC%, and VC dropped to 59-20 and 79-70% of the normal value, respectively. RV increased up to 142-196% of the normal value; PaO2 reduced up to 79-60% mm Hg.