Treatment of cavitary and infiltrating pulmonary tuberculosis with and without the immunomodulator Dzherelo.

An open-label, 60-day trial was conducted in 75 newly diagnosed tuberculosis (TB) patients to assess the adjunctive effect of the oral immunomodulator Dzherelo with standard anti-TB chemotherapy (ATT) consisting of izoniazid, rifampicin, pyrazinamide and streptomycin (HRZS) administered as directly observed therapy (DOT). Group 1 (n = 28) with cavitary TB and group 2 (n = 17) with infiltrating pulmonary TB received 50 drops of Dzherelo twice daily in addition to HRZS. Group 3 (n = 30), which served as a control, received ATT only. Liver damage indicators, bilirubin, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) decreased to normal levels in groups 1 and 2, but increased significantly in group 3. Kidney failure markers, urea and creatinine, normalized in Dzherelo recipients, but were unchanged or worsened in the ATT-only group. The changes in serum lactate dehydrogenase, catalase, malondialdehyde and diene conjugates suggested that Dzherelo downregulates TB-associated inflammation. The anti-inflammatory property of Dzherelo was further supported by a favourable haematology profile, reduced erythrocyte sedimentation rate and faster defervescence. Radiological recovery was significant in both Dzherelo groups, but not in the control group (p = 0.0085, p = 0.025 and p = 0.23, respectively). These findings correlated positively with sputum smear conversion and clinical findings (r = 0.94; p < 0.05). Mycobacterial clearance at day 30 was observed in 77%, 72% and 40% of patients in groups 1, 2 and 3, respectively. After 2 months sputum conversion rates in groups 1, 2 and 3 were 93%, 89% and 70%, respectively. Sixty-day treatment outcomes in groups 1, 2 and 3 as assessed by improvement in clinical features and respiratory function attained respective p-values of 0.008, 0.25 and 0.72, and 0.013, 0.48 and 0.0015. Dzherelo is thus useful as an immunotherapeutic adjunct in the management of TB.

[The reactivation of pulmonary tuberculosis after effective chemotherapy using rifampicin]. / Reaktivatsiia tuberkuleza legkikh posle éffektivnoi khimioterapii s primeneniem rifampitsina.

The authors present an analysis of dynamic five-year follow-up of 141 patients with freshly detected destructive pulmonary tuberculosis that received treatment with isoniaside and rifampicin in combination with other drugs. It was found that reactivation of pulmonary tuberculosis with the use of rifampicin is observed in 11 +/- 5% of patients and is accompanied by phenomena of not infrequently marked intoxication and chest symptoms and complaints. The importance of timing the main course of chemotherapy (not less than 12 months) and regular prophylactic autumn-spring course of treatment in the prophylaxis of reactivations of pulmonary tuberculosis.

[Interactions of male sex, thyrotropic and chorionic gonadotropic hormones in ontogenesis]. / O vzaimodeistvii muzhskogo polovogo, tireotropnogo i khorionicheskogo gonadotropnogo gormonov v ontogeneze.

The influence of thyrotropin and chorionic gonadotropin on the testicles and of testosterone and its 5 alpha-reduced metabolites upon the thyroid was studied in ontogenesis of rats and rabbits. It was determined that thyrotropin and gonadotropin stimulate the testicle development, exhibiting different effects on their structures. Thyrotropin has a direct action upon the testicles and does not affect the thyroid, that was proved by thyroidectomy. This effect is manifested already in the prenatal period of the development. Testosterone and its metabolites exert a direct action on thyroid function, their effects on the organ being different.

[Effect of the male sex hormone and its 5 alpha-reduced metabolites on the function of the thyroid in vivo and in vitro]. / Vliianie muzhskogo polovogo gormona i ego 5 alpha-vosstanovlennykh metabolitov na funktsional'noe sostoianie shchitovidnoi zhelezy in vivo i in vitro.

The administration of testosterone propionate, dihydrotestosterone and androstandiol to male rats was followed by different changes in thyroid function. Testosterone propionate exerted a stimulating effect, whereas its metabolites induced marked depression of thyroid functional activity in the experiments in vivo. In vitro both sex hormones and 5-alpha-reduced metabolites inhibited radioactive iodine absorption by rat thyroid slices and human thyrotoxic struma. The data demonstrate that testosterone may produce a direct effect on the thyroid without the hypophysis.

[Effect of testosterone and its 5-alpha-reduced metabolites on thyroid function and protein synthesis]. / Vliianie testosterona i ego 5-al'fa-vosstanovlennykh metabolitov na funktsional'noe sostoianie shchitovidnoi zhelezy i sintez belka.

Experiments on male rats were made to study and compare the effect of testosterone, 5 alpha-dihydrotestosterone and 5 alpha-androstane-3 beta, 17 beta-diol on thyroid function and proliferation of thyroid parenchyma, as well as on protein synthesis by it. Administration of testosterone and androstanediol slightly increased intrathyroid hormonogenesis, while dihydrotestosterone reduced it. At the same time testosterone and, to a greater extent, its 5 alpha-reduced metabolites decreased the weight of the thyroid gland. This decrease and suppression of thyroid parenchyma proliferation under the effect of the compounds in question is accounted for by the inhibitory effect produced by all the test androgens on protein synthesis by thyrocytes.