Selected factors of the innate immunity in Polish patients suffering from pulmonary tuberculosis.

We conducted a prospective study of 453 Polish patients suffering from pulmonary tuberculosis and 267 healthy controls. Selected polymorphisms of the genes encoding for collectins, ficolins and MBL-associated serine protease 2 were investigated as were serum concentrations of mannose-binding lectin, surfactant protein D, ficolin-1 and ficolin-3. The number of MBL2 gene exon 1 variant allele carriers was significantly higher in patients, compared with controls. The homozygosity for SFTPA2 +26 C > A SNP variant allele occurred less commonly within TB, while homozygosity for the FCN1 -542 G > A major allele was less frequent within the control group. Two patients were found MASP-2-deficient. Serum concentrations of MBL, SP-D and ficolin-1 were higher amongst patients while the converse was found for ficolin-3. Ficolin-1 had high specificity to differentiate between individuals with tuberculosis and healthy persons and therefore may be considered potential disease marker.

Socio-economic status and the duration of pulmonary tuberculosis symptoms in women treated at the Mazovian Treatment Centre of Tuberculosis and Lung Diseases in Otwock.

INTRODUCTION: The prevalence of tuberculosis depends on various factors such as migration, homelessness, malnutrition, unemployment, bad life conditions and the aging of a society. The aim of this study was to evaluate tuberculosis in females treated at the Mazovian Treatment Centre of Tuberculosis and Lung Diseases (Mazowieckie Centrum Leczenia Chorób Pluc i Gruzlicy) in Otwock, regarding the context of demographic, social and professional status of female patients. The duration of the illness and the extent of radiographic changes were also taken into consideration. MATERIAL AND METHODS: The study was carried out retrospectively. The medical documentation that was evaluated concerned 100 women, aged between 20 and 92, hospitalized at the Mazovian Treatment Centre of Tuberculosis and Lung Diseases in Otwock in the years 2005 and 2006 due to bacteriologically confirmed tuberculosis. RESULTS: Most women with tuberculosis lived in cities (65%), 32% of the evaluated patients lived in villages and 3% were homeless. 1/3 of females were under 40 years of age, and 1/3 were over 60 years of age. Only 29% of the women were professionally active and 25% were unemployed. 60% of women were not married. 35% of women with tuberculosis were bringing up children and 7% had abandoned their offspring. More than 1/3 of women had had tuberculosis symptoms for more than half a year before tuberculosis was diagnosed. 40% of women with tuberculosis had small radiological changes (1 to 2 lung fields); however, 26% of them had extensive changes covering 4 to 6 lung fields. CONCLUSIONS: The majority of women with tuberculosis in the Mazovian district are single, over 40 years old, unemployed inhabitants of cities. 30% of women in the study group had had symptoms for more than 6 months before tuberculosis was diagnosed. 40% of women with tuberculosis had very extensive radiological changes covering 4 to 6 lung fields.

Correlation of N-acetyltransferase 2 genotype with isoniazid acetylation in Polish tuberculosis patients.

UNLABELLED: Isoniazid (INH), a key agent in the treatment of tuberculosis (TB), is metabolized primarily by the genetically polymorphic N-acetyltransferase 2 (NAT2) enzyme. Patients treated with INH can be classified as fast, intermediate, and slow acetylators. The objective of this study was to explore the relationship between NAT2 genotypes and the serum concentrations of INH. Blood samples from 130 patients were taken for the analysis, and plasma INH concentrations were determined by using the high-performance liquid chromatography (HPLC) technology. Acetylation genotype was determined on genomic DNA by using an allele-specific polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. Once the NAT2 genotypes were established, patients were classified into three categories: fast, intermediate, and slow acetylators. Of the 130 patients studied, 84 (64.6%) were slow, 39 (30%) were intermediate, and 7 (5.4%) were fast acetylators. Analysis of INH concentrations in the blood of patients receiving the approximate doses of the drug revealed that, at the time intervals examined, the average concentration of INH was 2- to 7-fold higher among slow acetylators compared to fast and intermediate acetylators. CONCLUSION: Determining mutations in the NAT2 gene enabled the identification of the INH acetylation type in patients and the genotyping results were consistent with the phenotype determined by methods of measurement of drug bioavailability.

[Socio-economic status and duration of TB symptoms in males treated at the Mazovian Treatment Centre of Tuberculosis and Lung Diseases in Otwock]. / Status spoleczno-ekonomiczny i czas trwania objawów u mezczyzn chorych na gruzlice leczonych w Mazowieckim Centrum Leczenia Chorób Pluc i Gruzlicy w Otwocku.

INTRODUCTION: The incidence of tuberculosis depends on many factors, not only on health issues but also on socioeconomic factors. The aim of this study was to assess the duration of symptoms and the extent of radiological changes in men with bacteriologically confirmed pulmonary tuberculosis in relation to their socioeconomic status. MATERIAL AND METHODS: This was a retrospective study based on the analysis of 300 hospital records of patients hospitalised in 2004-2006 in the male ward of the Mazovian Treatment Centre of Lung Diseases and Tuberculosis in Otwock. In all patients, the diagnosis of tuberculosis was bacteriologically confirmed. We evaluated the duration of symptoms prior to hospitalisation, the extent of radiological changes and socioeconomic status. We also took into account the place of residence, professional activity, age and marital status. RESULTS: Among patients with TB hospitalised in the Mazovia Region, 74% were professionally inactive persons and 57% were unemployed. Patients population in cities and villages were similar, but as much as 10% of the patients hospitalised who were actively spreading bacilli in Mazovia Region were homeless. In the study group, 60% of the men were unmarried. In 63% of the patients symptoms of tuberculosis were present for more than two months. Chronic symptoms were reported more often in the unemployed (60%) and in single patients. As much as 81% of the patients at the initiation of treatment, had extensive radiological changes in 3 or more lung fields. Quite often sweeping pulmonary changes were observed in the homeless, unemployed and pensioners. Sputum smear-positive tuberculosis, was demonstrated in 87% of the examined patients. CONCLUSIONS: The incidence of tuberculosis observed in the Mazovia Region was especially observed in the unemployed, disabled and pensioners. Among these patients, many were homeless. The majority of patients in Mazovia Region at the start of treatment already had very extensive radiological changes and the symptoms were present with them for several weeks.

[Spleen and medullary tuberculosis]. / Gruzlica sledziony i szpiku.

Spleen is a rare extra-pulmonary tuberculosis manifestation. The spleen tuberculosis is caused by the blood derivative dissemination of mycobacteria. The symptoms can suggest a hematological disease, but it is difficult to make a diagnosis, especially when there are no pulmonary changes. The case of a 27-year-old woman with unclear etiology bone marrow hypoplasia was presented. The patient experienced: fever, body weight loss, pancytopenia and spleen enlargement with numerous focal echographic changes. The splenectomy revealed in a histopathologic examination productiva caseosa tuberculosis. The bone marrow trepanobiopsy revealed as well tuberculosis changes. The antimycobacteria treatment caused an improvement of the clinical state and the regression of symptoms.