Biochemical markers assessing rate of reparative processes in patients with infiltrative pulmonary tuberculosis

• Published in: Infekt͡s︡ii͡a︡ i immunitet Vol. 13; no. 5; pp. 931 - 938
• Main Authors: Esmedlyaeva, Dilyara S., Alekseeva, Nina P., Dyakova, Marina E.
• Format: Journal Article
• Language: English
• Published: Sankt-Peterburg : NIIÈM imeni Pastera 30-11-2023
• Subjects: biomarkers; matrix metalloproteinases; neutrophil elastase; repair; tissue inhibitors of matrix metalloproteinases; tuberculosis
• DOI: 10.15789/2220-7619-BMA-8034
• EISSN: 2313-7398
• ISSN: 2220-7619

Theeffectiveness of chemotherapy for infiltrative pulmonary tuberculosis (ITL) is determined by proper timing and adequacy of treatment. The speed of reparative changes in the pulmonary parenchyma is associated with the effectiveness of therapy. Different classes of proteinases are involved in extracellular matrix remodeling. The aim of the study was to evaluate a potential of using the markers of proteinase/inhibitors axis for predicting effectiveness of therapy in patients with ITL due to varying resistance ofMycobacterium tuberculosisto anti-tuberculosis drugs (PTP).Materials and methods.A retrospective study included 60 and 55 ITL patients with the drug sensitive (DS) and drug resistance (DR) Mtb strains, respectively. Patients were divided into two groups according to therapy effectiveness. The levels of blood serum matrix metalloproteinase MMP-1, MMP-3, MMP-8, MMP-9 and their TIMP-1 inhibitor, neutrophil elastase (NE), alpha-2 macroplobulin (MG) and proteinase inhibitor (PI) were determined. Statistica 10.0 and R software packages were used.Results. According to the model of discriminant analysis, the pattern of host inflammatory response in ITL was accounted for not only by varying pathogen resistance, but also by the different size of lung damage. Patients with a limited and widespread process with the DS of the pathogen strains were assigned to group I and II, and DR — to group III and IV group, respectively. The decisive in the speed of tissue repair was the number of neutrophils bearing various levels of proteinase MMP-8, MMP-9 (I group) or TIMP-1 and PI inhibitors (II group). Only combining biochemical data with the those on radiation methods are possible for prognosis in a group of patients with DR (III and IV).Conclusions.Combinations of the markers of the proteinase/inhibitors axis are informative in assessing a rate of reparative changes in ITL and differ not only depending on the pathogen DS strains, but also from the size of destructed pulmonary parenchyma. Differences in parameter combinations are accounted for by history of a specific disease.