Changes the level of the acute phase proteins during the treatment of patients with pulmonary tuberculosis combined with diabetes mellitus

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Aim. The study of the dynamics of acute phase proteins in the process of complex treatment of patients with tuberculosis, combined with different types of diabetes mellitus, before and during treatment. Materials and methods. We studied 100 patients with pulmonary tuberculosis, which were divided into 2 groups. The first group included 40 patients with pulmonary tuberculosis in combined with type 1 diabetes. The second group consisted of 60 patients with pulmonary tuberculosis in combined with type 2 diabetes. The levels of C-reactive protein, serum amyloid protein A, a1-antitrypsin (a1-АТ), haptoglobin and fibrinogen were determined. Studies were performed prior to and on a monthly basis during the first 6 months of complex treatment. Results. By the end of the 6-month effective treatment, the level of most phase proteins (APPs) in patients with both types of diabetes returned to normal, but a moderate increase in a1-AT remained, indicating that the inflammatory process was incomplete and, possibly, due to activation of limited proteolysis reactions during reparative processes. At the same time, individual indicators changed in patients with different types of diabetes at different rates. Normalization of most acute-phase reactants during effective treatment in patients with type 2 diabetes was slower. The different rates of reduction and normalization of individual APPs in patients with different types of diabetes, apparently, was associated with the peculiarities of the deflation of their protective reactions of the body as they overcome the infectious aggression and resorption of the inflammatory substrate. With ineffective treatment, the positive dynamics of C-reactive protein and serum amyloid protein A was slow and incomplete, and the initially high values of a1-AT and haptoglobin did not change throughout the duration of treatment. Conclusions. It was found that in patients with combined pathology, the dynamics of changes in the levels of the acute APPs was directly related to its effecacy.

About the authors

Rizvan Yu. Abdullaev

Central Research Institute of Tuberculosis

Email: rizvan0403@yandex.ru
D. Sci. (Med.), Prof Moscow, Russia

Oksana G. Komissarova

Pirogov Russian National Research Medical University

Email: oksana.komissarova.72@mail.ru
д-р мед. наук, зам. дир. по научной и лечебной работе, проф. каф. фтизиатрии лечебного фак-та Moscow, Russia

Olga O. Berezhnaia

Pirogov Russian National Research Medical University

Email: olga.berejnaya12@gmail.com
Central Research Institute of Tuberculosis, Assistant Moscow, Russia

Vladimir V. Romanov

Central Research Institute of Tuberculosis

D. Sci. (Med.), Prof. Moscow, Russia

References

  1. Дедов И.И., Шестакова М.В., Викулова О.К. и др. Сахарный диабет в Российской Федерации: распространенность, заболеваемость, смертность, параметры углеводного обмена и структура сахароснижающей терапии по данным Федерального регистра сахарного диабета, статус 2017 г. Сахарный диабет. 2018; 21 (3): 144-59. @@Dedov I.I., Shestakova M.V., Vikulova O.K. et al. Sakharnyi diabet v Rossiiskoi Federatsii: rasprostranennost', zabolevaemost', smertnost', parametry uglevodnogo obmena i struktura sakharosnizhaiushchei terapii po dannym Federal'nogo registra sakharnogo diabeta, status 2017 g. Sakharnyi diabet. 2018; 21 (3): 144-59 (in Russian)
  2. Комиссарова О.Г., Абдуллаев Р.Ю., Михайловский А.М. Сахарный диабет как фактор риска развития туберкулеза: патофизиологические аспекты. Медицинский альянс. 2017; 3: 28-34.@@Komissarova O.G., Abdullaev R.Iu., Mikhailovskii A.M. Sakharnyi diabet kak faktor riska razvitiia tuberkuleza: patofiziologicheskie aspekty. Meditsinskii al'ians. 2017; 3: 28-34 (in Russian).
  3. Jeon C.Y, Murray M.B. Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS Med 2008; 5 (7): p.e152.
  4. Ronacher K, van Crevel R, Critchley J.A et al. Defining a Research Agenda to Address the Converging Epidemics of Tuberculosis and Diabetes: Part 2: Underlying Biologic Mechanisms. Chest 2017; 152 (1): 174-80.
  5. Комиссарова О.Г., Абдуллаев Р.Ю., Коняева О.О., Михайловский А.М. Распространенность, клинические проявления и эффективность лечения туберкулеза у больных сахарным диабетом. Врач. 2017; 2: 24-8. @@Komissarova O.G., Abdullaev R.Iu., Koniaeva O.O., Mikhailovskii A.M. Rasprostranennost', klinicheskie proiavleniia i effektivnost' lecheniia tuberkuleza u bol'nykh sakharnym diabetom. Vrach. 2017; 2: 24-8 (in Russian).
  6. Смурова Т.Ф., Ковалева С.И. Туберкулез и сахарный диабет. М.: Медкнига, 2007. @@Smurova T.F., Kovaleva S.I. Tuberculosis and diabetes. Moscow: Medkniga, 2007 (in Russian).]
  7. Critchley J.A, Restrepo B.I, Ronacher K et al. Defining a Research Agenda to Address the Converging Epidemics of Tuberculosis and Diabetes. Part 1: Epidemiology and Clinical Management. Chest 2017; 152: 165-73.
  8. Каминская Г.О., Абдуллаев Р.Ю. Патофизиологические предпосылки неблагоприятного влияния сахарного диабета на течение туберкулеза легких. Туберкулез и болезни легких. 2014; 3: 5-10. @@Kaminskaia G.O., Abdullaev R.Iu. Patofiziologicheskie predposylki neblagopriiatnogo vliianiia sakharnogo diabeta na techenie tuberkuleza legkikh. Tuberkulez i bolezni legkikh. 2014; 3: 5-10 (in Russian).
  9. IDF Diabetes Atlasт Eighth Edition 2017. IDF [Official website]. http://www.idf.org/diabetesatlas
  10. World Health Organization, Global tuberculosis report 2018.WHO/CDS/TB/2018.20. http://www.who.int
  11. Каминская Г.О., Абдуллаев Р.Ю., Комиссарова О.Г. Состояние белкового обмена как фактор неспецифической реактивности организма больных туберкулезом легких. Туберкулез и болезни легких. 2012; 12: 30-5. @@Kaminskaia G.O., Abdullaev R.Iu., Komissarova O.G. Sostoianie belkovogo obmena kak faktor nespetsificheskoi reaktivnosti organizma bol'nykh tuberkulezom legkikh. Tuberkulez i bolezni legkikh. 2012; 12: 30-5 (in Russian).]
  12. Комиссарова О.Г., Абдуллаев Р.Ю., Лепеха Л.Н., Ерохин В.В. Лекарственно-устойчивый туберкулез легких при различной интенсивности синдрома системного воспалительного ответа. М.: У Никитских ворот, 2013.@@Komissarova O.G., Abdullaev R.Iu., Lepekha L.N., Erokhin V.V. Drug-resistant pulmonary tuberculosis with varying intensity of the systemic inflammatory response syndrome. Moscow: U Nikitskikh vorot, 2013 (in Russian).]
  13. Unsal E, Aksaray S, Koksal D, Sipit T. Potential role of interleukin 6 in reactive thrombocytosis and acute phase response in pulmonary tuberculosis. Postgrad Med 2005; 81: 604-7.
  14. Каминская Г.О., Абдуллаев Р.Ю., Комиссарова О.Г. Особенности синдрома системного воспалительного ответа и нутритивного статуса у больных туберкулезом легких с сопутствующим сахарным диабетом 1-го и 2-го типов. Туберкулез и болезни легких. 2017; 95 (3): 32-40. doi: 10.21292/2075-1230-2017-95-3-32-4 @@Kaminskaia G.O., Abdullaev R.Iu., Komissarova O.G. Osobennosti sindroma sistemnogo vospalitel'nogo otveta i nutritivnogo statusa u bol'nykh tuberkulezom legkikh s soputstvuiushchim sakharnym diabetom 1-go i 2-go tipov. Tuberkulez i bolezni legkikh. 2017; 95 (3): 32-40. doi: 10.21292/2075-1230-2017-95-3-32-4 (in Russian).

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