Disturbances of the antioxidant system in patients with pulmonary drug susceptible and multidrug-resistant tuberculosis

Abstract

Introduction. The Biomarkers of thiol-disulfide metabolism (TDM) reflect the deficiencies of the antioxidant system (AOS) and the protective mechanisms against the oxidative stress (OS), which is a contributing factor in the development of multidrug-resistant tuberculosis (TB-MDR). Purpose. To assess the disturbances of the acitvity of the TDM enzymeas in the peripheral blood serum (PBS) of the patients with pulmonary drug susceptible and MDR-TB. Material and methods. Indicators of the TDM: the level of total glutathione (tGSH), reduced glutathione (rGSH), oxidized glutathione (GSSG), rate rGSH/GSSG, activity of glutathione enzymes: glutathione-reductase (GR), glutathione-peroxidase (GPO), glutathion-S-transferase (GST), - glutamyl transpeptidase (-GTP) in 36 healthy individuals (control group-CG), 54 new cases with susceptible TB (1st study group-1st SG) and 56 new cases with MDR-TB (2nd study group-2nd SG). Results. Indices of TDM: level of tGSH was statistically lower in both SG (1st SG and 2nd SG) compared with SG, lower in 1st SG (80%) and 2nd SG (85%); rGSH was moderatly lower in both SGs. Concentration of GSSG was statistically diminished in SGs, lower in 1stSG (30%) vs 2ndSG (25%). The rate rGSH/GSSG was higher in 1stSG (1,19) vs 2ndSG (1,15). GST activity was decreased in 1stSG (33%) and increased in 2ndSG (30%). GR was moderatly increased in both SGs. GPO was statistically increased in 1stSG (20%) and slightly increased in 2ndSG. -GTP was increased, with superior level in 2ndSG (83%) vs 1stSG (47%). Conclusion. In susceptible TB and MDR-TB were established important deficiencies of the TDM, which permit development of programms for precocious diagnosis, prevention of complications and improvement of applied treatment.