Pathogenetic diversity of the immune disturbances in patients with pulmonary drug susceptible and drug resistant tuberculosis

Abstract

Introduction. The immune response to M. tuberculosis infection consists mainly in the activation of the cell-mediated immune response (CIR). Natural resistance (NR) and humoral immunity (HI) contribute to a long-lasting immune resistance to reinfection and reactivation of latent infection. Purpose. Assessment of the pathogenetic diversity of immune disorders (ID) in serum in patients with pulmonary susceptible tuberculosis (S-TB) and MDR-TB. Material and methods. Indicators of CIR (CD3+), NR (phagocytic number), and HI (CD19 +) were determined in 36 healthy individuals (control group-CG), 57 new cases with S-TB (study group 1-SG1) and 72 new cases of MDR-TB (study group 2-SG2). The average was reported to the CG which was the reference value, %. Range 1-33% of the reference value in CG considered the 1st degree of ID, 34-66% - the 2nd degree ID, >66% -the 3rd degree ID, as positiveimmune overactivity (IOA) and negative-immune deficiency (ID). Results. Indices of CIR showed in the SG1 the cell-mediated immune defficiencies (CID) in 23 (41%) cases all of the 1st degree ID, in the SG2- CID of the 1st degree was in 60 (82%) and of 2nd degree CID - in 10 (18%) of cases. In the SG1 the CID was established in 32 (91%) and HI deficiencies (HID) in 3 (9%). In the SG2 the CID was in 26 (90%), HID in 6 (10%) and NR deficiencies (NRD) in 8(23%) of cases. SG1 the 1st degree IOA was detected in 26(43%), 2nd degree 11(31%) and 3rd degree 9 (26%) cases. In SG2 the 1st degree IOA was established in 10 (16%), 2 nd degree in 22 (36%) and 3 rd degree in 29 (53%) of cases. Conclusion. The deficiencies of the CIR were more frequently, established in patients with MDR-TB, associated with a higher rate of NRD and HID and a higher degree of IOA.