THE ROLE OF SERUM INTERLEUKINS IN THE DIFFERENTIAL DIAGNOSIS OF BRONCHOOBSTRUCTIVE SYNDROME IN PATIENTS WITH TUBERCULOSIS AND NON-SPECIFIC LUNG DISEASES

Abstract

Abstract. The current problem of pulmonology in modern conditions is the spread of respiratory diseases, which has caused an increase in morbidity, disability and mortality from this pathology. Such diseases include chronic obstructive pulmonary disease (COPD), bronchial asthma (BA), tuberculosis (TB), pneumonia (PN), which at a certain stage of their development have the same symptoms and syndromes, in particular bronchoobstructive syndrome (BOS), which requires verification of the diagnosis. The aim of the work is to study the diagnostic value of serum cytokine profile indicators in patients with uncomplicated tuberculosis and nonspecific lung diseases accompanied by bronchoobstructive syndrome. Materials and methods. The examinations were conducted in 65 patients with pulmonary tuberculosis (TB) with symptoms of bronchoobstructive syndrome (BOS), 64 patients with pneumonia with BOS. The control group consisted of 27 patients with chronic obstructive pulmonary disease (COPD) and 25 patients with bronchial asthma (BA). In patients of the examined groups, the content of pro- and anti-inflammatory interleukins was determined in the blood serum. Results and discussion. The level of pro-inflammatory cytokines IL-1β, IL-6, TNF-α in the blood serum in patients with COPD-induced BOS exceeds those in healthy donors and controls by more than 2.4–5.5 times, while the levels of IL-4 and IL-2 are 2.0 times lower than those in donors. The level of proinflammatory cytokines (IL-4, IL-6) indicates a high probability of an unfavorable course with a probable prolongation of the underlying disease. In case of COPD-induced BOS or asthma, an increase in the content of proinflammatory cytokines in tuberculosis patients may be a prerequisite for more frequent exacerbations of COPD and, as a result, the formation of its complications, and in pneumonia with BOS it is a factor in the aggravated course of asthma and an increase in the volume of treatment. Conclusions. The study of the cytokine profile of blood serum in patients with tuberculosis or nonspecific lung diseases with bronchial obstruction phenomena allowed us to determine their role in assessing the course of the pathological process, choosing optimal treatment methods, and predicting the development of complications.