UDC: 616.24-002.5:615.015.8]-085.281-078.73-092-036

Immunological methods are important for diagnosing tuberculosis, evaluating the process activity, and forecasting the course of the disease and recovery. 
Materials and methods. 47 patients with first diagnosed destructive sputum smear-positive pulmonary tuberculosis underwent a complex immunoassay. The patients were divided into two groups based on the sensitivity/resistance of mycobacterium tuberculosis to antimycobacterial agents. The first group consisted of 22 patients with first-diagnosed chemosensitive tuberculosis with preserved sensitivity to antimycobacterial agents. The second group consisted of 25 patients with multi-drug resistant tuberculosis pulmonary tuberculosis (MDR-TBP). 
The research was conducted during the 2018-2021 years. Results Specific cell response disorders in patients with pulmonary tuberculosis are associated with the multistructural T-cell protection misbalance caused by the quantitative changes of its components, the increase/decrease in the quantity of certain lymphocyte pools specifying the immune response vector. In cases of tuberculosis, phagocytosis plays an important role. Phagocytosis might release cells from the tuberculosis pathogen. To achieve this, the activation of cells should reach a certain level. However, the initial protective nature of cell activation might become aggressive. The T-cell immunity disorders were more evident in patients with MDR-TBP versus donors and patients with chemosensitive tuberculosis. The apparent decrease in СD3+СD56+, СD3+СD4+ pools and the increase in СD3+СD8+ were revealed in cases of MDR-TBP tuberculosis versus chemosensitive tuberculosis. The difference in СD3+СD4+, СD3+СD8+, СD3+СD4+/СD3+СD8+, CD3+СD8+HLA-DR+, СD16/56+8+ between the study and observational groups was statistically confirmed. The evident specific cell immunity disorders in patients with MDR-TBP aggravate the clinical course of the disease, causing destructive changes and acute and extensive processes. Conclusions Changes in different components of the immune system might occur during pulmonary tuberculosis (in T- and B-cells, phagocytic cells), specific and enzymatic processes are activated, and autoimmunization is evident. The intensity of the changes varies at different stages of the disease. Most immune disorders caused by the specific inflammation process require immune correction
Keywords: immune responsiveness, phagocytosis, T- and B-cell immunity, multi-drug resistant and chemosensitive tuberculosis 

UDC 616.24-002.5:615.015.8]-085.281-036.8-053.2/.6

Introduction. Against the backdrop of multiple and widespread drug resistance of Mycobacterium tuberculosis (MDR-TB), there has been 
a significant decline in the effectiveness of treatment of tuberculosis (TB) patients in Ukraine and globally. Therefore, in recent years, new 
antimycobacterial drugs, such as bedaquiline (Bdq), delamanid (Dlm) and pretomanid, have been introduced to improve treatment efficacy 
 in adults, children and adolescents.
Purpose. To study the effectiveness of complex treatment with bedaquiline (Bdq) and delamanid (Dlm) in children under 18 years old with 
multiple and extensively drug-resistant pulmonary TB (MDR/XDR-TB).
Materials and methods. To study the clinical efficacy of chemotherapy with Bdq and Dlm, a retrospective cohort analysis of medical 
records was conducted. The main group consisted of 40 children with MDR/XDR-TB who received comprehensive antimycobacterial therapy 
with Bdq and Dlm; and the control group consisted of 27 patients who received treatment without Bdq and Dlm.
Results. It was found that during the first three months of treatment, there was a decrease in bacilli in all patients treated with Bdq and Dlm and in the group of patients without these new drugs (control), but in the control group, the decrease was significantly slower, p<0.05. According to the immune system parameters, after the intensive phase was completed, the activity of a specific process was 1.7 times more frequent in patients of the control group than in the main group. After completion of the course of treatment, all patients in the main group showed resorption of infiltration, compaction of foci, and formation of fibrosis in the lungs according to the results of X-ray tomographic examination. However, in 14.8% of patients in the control group, treatment failure was noted with the resumption of bacterial release and destruction in the lung tissue, and in the main group, all patients had healing of the decay cavities. In the majority (77.5%) of patients in the main group, treatment resulted in the formation of small residual changes, but large residual changes were 2.3 times more common in the control group in the form of multiple dense foci, fibrosis and residual decay cavities.
Conclusions. Studies have shown the high efficacy of complex treatment with Bdq and Dlm in children and adolescents. In particular, in MDR/XDR-TB patients treated with Bdq and Dlm, treatment results were 2 times more likely to be considered «cured» than in the control group, and 1.5 times less likely to be considered «complete». The treatment success rate in the main group was 100.0%, and in the control group — 85.2%. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
Keywords: children, tuberculosis, adolescents, multidrug resistance, extensive drug resistance, treatment, bedaquiline, delamanid

The purpose of the work is to investigate the effect of bile acids on the ATPase activity of the colon mucosa in patients with overweight and irritable bowel syndrome (IBS).

Materials and methods. Completely examined 12 patients with IBS and overweight. We estimated the ATPase activity of colon mucous of the patients with IBS spectrophotometrically by determined the content of orthophosphate that was released after ATP hydrolysis. We studied the effect of 3-sulphate of taurolitocholate (TLC-S) on specific activities of Na⁺/K⁺-ATPase, Ca²⁺-ATPase of endoplasmatic reticulum (EPR), Ca²⁺-ATPase of plasmatic membrane (PM) and basal Mg²⁺-ATPase of postmitochondrial subcellular fraction of colon mucous of the patients with IBS.

Research results. We established the specific activities of Na⁺/K⁺-ATPase, Ca²⁺-ATPase of EPR, Ca²⁺-ATPase of PM and basal Mg²⁺-ATPase. There were (6.06 ± 1.61), (5.88 ± 1.19), (8.86 ± 1.56) (6.44 ± 2.02) μmol Pi/ mg protein per hour, respectively. TLC-S (50 μM) did not caused any change of Na⁺/K⁺-ATPase , as well as Ca²⁺-ATPases activities, but statistically significant increased activity of Mg²⁺-ATPase of postmitochondrial subcellular fraction of colon mucous of the patients with IBS by 4 fold.

Conclusions. TLC-S increased basal Mg²⁺-ATPase in the postmitochondrial fraction of colon mucous of the patients with overweight and IBS, but had no effect on Na⁺/K⁺-ATPase and Ca²⁺-ATPases activities. It has been suggested that activation of basal Mg²⁺-ATPase under by TLC-S may indicates the role of the endo-lysosomal system of epitheliocytes of colon mucous in developing of pathology IBS.

Key words: irritable bowel syndrome, overweight, ATPase, bile acids.

The aim: The study is to research the resolution of perifocal brain tissue at various type strokes using immunomorphology
Materials and methods: The immunohistochemical study of perifocal brain tissue in 21 cases of various strokes types was condacted
Results: When comparing the GFAP + astrocytes detection area at IS, HS and IS with HT, no significant difference was found. At the 1st degree of GFAP + astrocytes were in the border around the necrosis nucleus at IS and IS with HT, and at HS GFAP + astrocytes accumulated along the hematoma edge. CD34 + cells were found in most cases of strokes. 
Over time, cases with a larger CD34 + cells detection area increased (Kendal’s Tau = 0.512, p = 0.001) in all groups. The capillary network at HS was around the hematoma and formed a gliomesodermal capsule with microglia and inflammation. 1st degree τ-protein accumulation was detected in 2/3 of cases (66.7%) of all strokes without significant difference. If compared in different stroke periods, τ-protein detection frequency increased and accumulated in brain structures – Kendal’s Tau = 0.359; p = 0.023.
Conclusions: With the development of the disease, the number of cases with a larger area of detection of GFAP + astrocytes and CD34 + cells increased in strokes of various types. Ʈ-protein was detected in neurons in all variants of ACVA in the first period.

Many nano/microparticles (n/µP), to which our body is exposed, have no physiological way of removal. Our immune system sense these “small particulate objects”, and tries to decrease their harmfulness. Since oxidation, phagocytosis and other methods of degradation do not work with small, chemically resistant, and hydrophobic nanoparticles (nP). This applies to soot from air pollution, nano-diamonds from cosmic impact, polishing and related machines, synthetic polymers, and dietary n/µP. Our body tries to separate these from the surrounding tissue using aggregates from neutrophil extracellular traps (NETs). This effectively works in soft tissues where n/µP are entrapped into granuloma-like structures and isolated. The interactions of hydrophobic nanocrystals with circulating or ductal patrolling neutrophils and the consequent formation of occlusive aggregated NETs (aggNETs) are prone to obstruct capillaries, bile ducts in gallbladder and liver, and many more tubular structures. This may cause serious health problems and often fatality. Here we describe how specific size and surface properties of n/µP can activate neutrophils and lead to aggregation-related pathologies. We discuss “natural” sources of n/µP and those tightly connected to unhealthy diets.