Nonspecific respiratory diseases disrupt various components of local lung protection, impair mucociliary clearance, and contribute to increased bacterial colonization of the mucous membranes, thereby raising the risk of secondary bacterial infections. Therefore, it is crucial to determine the role of each infectious agent in the onset and progression of the disease.

УДК: 616.233 –002.2: 616.24 –002.5

Анотація. У крові 65 хворих на вперше діагностований деструктивний туберкульоз легень (ВДТБ) з бактеріовиділенням (БК+) і у 53,8 % випадків з коморбідністю ХОЗЛ (дослідна група) вивчали особливості системної запальної відповіді, рівня ендогенної інтоксикації, прооксидантно-антиоксидантних процесів, аденозиндезамінази. Виявлено більшу вираженість гострофазної реакції, рівня ендогенної інтоксикації, активність та інтенсивність прооксидантних і пригнічення антиоксидантних процесів у хворих на туберкульоз легень ускладнений ХОЗЛ, а також середньої сили корелятивний зв’язок між ТБК-активними продуктами і каталазною активністю (r = 0,64), гаптоглобіном і активністю аденозиндезамінази (r = 0,60), паралелізм між рівнем підвищення активності аденозиндезамінази і середньомолекулярних пептидів (коефіцієнт кореляції r1 = 0,77; r1 = 0,82). Виявлені особливості в досліджуваних процесах вимагають індивідуалізованого підходу до проведення лікування.

Abstract. In the blood of 65 patients with newly diagnosed destructive pulmonary tuberculosis (VTTB) with bacterial excretion (BC +) and in 53.8% of cases with comorbidity of COPD (experimental group) studied the features of the systemic inflammatory response, endogenous intoxication, prooxidantsin-antioxidant prooxidant. The severity of the acute phase reaction, the level of endogenous intoxication, activity and intensity of prooxidant and inhibition of antioxidant processes in patients with pulmonary tuberculosis complicated by COPD, as well as moderate correlation between TBA-active products and catalase activity, (r = 0,64), haptoglobin and adenosine deaminase activity (r = 0.60), parallelism between the level of increased adenosine deaminase activity and SMP (correlation coefficient r1 = 0.77; r1 = 0.82). Identified features in the studied processes require an individualized approach to treatment.

ABSTRACT
The aim: To evaluate the dynamics of the interferon and collagen-IV systems in bronchoalveolar lavage in the treatment of chronic obstructive pulmonary disease using the tiotropium bromide medication.
Materials and methods: The study involved 60COPD patients with bronchial obstruction of the II degree before and on days 30 and 60 of therapy using conventional treatment regimens and inhalations of tiotropium bromide a the dose of 18 mcg once a day.The collagen-IV levels in bronchoalveolar fluid were determined by means of enzyme-linked immunoassay using “StatFax 303 Plus” analyzer and “Biotrin Collagen IV EIA” reagents. The level of IFN-γ was identified with the help of enzyme-linked immunoassay using “StatFax 303 Plus” analyzer and “ProKon” reagents (LLC “Protein Contour”, Russia) in bronchoalveolar fluid obtained during fiber-optic bronchoscopy.
Results: When examining GroupI patients on the 30th day we found out that the content of collagen-IV in the bronchoalveolar fluid had decreased by only 10.29% (p <0.05).
Detection of collagen-IV indices in Group II patients on the 30th day of tiotropium bromide use showed the 29.43% (p <0.05) decrease in its content as compared to the initial indices. In Group III patients, the concentration of collagen-IV had a maximum tendency to normalize and made up (24.72 ± 1.15) ng/ml, and decreasedby 2.44 times (p <0.05) as compared to the initial indices. Our examination of 12 patients from the comparison group I on the 60th day of treatment revealed even a slight increase in the content of collagen-IV in the bronchoalveolar fluid, as compared with the data obtained on the 30th day. Theidentified IFN-γ deficiency is indicative for the COPD of the II degree of bronchial obstruction, and its indices were 2.29 times lower than those observed in people from the control group. On day 30, we found out that the content of IFN-γ in Group I patients increased by only 10.29% (p>0.05). Detection of IFN-γ in Group II patients showed 42.27% (p<0,05) increase in its content as compared to the initial indices. The most favorable dynamics of IFN-γ levels in bronchoalveolar contents wasobservedin Group III patients, and at the time of observation itmadeup (1.16 ± 0.08) pg/ml, having 2 times (p<0.05) increasedas comparedtotheinitial indices. However, in contrast to those taking tiotropium bromide, we examined 12 patients from Group I on the 60th day of treatment and found no significant positive dynamics of IFN-γ content in bronchoalveolar fluid as compared to the indices obtained on day 30.
Conclusions: The obtained findings indicate the effect of tiotropium bromide on the reduction of interferon-γ and reduce of collagen-IV levels, which depend on the duration of its use.