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The paper shows that there is an association of the pattern of lung lesion with the endogenous intoxication in adolescents patients with pulmonary tuberculosis. Based on the spectrograms of plasma and the levels of low and medium molecular-weight substances, the authors revealed clinical features in relation to the level of endogenous intoxication and to the values of cellular responses.

An examination of 144 patients with different forms of pulmonary tuberculosis has revealed that serum adenosine deaminase (ADA) has a higher activity in the patients than in healthy individuals (a control group). The level of its activity is in proportion to the severity of a pulmonary process and achieves its peak in caseous pneumonia. In infiltrative tuberculosis, there is a direct relationship between the activity of ADA, the number of involved segments and bacterial isolation. The activity of ADA has been shown to be increased by its isoenzyme ADA-2. The unidirectional changes in the activity of ADA and the clinical and X-ray characteristics of the disease treated with antituberculous drugs make it possible to recommend this parameter as an additional criterion for evaluating the specific features of a process in the lung and the adequacy of therapy.

The paper provides data on the serum levels of adenosine deaminase (ADA) in patients with acutely progressive pulmonary tuberculosis (APPT). The highest levels corresponded to the severity of the disease, high bacterial isolation, the extent of destructive and infiltrative changes in lung tissue, and endotoxemia. This indicates that ADA measurement is an additional criterion for assessing the health status in APPT patients and the magnitude of destructive processes. Moreover, the measurement is of prognostic value as it provides an objective assessment of the course of an acute progressive process an the efficiency of chemotherapy used.

The serum activity of the enzyme adenosine desaminase (ADA) was studied in patients with infiltrative tuberculosis in relation to IL-1 beta, TNF-alpha, IL-2 productions, the magnitude of a lymphocytic proliferative response to PPD and PGA. There was an association of high ADA levels with the severity of a tuberculous process, with the least IL-2 production together with drastically increased IL1 beta and significant disorders in the TNF-alpha system. Moderate ADA increases reflect the regularly enhanced activity of immunocompetent cells in response to an infectious agent. The findings indicate that a simple biochemical test may be used for rapid preliminary evaluation of the severity of disease and immune performance.

Examining the activity of serum adenosine deaminase in 112 patients with lymphadenopathy of various etiology revealed its increase (at the discriminant level equal or exceeding 20 U/l) in 86% of 50 patients with active tuberculous infection. The specificity of the parameter as a test for tuberculous peripheral lymph nodal lesion is 90.3%, the positive and negative prognostic significances are 83 and 89%, respectively, the diagnostic efficiency is 88.4%.

The paper gives the results of treating 60 adolescents suffering from destructive pulmonary tuberculosis. A multimodality treatment using oliphenum, prednisolone or their combination causes an increase in therapeutical efficiency and a reduction in the time of treatment by the average of 2-3 months.

The multidimensional statistical analysis was used to thoroughly study the status of lipid peroxidation, the antioxidative system and proteolytic inhibitors in 22 patients with an active and 26 with a metatuberculous deforming osteoarticular process. In both cases, enhanced lipid peroxidation is followed by various changes in the systems of endogenous antioxidants and inhibitors of proteolysis. Imbalance of these systems in the active process, unlike the deforming osteoarticular one, requires a differential approach when proteolytic antioxidants and inhibitors are used.

Changes in lipid peroxidation parameters (LP), antioxidant system and proteinase inhibitors were studied at different evolutionary stages of experimental osteoarticular tuberculosis in 30 rabbits. All stages of the process were characterized by LP activation which in animals of all groups (except rabbits having the acute stage of arthritis) is accompanied by compensatory increase of superoxide dismutase and ceruloplasmin activity. Deficiency of superoxide dismutase found in the acute stage of arthritis with a growth of LP activity shows its inadequate production at a given stage of articular inflammation. Decrease in alpha 1-proteinase inhibitor activity at the stage of osteitis with reactive synovitis can be caused by the influence of LP products. The importance of this mechanism in the inhibition of alpha 1-proteinase inhibitor, together with reduction in its production at the acute stage of arthritis, cannot be ignored. The results obtained make it possible to recommend further study of the perspectives of antioxidants use in osteoarticular tuberculosis.

A correlation between the informativeness of the proteinogram, blood ceruloplasmin and haptoglobin levels and connective tissue metabolism indices used to characterize the inflammatory process activity was performed in 55 patients with different stages of tuberculosis of bones and joints. Among the acute phase proteins examined, the most sensitive indices include ceruloplasmin and haptoglobin found in their combination. A higher urinary oxyproline and glycosaminoglycan excretion in different forms of osteoarticular tuberculosis (both of an inflammatory and a degenerative type) should not be interpreted as an indication of activity of the specific process.