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There is a need to further characterize the antibody response to vimentin in relation to it possible involvement in pathogenicity of sarcoidosis, and other lung disorders. Objectives: We investigated serum samples from patients with sarcoidosis, healthy and diseased control subjects to evaluate levels and frequency of these antibodies. Materials and methods. A retrospective-prospective comparative study was performed in the years 2014-2017. 188 serum samples were examined for presence of autoantibodies to mutated citrullinated vimentin (anti-MCV). Patients with elevated anti-MCV levels were tested for antibodies to a cyclic citrullinated peptide (anti-CCP) and citrullinated vimentin (anti-Sa). Additionally, sera from 93 patients with sarcoidosis and 40 healthy subjects were evaluated for the presence of autoantibodies to non-modified vimentin. In all cases ELISA assays was used. The results were considered statistically significant at p-value less than 0.05. Results of the study. The high concentrations of anti-MCV. antibodies were more frequent in patients with sarcoidosis (40.9% of the cases, 38/93), compared to the control groups (23.6% and 25.0% of cases, respectively). In sarcoidosis, clinical symptoms similar to the autoimmune pathology were described. A moderate positive correlation between the anti-MCV and anti-Sa antibodies (r = 0.66) was found in 13 patients with sarcoidosis. There was no significant difference between the levels of the anti-MCV and the anti-CCP in patients with non-infectious lung diseases and the healthy control group. Conclusion. A high level of anti-MCV antibodies in patients with sarcoidosis characterizes the presence of an autoimmune process that is not related to citrullination. The absence of a significant difference in the level of antibodies to modifications of vimentin in patients with sarcoidosis may indicate the autoimmune process.

Sarcoidosis and tuberculosis share several similar clinical and pathogenic characteristics that make some researchers consider a common pathogenesis for these diseases. Human leukocyte antigen (HLA) genotypes are studied both in sarcoidosis and tuberculosis patients, but to our knowledge, there are no comparative studies of genetic predisposition for sarcoidosis and tuberculosis development. The aim of this review was to analyse the relationship between HLA genotypes and the development of sarcoidosis and tuberculosis. Original and review articles published in various online databases from 1960 to 2019 were studied. The search results showed opposite effects of the HLA genotypes on predisposition to sarcoidosis or tuberculosis. It was revealed that the genotypes predisposing to the development of sarcoidosis (HLA-DRB1*03/07/15) have protective properties against the development of tuberculosis. Moreover, genotypes causing the development of tuberculosis (HLA-DRB1*04) have a protective effect on the development of sarcoidosis. The results of this narrative review of the literature may allude to the existence of genetic predispositions that lead to the development of an antibacterial or autoimmune response to mycobacteria., The HLA-DRB1*03/07/15 genotypes predispose to the development of sarcoidosis and have protective properties against the development of tuberculosis, while the HLA-DRB1*04 genotype has an opposite effect on the development of these diseases https://bit.ly/2Tl2rj1

Sarcoidosis is a systemic granulomatous disease that develops due to the Th1, Th17 and Treg lymphocytes disturbance. There is an assumption, that B cells and follicular T-helper (Tfh) cells may play an important role in this disorder, as well as in several other autoimmune diseases. The aim of this study was to determine CD19+ B cells subset distribution in the peripheral blood and to define disturbance in the circulating Tfh cells subsets in patients with sarcoidosis. The prospective comparative study was performed in 2016–2018, where peripheral blood B cell subsets and circulating Tfh cell subsets were analyzed in 37 patients with primarily diagnosed sarcoidosis and 35 healthy donors using multicolor flow cytometry. In the results of our study we found the altered distribution of peripheral B cell subsets with a predominance of “naïve” (IgD + CD27−) and activated B cell (Bm2 and Bm2′) subsets and a decreased frequency of memory cell (IgD+ CD27+ and IgD− CD27+) in peripheral blood of sarcoidosis patients was demonstrated. Moreover, we found that in sarcoidosis patients there are increased levels of B cell subsets, which were previously shown to display regulatory capacities (CD24+++ CD38+++ and CD5 + CD27−). Next, a significantly higher proportion of CXCR5-expressing CD45RA − CCR7+ Th cells in patients with sarcoidosis in comparison to the healthy controls was revealed, that represents the expansion of this memory Th cell subset in the disease. This is the first study to demonstrate the association between the development of sarcoidosis and imbalance of circulating Tfh cells, especially CCR4− and CXCR3-expressing Tfh subsets. Finally, based on our data we can assume that B cells and Tfh2- and Tfh17-like cells – most effective cell type in supporting B-cell activity, particularly in antibody production – may be involved in the occurrence and development of sarcoidosis and in several other autoimmune conditions. Therefore, we can consider these results as a new evidence of the autoimmune mechanisms in the sarcoidosis development.

Immunological testing for tuberculosis has been one of the most rapidly developing areas in the last decade. A new-generation immunological skin test, Diaskintest (DST), has been developed in the Russian Federation and successfully implemented into clinical practice since 2009. This article presents the results of a meta-analysis of publications reporting data on the use of the recombinant tuberculosis allergen DST (n = 121) from 2009 to 2019 included in Russian and international databases. The analysis included a total of 61 papers consistent with the study design, which cumulatively presented the results of 3,777,083 patients tested with DST (83.0%). The obtained data showed that the overall diagnostic sensitivity of the test in this population, regardless of age, was 86.0%, with 98.0% negative results. It was found that the intensity of the immune response of tuberculosis patients to specific ESAT-6 and CFP-10 antigens of DST may depend on the biological properties of the pathogen characteristic to various Mycobacterium tuberculosis genotypes, tuberculosis severity, and the presence of concomitant diseases. These factors are more prevalent in the adult population. In children, however, the test sensitivity reaches 100%. The proportion of positive DST results in HIV-positive patients tested for tuberculosis was 60.0%. The analysis showed that the accuracy (overall validity) of DST was 95.1% in the total studied population (95% confidence interval [CI]: 95.06–95.1) and 92.4% in HIV-positive patients (95% CI: 91.9–92.7).

Tuberculosis is still an important medical and social problem. In recent years, great strides have been made in the fight against

Clinical and radiological features of tuberculosis and sarcoidosis are quite overlapping, and therefore, a diagnostic dilemma often persists. There are no commonly accepted criteria for the diagnosis of sarcoidosis due to the lack of data on the etiology of the disease. The exclusion of tuberculosis in every patient with suspected sarcoidosis is a mandatory stage of diagnosis, especially in countries with a high burden of tuberculosis. A prospective study was conducted with two groups of patients: group I (n = 50)-patients with pulmonary sarcoidosis established according to standard criteria; group II (n = 28)-patients with pulmonary tuberculosis with bacterial excretion. The control group (n = 24) was presented by healthy subjects. The examination complex included x-ray, bacteriological, immunological (Mantoux test with 2 TE, TB.SPOT test), and histological methods. All patients and healthy subjects were assessed for immune complexes with the use of the dynamic light scattering (DLS) method and adding of "healthy lung tissue extract" antigens and specific tuberculosis antigens ESAT-6 and SFP-10 in vitro. Significant differences were found in determining specific immune complexes in patients with pulmonary sarcoidosis and pulmonary tuberculosis. Registration of specific immune complex formation with "healthy lung tissue extract" in 100% cases may indicate the autoimmune nature of sarcoidosis. The absence of the immune complex formation in response to ESAT-6/SFP-10 antigens can be used for the differential diagnosis of two diseases. The diagnostic significance of the DLS method was 100% for sarcoidosis and 92.2% for tuberculosis. The data obtained in the study allows not only understanding the etiology of sarcoidosis, but also obtaining new criteria for the differential diagnosis of tuberculosis and pulmonary sarcoidosis.

Introduction: The clinical pattern of a number of granulomatosis diseases is pretty similar, whereas their course, degree of epidemiologic threat, treatment options and prognosis for life are different. The objective of the study. To determine the criteria of autoimmune inflammation in sarcoidosis. Materials and Methods: 187 subjects were enrolled in the study, that were divided into two groups in line with the objectives of the study. All patients passed through standard diagnostic complex, that was supplemented with special immunologic and laboratory methods. There were 2 groups in the study: I group (n = 114) – patients with lung sarcoidosis; II group (control) – healthy subjects (n = 73), who met eligibility criteria. Analysis of data was done by Statistica 10.0. Differences were significant at p Results of the study: In patients with sarcoidosis there were observed: high level of immune complexes with antigens of standard «extract of healthy lung tissue»; high level of auto-antibodies to MCV (modified vimentin) over 14 U/ml, and rheumatoid factor on the background of changes in B-lymphocytes sub-population in peripheral blood - ratio of «naive» В-lymphocytes to “memory cells” more than 2:1. The same time above mentioned observations were registered in healthy subjects in single cases only, that evidences that their appearance serves as a marker for high risk of sarcoidosis development. Conclusions: High level of auto-antibodies to modified vimentin on the background of sub-population B-lymphocytes’ changes and high level of immune complexes targeted to lung tissue are the signs of auto-immune inflammation in sarcoidosis with diagnostic value 99%.

Take-Home Message.This study provides a new diagnostic index based on the antibodies to mutated citrullinated vimentin concentration and the level of different B subsets. Determination of index over 5 Units proved to be characteristic of sarcoidosis, what might help to differentiate SD from TB.Abstract. In some cases there is a problem of differential diagnosis of sarcoidosis(SD) and tuberculosis(TB)because of the similarities in clinical, X-ray and laboratory features. The aim of this study was to search for new differential diagnostic criteria for sarcoidosis and tuberculosis by calculating the index, based on the level of autoantibodies to modified citrullinated vimentin (anti-MCV) and the level of B-cell subpopulations. These parameters were measured in patients with sarcoidosis (n = 93), tuberculosis (n = 40) and healthy donors (n = 40) using the ELISA and cytometry. The absence of a statistically significant difference when comparing the level of anti-MCV, the number of B-cells in SD and TB suggests that these changes may be characteristic of granulomatous diseases. The use of the formula Ds=([B-naïve%]\[B-memory%])*([B-CD38%]+[B-CD5%])/[anti-MCV] might allow to differentiate SD with an increase in the calculated index of more than 5 units with a sensitivity of 80.00% and specificity of 93.10% (AUC = 0.926).

Sarcoidosis (SC) is the granulomatous disease of an unknown origin, where the differential diagnosis with tuberculosis (TB) is challenging and vital for patients’ prognosis. The common neurological complication in SC is a small fiber neuropathy (SFN), that is considered to be the result of the chronic inflammation, and remains significantly understudied. There is no reliable data, whether such complication is observed in TB patients, where the systemic inflammation is also described. Aim: To identify the clinical and histological correlates of the small fiber neuropathy in sarcoidosis and tuberculosis patients.Materials and methods. A study was performed in 2018 – 2019 years and included 71 patients with pulmonary sarcoidosis (n=25), pulmonary tuberculosis (n=21), and healthy subjects (n=25). For the clinical verification of the SFN, the “Small fiber neuropathy screening list” (SFN-SL) was used. A punch biopsy of the skin was performed followed by the enzyme immunoassay analysis with PGP 9.5 antibodies.Results of the study: Up to 60% of sarcoidosis patients and 19% tuberculosis patients report the presence of at least one complaint, which may be associated with SFN. The most frequent complaints included dysfunctions of the cardiovascular, musculoskeletal system and gastrointestinal tract. A negative, statistically significant correlation between the intraepidermal nerve fiber density (IEND) and SFN-SL score was revealed in both groups (Spearman coefficient, r = -0.3508, p = 0.0102, and r = -0.7382, p = 0.0064, respectively). Wherein, the density of small nerve fibers in the patients with pulmonary sarcoidosis was lower, compared to the patients with tuberculosis (Mann-Whitney test, p = 0.0047). Conclusion: In patients with pulmonary sarcoidosis, small fiber neuropathy may develop as a result of systemic immune-mediated inflammation. The most common symptoms of this complication were dysautonomia and mild sensory dysfunction. Wherein, in tuberculosis patients clinical and histological symptoms of the small fiber neuropathy were subsequently less prominent, which may represent the difference between the autoimmune and bacterial inflammation. The validated questionnaires and histologic verification of the diagnosis help to establish the severity of neuropathy of small fibers, to determine the prognosis, to plan the treatment strategн, and also may allude the possibility for the additional criteria of differential diagnosis between two diseases.

Tuberculosis is still an important medical and social problem. In recent years, great strides have been made in the fight against M. tuberculosis, especially in the Russian Federation. However, the emergence of a new coronavirus infection (COVID-19) has led to the long-term isolation of the population on the one hand and to the relevance of using personal protective equipment on the other. Our knowledge regarding SARS-CoV-2-induced inflammation and tissue destruction is rapidly expanding, while our understanding of the pathology of human pulmonary tuberculosis gained through more the 100 years of research is still limited. This paper reviews the main molecular and cellular differences and similarities caused by M. tuberculosis and SARS-CoV-2 infections, as well as their critical immunological and pathomorphological features. Immune suppression caused by the SARS-CoV-2 virus may result in certain difficulties in the diagnosis and treatment of tuberculosis. Furthermore, long-term lymphopenia, hyperinflammation, lung tissue injury and imbalance in CD4+ T cell subsets associated with COVID-19 could propagate M. tuberculosis infection and disease progression.

Background: Nowadays, there is no doubt that the development of infectious process is determined not only by individual features of a human, but also by features of infection agent. It is commonly known that ability to form an adequate immune response is based on immunogenetic peculiarities of macroorganism. Methods: The immunogenetic study was performed in 228 children from 1 to 15 years old with different manifestations of tuberculosis (TB). Control group was consisted of 446 adult healthy donors-residents of the Northwestern region of Russia. Human leukocyte antigens (HLA)-DRB1* allelic genes were assessed in all individuals. Results: HLA-DRB1 alleles *01, *03, *11, *13, *07, and *15 were observed significantly rare in children with TB in comparison with healthy donors that may indicate their protective role in the development of the disease. It was also noticed that DRB1 *07 and *15 alleles were observed significantly rare in children with lung TB in comparison with other forms of disease that allows to assume a protective function of these alleles for lung TB with no influence on development of generalized TB. This assumption requires further researches. Conclusion: As a result of the study, statistically significant differences in the distribution of HLA-DRB1* alleles in children with TB in comparison with a control group for *01, *03, *11, *13, *07, *15, and *16 alleles were found. It may indicate their protective role in the development of TB. DRB1 *07 and *15 alleles were observed significantly rare in children with single TB than in children with generalized TB and healthy controls.

Post COVID-19 Syndrome (PCS) is a complex of various symptoms developing a month or more after the acute phase of the disease. The cases of PCS development among patients with asymptomatic/mild forms are frequently reported; however, the pathogenesis of PCS in this group of patients is still not completely clear. The publications about COVID-19 which were published in online databases from December 2019 to September 2021 are analyzed in this review. According to the analysis, PCS develops on average in 30–60% of patients, mainly among women. Fatigue, shortness of breath, cough, and anosmia were reported as the most common symptoms. The possible association between the described PCS symptoms and brain damage was revealed. We assume the possibility of an alternative course of COVID-19, which develops in genetically predisposed individuals with a stronger immune response, in which it predominantly affects the cells of the nervous system, possibly with the presence of an autoimmune component, which might have similarity with chronic fatigue syndrome or autoimmune disautonomia. Thus, the gender (female) and the presence of anosmia during an asymptomatic or mild course of the disease can be predictive factors for the development of PCS, which can be caused by autoimmune damage to neurons, glia, and cerebral vessels.

The World Health Organization (WHO) regularly updates definitions used for the management of tuberculosis (TB). The adoption of definitions consistent with scientific progress is challenging. Recently some authors have proposed that WHO should develop a new definition of cure, applied 1 year after treatment completion, for rifampicin- and multidrug-resistant (RR/ MDR) TB. However, loss to follow-up or death from a cause other than TB in the 12-month period after treatment completion can potentially underesti- mate cure rates. Furthermore, the role of reinfection needs to be considered when defining relapses. Herein we present the consensus opinions from commit- tees within the new Global Tuberculosis Network (GTN) about current and po- tential new treatment outcome defini- tions for RR/MDR-TB and definitions for different types of drug-resistant cases (Table 1).

Introduction: Sarcoidosis (SD) is considered to be a T-cell-driven disorder, but recent studies show also B-cells participation in SD (Musaelyan, 2018; Saussine, 2012). The aim was to determine the different subsets of memory B-cells in SD. Methods: A prospective comparative study was conducted in 2016-2018 with examination of patients with SD (n=37) and healthy control (HC) (n=35). 200 μL of whole blood were stained on surface with fluorochrome-conjugated monoclonal antibodies: anti-IgD Alexa Fluor 488 (clone IA6-2, isotype - Mouse IgG2a, κ), anti-CD38 PE (clone LS198-4-3, isotype - IgG1 Mouse). IgD, CD19 - BioLegend, Inc. (USA), CD38 - Beckman Coulter, Inc (USA). Sample acquisition was performed with a Navios flow cytometer (Beckman Coulter, Inc., USA). Supported by Russian Federation Government Grant (contract N14.W03.31.0009 of 13.02.2017). Results: The frequency of B cells in SD was significantly higher than in HC (14.48% (9.86; 17.29) vs 11.09% (8.52; 13.28), p=0.008). “Activated naive” Bm2 cells and pre-germinal-center Bm2’ cells were significantly increased in SD vs HC (65.40 (62.13; 72.13) vs 56.79 (49.89; 67.71), p=0.001 and 8.06 (6.14; 11.35) vs 3.98 (2.68; 6.27), p Conclusions: We have demonstrated the altered distribution of peripheral B cell subsets with a decreased frequency of memory B cell subsets and a predominance of “naive” and activated B cell subsets in SD. These data point to direct involvement of B cells in pathogenesis of SD.

In the last 30 years, improvement of diagnostic methods enabled routine evaluation of small A-delta and C nerve fibers impairment, which results with the clinical condition known as a small-fiber neuropathy (SFN). This syndrome develops as a result of metabolic, toxic, immune-mediated, or genetic factors. The main clinical features include neuropathic pain and autonomic disturbance, which are occasionally disclaimed due to outstanding fatigue, daily performance decline, anxiety, and depression. As clinical, neurological, nerve conduction, and electromyography studies are commonly normal, diagnosis often depends on the finding of decreased intra-epidermal density of nerve fibers, per skin biopsy. This review highlights the etiology, clinical, diagnostic aspects, and SFN treatment.

Tuberculosis (TB) is still a major public health concern, mostly affecting resource-constrained settings and marginalized populations. The fight against the disease is hindered by the growing emergence of drug-resistant forms whose management can be rather challenging. Surgery may play an important role to support diagnosis and treatment of the most complex cases and improve their therapeutic outcome. We conducted a non-systematic review of the literature based on relevant keywords through PubMed database. Papers in English and Russian were included. The search was focused on five main areas of intervention as follows: (I) diagnosis of complicated cases; (II) elimination of contagious persisting cavities, despite appropriate chemotherapy; (III) treatment of destroyed lung; (V) resection of tuberculomas; (VI) treatment of tuberculous pleural empyema. Although specific practical guidelines concerning surgical indications and approaches are currently unavailable, a summary of the evidence emerged from the scientific literature was elaborated to help the clinician in the management of severely compromised TB patients. The decision to proceed to surgery is usually individualized and a careful assessment of the patient’s risk profile is always recommended before performing any procedure in addition to appropriate chemotherapy.

Background: The WHO strategy for eradication of tuberculosis (TB) by 2035 (The End TB Strategy) is aimed at an early and precise diagnosis and subsequent effective treatment of TB patients. Currently, there is no gold standard for the diagnosis of latent TB infection. This study evaluated the diagnostic capabilities of a new intradermal test using recombinant TB allergen (Diaskintest) compared with tuberculin skin test (TST) and commercial TB interferon-gamma release assays (IGRAs). Methods: A post-hoc data analysis that involved examining 860 HIV-negative, bacillus Calmette–Guerin (BCG)-vaccinated persons aged 1–65 years who visited the TB health-care institutions of Saint Petersburg to rule out or confirm an active TB was conducted from 2011 to 2016. Results: A high degree of consistency of the Diaskintest results with the enzyme-linked immunospot and QuantiFERON-TB Gold In-Tube test (ELISPOT and QFT) results was observed in the examined pediatric population (n = 696), with a Diaskintest cutoff ≥5 mm: the kappa consistency indices were 1.000 and 0.937, for ELISPOT and QFT, respectively. A high sensitivity of Diaskintest, comparable with the IGRA tests, was observed in patients with a confirmed TB diagnosis in all age groups. The sensitivity of Diaskintest in patients of the TB/MTB + group aged 18 years and older was 88.7%; of ELISPOT, 90.6%; of QFT, 87.0%. The conducted analysis has shown a high concordance of results of the commercial TB tests in adult HIV-negative patients (n = 164) with a Diaskintest cutoff ≥5 mm: the kappa indices were 0.805 and 0.636 (Diaskintest vs. ELISPOT and QFT, respectively) among BCG-vaccinated people. Conclusion: According to the WHO recommendations, replacing the TST by IGRAs is not recommended as a public health intervention in resource-constrained settings because the IGRA tests are more costly and technically complex to conduct than the TST. Diaskintest has comparable complexity to the TST and its performance is close to that of IGRA in a BCG-vaccinated population. Thus, our study demonstrates that replacing the TST by Diaskintest can be recommended as a public health intervention in resource-constrained and universal BCG vaccination settings.

The multi-drug resistant pulmonary tuberculosis (PT) increased in recent years. Prognostic factors and functional status in estimating risk of lung resection for patients with PT is not definitely. Aim of study was to elucidate the prognostic factors for pneumonectomy in patients with PT. Methods: We analysed preoperative clinical and pulmonary function status and 30-day period after pneumonectomy in 56 patients with PT. All patients were performed Spirometry, Bodyplethysmography, measurement of Diffusion capacity for carbon monoxide (DLCO) on MasterScreen Body Diffusion (VIASYS Healthcare), Computed tomography on AQUILION PRIME (TOSHIBA) before surgery. We used descriptive statistics and Mann-Whitney U Test. Data are presented as mean±SD. Statistical significance was determined at a p-value Results: There was not registered 30-day postoperative mortality in all surveyed patients. The complications following surgery were in 13 patients. Those patients were older (45,2±12,4 years vs 36,5±10,8, p Conclusion: The possible poor prognostic factors were age after 45, COPD as comorbidity, mixed ventilation disorders, bronchospasm and significant decrease of diffusion capacity. The meaning of pulmonary function testing as criterion of functional operability for patients with PT demands the further analysis.

Association between smoking, COPD and Pulmonary tuberculosis (PT) is often under estimated. Most of patients with PT are smokers and may often have co-morbidity as COPD. Aims: to evaluate the effect of smoking and COPD on outcomes of diffusion lung capacity in patients with PT Methods: 82 patients with PT with infiltrates in 1-3 segments and disease duratuion till 1 year are examined. 1 group - 35 non-smokers, 2 - 29 smokers without signs of COPD (9,0 pack-years of smoking, 95% CI 3,7-14,3), 3 - 18 patients with COPD (37,8 pack-years, 95% CI 19,3-56,2). We used spirometry, bodyplethysmography, measurement of diffusion capacity for carbon monoxide by single breath method (DLCO) on MasterScreen Body Diffusion (VIASYS healthcare), Computed tomography on TOSHIBA AQUILION 32. We used descriptive statistics and Spearman correlation analysis (Statistica, statSoft Inc., USA). Results: There were not significant ventilation disorders in groups 1 and 2. DLCO was moderately decreased in both groups. But only non-smokers had significantly more DLCO vs patients with COPD (78,7±11,2 vs 66,7±11,3, p 0,05). There was an increase in hemoglobin from group 1 to 3 (12,8; 14,2; 15,2; p Conclusions: The patients who had the association COPD and PT had most significant decrease of DLCO, but mean value of DLCO in smokers and COPD patients was not significantly different. DLCO decreasing was associated with the pack-years of smoking.

The paper sets forth the stages of design and introduction of the new Russian tuberculosis (TB) drug perchlozon registered in the Russian Federation in 2012. Based on the results of Phases I-III clinical trials, the authors evaluate the efficacy and safety of the agent and consider the adverse effects of its treatment for respiratory TB. The use of perchlozon as a component of combination therapy versus standard chemotherapy regimens significantly reduces abacillation time in pulmonary TB caused by its drug-resistant pathogen. In terms of the higher prevalence of TB induced by its pathogen resistant to many drugs (with multiple and broad-spectrum drug resistance), perchlozon is an essential drug that has antituberculous activity mainly against multidrug-resistant Mycobacterium tuberculosis strains and gives patients with the severest and epidemiologically poor form of TB the chance to recover.Изложены этапы разработки и внедрения нового отечественного противотуберкулезного препарата перхлозон, зарегистрированного в Российской Федерации в 2012 г. С учетом результатов клинических исследований I-III фазы оценены эффективность и безопасность препарата, рассмотрены нежелательные эффекты лечения туберкулеза (ТБ) органов дыхания. Перхлозон в составе комплексной терапии по сравнению со стандартными схемами химиотерапии достоверно сокращает сроки абациллирования при ТБ легких, вызванного устойчивым к лекарственным препаратам возбудителем. В условиях роста распространенности ТБ, вызванного возбудителем, устойчивым ко многим лекарственным препаратам ('с множественной и широкой лекарственной устойчивостью'), перхлозон является необходимым препаратом, который обладает выраженной противотуберкулезной активностью, прежде всего в отношении штаммов микобактерий, устойчивых к лекарственным препаратам, и дает шанс на выздоровление пациентам с наиболее тяжелой и эпидемиологически неблагоприятной формой ТБ.