Typing of Mycobacterium tuberculosis strains resistant to rifampicin and isoniazid by molecular biological methods.

Mutations in the rpoB, katG, inhA, oxyR/ahpC genes in rifampicin- and isoniazid-resistant M. tuberculosis strains isolated from residents of Moscow, Astrakhan', and Moldova Republic were studied by molecular biological methods (heteroduplex analysis, single strand conformational polymorphism, biochips). Twenty-five combinations of mutations were detected. Some differences in the type distribution of detected mutations were found. The use of biochips is the most perspective method for determining the type of mutation.

[The immunological aspects of metatuberculous pneumosclerosis]. / Immunologicheskie aspekty metatuberkuleznogo pnevmoskleroza.

It was found that a relationship exists between x-ray changes in the lungs, levels of IgG, IgM, IgA, antibodies counts in tuberculin enzyme immunoassay, circulating immune complexes (CIC), heterophilic antibodies and metatuberculous pneumosclerosis in patients with a history of active tuberculosis. A direct relationship was established between the advance of metatuberculous pneumosclerosis and CIC levels. The latter clearly reflect basic immunological mechanisms of fibrogenesis.

[Immunologic reactivity in patients with disseminated pulmonary tuberculosis with polysensitization]. / Immunologicheskaia reaktivnost' bol'nykh disseminirovannym tuberkuloezom legkikh s polisensibilizatsiei.

Study of immunologic reactivity in patients with disseminated pulmonary tuberculosis has demonstrated that 80% of patients have sensitization to Mycobacterium tuberculosis antigens, in addition to that to bacterial flora (Streptococcus, Staphylococcus, Pneumococcus). The degree of immunity system damage depends on the character of the course and dissemination of the pathologic process. Three degrees of immunity system damage were distinguished: sharply manifested degree with suppression of all types of cellular immune response and activation of humoral immunity, which is seen in patients with bilateral caseous pneumonia and military pulmonary tuberculosis; manifested degree with suppression of cellular immunity, natural organism's resistance and moderate decrease of humoral immunity typical of subacute disseminated pulmonary tuberculosis; moderate degree with mild changes in cellular and humoral immune response and natural organism's resistance and high sensitization in the lymphocyte blast transformation reaction with specific antigen, which occurs in chronic disseminated pulmonary tuberculosis.

[Specific antibodies to different mycobacterial antigens in patients with pulmonary tuberculosis]. / Spetsificheskie antitela k razlichnym mikobakterial'nym antigenam u bol'nykh tuberkulezom legkikh.

Antibodies to three mycobacterial antigens, Soviet tuberculin and ultrasound-treated Mycobacterium tuberculosis (H37Rv) and M. bovis (BCG) were detected by enzyme immunoassay in 90 patients with pulmonary tuberculosis and 75 normal subjects. Antibody detection rates and levels were found related to the form of tuberculous process. The detection rate was rather low in focal tuberculosis and virtually the same for all the antigens (15.3 percent). In disseminated processes (infiltrative and particularly disseminated and fibrous-cavernous) antibodies are detected more often in higher titers than in local processes, and their levels are different with different antigens. The method was more sensitive with ultrasound-treated antigens of M. tuberculosis (H37RV) and M. bovis (BCG) than with PPD. Simultaneous enzyme immunoassay with three antigens detected up to 75 percent of antituberculous antibodies in infiltrative, up to 92 percent of antibodies in disseminated, and up to 100 percent of antibodies in fibrous-cavernous tuberculosis.

[The characterization of the spectrum of the antibody response to Mycobacterium tuberculosis antigenic determinants by immunoblotting]. / Kharakteristika spektra antitel'nogo otveta na antigennye determinanty Mycobacterium tuberculosis metodom immunoblottinga.

The spectrum of antibody response to M. tuberculosis antigenic determinants H37Rv and M. bovis antigenic determinants BCG was studied in serum samples from 33 healthy donors and 31 patients with infiltrative pulmonary tuberculosis by the method of immunoblotting. The study revealed that most frequently tuberculosis patients showed response to Ag-H37Rv with molecular weights of 52, 39, 35, 21, 31, 68 kD (44.4-22.2%) and Ag-BCG with molecular weights 60, 58, 50, 25, 54, 70 kD. (33.3-22.2%). By month 9 of effective chemotherapy binding predominantly with Ag-H37Rv determinants of 31, 62, 35, 75, 56, 28, 19, 5, 13 kD (75-37.5%) and Ag-BCG determinants of 13, 34, 38, 44, 19, 36, 45, 52, 58, 60 70 kD (37.5-25%) were registered. Some differences in the spectra of antibody response to Ag-H37Rv and Ag-BCG determinants were noted.

[Dependence of sensitization to specific and nonspecific antigens on the individual type of immune reaction in patients with pulmonary tuberculosis]. / Zavisimost' sensibilizatsii k spetsificheskim i nespetsificheskim antigenam ot individual'nogo tipa immunogo reagirovaniia u bol'nykh tuberkulezom legkikh.

Study of cellular sensitization and antibody formation in 317 patients with pulmonary tuberculosis (both concurrent and not concurrent with nonspecific lung diseases) to antigens of M. tuberculosis, staphylococcus, streptococcus and pneumococcus revealed their various interaction in relation to the type of immune reaction. It was noted that with a normergic type of immune reaction, the levels of cellular sensitization and antibody formation to M. tuberculosis antigens were consistent with a hyperergic type, a higher level of cellular sensitization inhibited antibody formation; and with a hypoergic type, the inhibition of cellular sensitization level was accompanied by hyperproduction of antibodies. With an anergic type of immune reaction, inhibition of cellular sensitization and antibody formation to M. tuberculosis antigens was recorded.