[Red blood cell metabolic changes in patients with acutely progressive pulmonary tuberculosis].
In 52 patients with acutely progressive pulmonary tuberculosis (APPT), their red blood cells were used to determine the values of their energy metabolism by lactate dehydrogenase (LDG) and glucose-6-phosphate dehydrogenase (G-6-PDG), the antioxidative defense from the activity of superoxide dismutase (SOD) and catalase and from the levels of malonic dialdehyde (MDA), as well as the intraerythrocytic level of platelet activation factor (PAF) and 2,3-diphosphoglycerinic acid (2,3-DPGA). The concentration of plasma hemoglobin (Hb) was measured as an indicator of spontaneous hemolysis. In the red blood cells from patients with APPT, the activity of LDG and SOD was found to be drastically suppressed, the content of MDA was increased, the intracellular level of PAF was lowered and the concentration of 2,3-DPGA was very moderately elevated. The plasma concentration of free Hb is thrice as high as the normal value. Following 3 months of chemotherapy with 4-5 drugs, the activity of LDG became higher, yet remaining less than the normal values and that of G-6-PDG significantly dropped. The activity of SOD and catalase increased, but the level of MDA remained high. There was a drastic fall in the intracellular levels of PAF. The plasma concentration of free Hb dropped, but remaining significantly higher than the normal values. Possible ways of correcting the changes found are discussed in the paper.
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ABSTRACT: Increased amounts of reactive oxygen species (ROS) are produced as a consequence of a phagocyte respiratory burst during pulmonary inflammation. The aim of our study was to assess the concentration of malondialdehyde (MDA) and trace metals in patients with active pulmonary tuberculosis (TB). Eighty-three subjects were enrolled into the study and prospectively divided into three groups: 22 subjects with healthy controls (group I), 21 patients with inactive pulmonary TB (group II), and 40 patients with active pulmonary TB (group III). Before beginning the therapy, plasma MDA and serum concentrations of zinc (Zn), copper (Cu), albumin, and iron (Fe) were measured. The concentration of MDA and Cu in group III were higher than in the other groups (p<0.0001). The serum Zn and albumin levels were significantly lower in group III compared with healthy controls (p<0.05). There was a positive correlation between MDA and erythrocyte sedimentation rate (r=+0.647, p<0.0001; Spearman’s test). Our data indicated increased circulating levels of MDA and changed serum trace metal levels in active pulmonary TB. Trace metal levels must be closely followed during the diseases process and further studies are needed to assess the role of antioxidants as adjuvant therapy in patients with active pulmonary TB.
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