Effects of first-line anti-TB drugs on the level of toxic plasma phospholipids
Background: The target of any toxic effect of anti-tuberculosis chemotherapy is primarily the cell. Changes in the structure and functions of cells affect the lipid composition of their membranes and, as a consequence, the lipid composition of blood plasma. The level of total plasma lysophospholipids in patients with newly diagnosed pulmonary tuberculosis is a sensitive marker of the state of the cells and can be used as a criterion for the prescription of corrective pathogenetic therapy. The aim of the study: To determine the change in the level of toxic phospholipids in patients with newly diagnosed pulmonary tuberculosis before treatment, after the end of the intensive phase of the main course of anti-tuberculosis therapy and against the background of corrective therapy. Materials and methods: The study included 232 patients with newly diagnosed pulmonary tuberculosis aged 20 to 59 years of both sexes. In all patients, focal and infiltrative pulmonary tuberculosis without signs of lung tissue decay was confirmed by X-ray and laboratory tests. Depending on the treatment, 3 groups were distinguished. The first group consisted of patients before the start of anti-tuberculosis chemotherapy, a total of 232 patients. The second group included patients after an intensive phase of the main course of anti-tuberculosis chemotherapy, a total of 184 patients. The third group included patients after the intensive phase of the main course of anti-tuberculosis chemotherapy with the use of the drug "Fosphogliv ©", a total of 48 patients. All patients were examined and received treatment on the basis of the Tver Regional Clinical Tuberculosis Dispensary in the period from 2012 to 2016. Flow thin-layer chromatography was used to isolate the fraction of total lysophospholipids. Results: The level of toxic plasma phospholipids in patients with first detected pulmonary tuberculosis before chemotherapy was 8.4%, and after the intensive phase of the main course increased to 16.0%. The use of the drug "Phosphogliv ©" in the complex therapy of patients with pulmonary tuberculosis made it possible to reduce the level of plasma lysophospholipids to 7.2%. Conclusion: In patients with pulmonary tuberculosis, prior to chemotherapy, there is a reduced level of total plasma lysophospholipids. Antituberculous chemotherapy has a membrane-destructive effect, which is accompanied by an increase in the level of total plasma lysophospholipids. Conducting corrective therapy using the drug “phosphogliv ©” allows you to reduce the level of total lysophospholipids in blood plasma and increase the overall resistance of the body.