[A comparative study of lymphocytic apoptosis and ventilation disorders in patients with pulmonary tuberculosis]

Due to the increasing interest in studies of apoptosis (programmed cell death) in the pathogenesis of many diseases and to the emergence of data on the direct impact of apoptotic disorders on the course of bronchial asthma and the magnitude of the obstructive syndrome, this study was undertaken to investigate apoptosis in patients with new-onset pulmonary tuberculosis who had varying bronchial obstructive syndrome. Twenty-eight patients with new-onset tuberculosis, including 25 (89.3%), 2(7.1%), 1(3.6%) patients with infiltrative, disseminated, and fibrocavernous pulmonary tuberculosis, respectively, were examined. The study of external respiratory function included spirometry, determination of the flow-volume of forced expiration, body plethysmography, examination of lung elasticity by esophageal probing. The mechanisms of spontaneous apoptosis of peripheral lymphocytes from donors and patients with pulmonary tuberculosis were studied. The apoptosis was evaluated in dynamics by some parameters: the change of the mitochondrial potential (MP), the level of phosphatidyl serine, as well as DNA fragmentation by flow cytofluorometry. The results have indicated that there are significant signs of impaired peripheral lymphocytic apoptosis. Examining external respiratory function indicated that the bronchial obstruction syndrome was mild in 7 (25%) patients, moderate in 11 (39.3%), and severe in 5 (17.9%), absent in 5 (17.9%). Mild restrictive disorders were detected in 11 (39.3%) patients. The factor associating the degree of obstruction, with the count of MC540(+)- and MC540-DiOC6(+)-lymphocytes, i.e., with the count of lymphocytes with cellular membranous changes and with the decreased MP, which are one of the most significant signs of apoptosis. Thus, there is a negative correlation of the parameters of apoptosis of peripheral lymphocytes from patients with tuberculosis with those of ventilation obstruction disorders, which suggests that impaired apoptosis might be involved in the development of bronchial obstruction.