The Effectiveness of Autologous Composition Based on Dendritic Cells in the Treatment of Pulmonary Tuberculosis with Extremely Drug Resistance After an Ineffective Course of Polychemotherapy

Le résumé fourni par la source

Despite the introduction of new anti-tuberculosis drugs, the problem of treating tuberculosis patients with a broad drug-resistant pathogen (XDR MBT) remains relevant. Aim of the study. Тo increase the effectiveness of treatment of this category of patients using an autologous composition based on dendritic cells activated by a specific antigen. Research materials and methods. А prospective study conducted in 2016-2019 included 52 patients, 36 (69.2%) men and 16 (30.8%) women, average age 43.2 ± 1.5 years. All patients received antituberculosis therapy in accordance with existing regulatory documents and recommendations. The main group consisted of 25 patients (48.1%) who agreed to immunotherapy with the introduction of an autologous composition with activated specific peptides ESAT-6 and SFP-10 dendritic cells against the background of anti-tuberculosis therapy. Statistical processing of the material carried out using the Statistica 10.0 application software package. Results. In 70.0% of cases (n = 14), there were no adverse reactions to suspension administration in patients of the main group. One patient (7.2%) had a general reaction in the form of tremor, chills after the first injection. In 5 (38.7%) patients on the 8th and 9th administration, a skin reaction was noted at the injection sites in the form of a papule, with a final regression of these changes after 8 weeks. By 18– 24 months of the course, anti-tuberculosis therapy in combination with immunotherapy in the first month of treatment allowed to obtain a positive effect according to clinical, bacteriological and radiological data in 64% of cases. It was not possible to obtain this result during therapy at the previous stages of treatment. In the comparison group, a positive result achieved only in 45.5% of cases. Conclusion. The results of the study suggest a positive effect of complex treatment with the inclusion of immunotherapy with an autologous composition based on dendritic cells in the most severe contingent of patients with pulmonary tuberculosis with broad drug resistance of the pathogen, even with an ineffective course of chemotherapy at the previous stage in 64% of cases.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.