DETERMINING MELATONIN AND SPECIFIC CYTOKINES LEVELS IN PULMONARY TUBERCULOSIS BASED ON THE PHARMACOLOGICAL RESISTANCE VARIANT

Global TB incidence increased by 1.9% for the second consecutive year in 2021 and 2022, reflecting the impact of disruptions to TB services due to the COVID-19 pandemic. In the European Region, the WHO recorded an increasing trend between 2021 and 2022 (2.5%).Melatonin levels have been studied in various autoimmune and allergic diseases. It is believed that melatonin can induce cytokine production in human peripheral blood. However, studies on plasma melatonin levels and their effects on the clinical course of the disease in patients with pulmonary tuberculosis are still minimal. The work aims to determine the level of melatonin and the concentration of individual cytokines in the blood plasma of patients with pulmonary tuberculosis and to assess their impact on the course of a specific tuberculosis process.Materials and methods. Determination of melatonin levels and cytokine levels (in particular, interleukin-6 and 10) in blood plasma was performed during the first 2 weeks of antimycobacterial treatment. The study included 30 patients with new cases of pulmonary tuberculosis with preserved sensitivity and 30 patients with multidrug resistance.Results of the study. The level of melatonin in the blood plasma of patients with pulmonary tuberculosis was determined, depending on pharmacoresistance. The severity of intoxication syndrome in the examined patients was analysed using a self-developed scale. The concentration of individual cytokines in the blood plasma of patients with pulmonary tuberculosis was studied, and a correlation analysis (Pearson correlation coefficient) was performed to determine their correlation with melatonin.Conclusions: It was proven that the content of IL-6 in the studied groups of patients significantly exceeded the HPI indicator: in group 1, the level of IL-6 was 11.04 times higher, in group 2 - 13.9 times (p<0.001). The concentration of IL-10 in the blood plasma of TB patients is significantly increased: in group 1, the level of IL-10 was 2.2 times higher, in group 2 - 1.7 times (p<0.001).The average value of melatonin in group 1 was 33.2±1.2 pg/ml and 29.4±2.3 pg/ml in group 2 and in the control group – 46.2±0.8 pg/ml (p=0.035). The linear correlation coefficient showed that in tuberculosis patients, there isalmost no correlation between the level of IL-6 and melatonin ( r = 0.14), and there is a positive, close relationship between the level of IL-10 and melatonin (r = 0.73).