THE INFLUENCE OF PLASMA LEVEL ALTERATIONS OF INFLAMMATORY, ENDOCRINE AND VASCULAR BIOMARKERS FOR THE FORMATION AND PROGNOSIS OF PULMONARY TUBERCULOSIS COMORBID WITH DIABETES MELLITUS TYPE-2

Tuberculosis (TB) remains as a most disseminated infectious disease resulting in different complications and lethal outcome. Studies conducted in last decades showed the increase frequency of pulmonary tuberculosis (PTB) in subjects suffered by diabetes mellitus type-2 (DMT2). The goal of the present investigation was to study the modulatory action of inflammatory cytokines (IL-1B, TNFα), vasoactive agents: epoxyeicosatrienoic acids (EETs), endothelin-1 (E-1), vascular endothelium growth factor (VEGF), resistin (R), lipid spectrum, catecholamines (noradrenaline, epinephrine) and endocrine factors – leptin and adiponectin plasma levels alterations in the formation and prognosis of PTB and PTB comorbid with DMT2. Observational study was carried out in 2023-2025 years period in Tbilisi National Center for Tuberculosis and Lung Diseases (Georgia). Recruiting male and female adult patients (18 and more years old, n=50) were divided into 3 groups: a) Healthy volunteers (HV)-n=10; b) Subjects with newly diagnosed PTB-n=20; c) Patients with PTB coincident with DMT2 (PTBDMT2)-n=20. All patients were involved in this study according inclusion and exclusion criteria. The existence of MTB along with clinical symptoms and X-rays examinations was confirmed by Gene Xpert MTB/RiF ULTRA Test. Plasma concentrations of abovementioned agents as well as glycemic control of fasting glucose, insulin and glycated hemoglobin - (HbA1C%) levels was performed by ELISA Kits method. Insulin resistance (IR) was calculated by HOMA-index using formula: [(fasting glucose (mmol/L X fasting insulin (micromole/L/22,5)]. Receiving results revealed in subjects suffered by PTBDMT2 significantly higher plasma level of cytokines IL-1 31,4 (4,2-60,0) pg/ml, P<0,1534) and TNFα 76,2 (3,5-120,0) pg/ml, P<0,0001), that more expressively positively correlated with elevated concentrations of vasoactive agents – E-1 10,3 (3,5-18,4) pg/ml, P<0,0008), catecholamines, VEGF 917,44 (400,0-1495) pg/ml, P<0,00054), R 43,8(14-259) pg/ml, P<0,03846) and endocrine factor leptin 2,02 (0,34-5,8) pg/ml, P<0,00001), providing marked negative relationship to EETs 6,9 (4,8-9,9) pg/ml and adiponectin 95,47 (18-305) pg/ml, P<0,00694) as compared to the same values of PTB and especially HV groups of patients. Such events were associated with lipid spectrum disorders in PTB and PTBDMT2 patients. It is suggesting that cytokines, vasoactive and endocrine agents can be considered as potential biomarkers for early diagnostic and assessment of treatment effectiveness and outcome of PTB and PTBDMT2.