vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2018-15-1-40-54vestim-413Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEРЕЗУЛЬТАТЫ ЛЕЧЕНИЯ МУЛЬТИРЕЗИСТЕНТНОГО ТУБЕРКУЛЕЗА С ИСПОЛЬЗОВАНИЕМ НОВЫХ ЛЕКАРСТВЕННЫХ СРЕДСТВ И КЛЕТОЧНЫХ ТЕХНОЛОГИЙRESULTS OF MULTIDRUG-RESISTANT TUBERCULOSIS TREATMENT USING NEW DRUGS AND CELLULAR TECHNOLOGIESГуревичГ. Л.HurevichGennady L.

д-р мед. наук, профессор, директор 

Долгиновский тракт, 157, 220053, г. Минск

D. Sc. (Med.), Professor, Director

157, Dolginovskii Tract, 220053, Minsk

ge.gurev@gmail.comСкрягинаЕ. М.SkryahinaElena M.

д-р мед. наук, профессор, заместитель директора по научной работе

Долгиновский тракт, 157, 220053, г. Минск

D. Sc. (Med.), Deputy Director for Research

157, Dolginovskii Tract, 220053, Minsk

alena.skrahina@gmail.comДюсьмикееваМ. И.DziusmikeyevaMarina I.

канд. мед. наук, заведующий отделением

Долгиновский тракт, 157, 220053, г. Минск

Ph. D. (Med.), Head of the Department

157, Dolginovskii Tract, 220053, Minsk

trimige@inbox.ruИсайкинаЯ. И.IsaykinaJanina I.

канд. биол. наук, заведующий лабораторией

ул. Фрунзенская, 43, 223053, Минский р-н, д. Боровляны

Ph. D. (Biol.), Head of the Laboratory

43, Frunzenskaya Str., v. Borovliany, 223053, Minsk Region

yaninai@mail.ruРеспубликанский научно-практический центр пульмонологии и фтизиатрииRepublican Research and Practical Center for Pulmonology and TuberculosisРеспубликанский научно-практический центр детской онкологии, гематологии и иммунологииRepublican Research and Practical Center for Pediatric Oncology, Hematology and Immunology2018030320181514054Copyright © Гуревич Г.Л., Скрягина Е.М., Дюсьмикеева М.И., Исайкина Я.И., 20182018Гуревич Г.Л., Скрягина Е.М., Дюсьмикеева М.И., Исайкина Я.И.Hurevich G.L., Skryahina E.M., Dziusmikeyeva M.I., Isaykina J.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/413

Мультирезистетный туберкулез является одной из актуальных проблем здравоохранения в Республике Беларусь.

Цель исследования – оценка эффективности новых лекарственных средств и схем химиотерапии, а также клеточных технологий как метода аддитивной терапии при лечении пациентов с туберкулезом с множественной и широкой лекарственной устойчивостью возбудителя (М/ШЛУ-ТБ).

Для оценки эффективности лечения на основании когортного анализа было отобрано 416 человек, которым были назначены новые схемы химиотерапии. Мультирезистентный туберкулез у пациентов выявляли с помощью оптимизированного алгоритма микробиологической диагностики с применением молекулярно-генетических методов. Разработана методика аутологичной трансплантации мультипотентных мезенхимальных стромальных клеток, входящая в комплексную схему лечения пациентов с М/ШЛУ-ТБ.

Предварительные результаты исследования свидетельствуют о высокой эффективности новых противотуберкулезных схем, а также клеточной технологии на фоне индивидуализированной химиотерапии в лечении лекарственно-устойчивого туберкулеза. При этом установлено, что бедаквилин и деламанид эффективны в сочетании с оптимизированными фоновыми схемами лечения, состоящими в том числе из перепрофилированных противотуберкулезных лекарственных средств, и вызывают незначительное количество побочных явлений. 

The detection of multidrug-resistant and extensively drug-resistant tuberculosis cases has become a major public health problem and an obstacle to effective global tuberculosis control.

We have set the task to improve the effectiveness of treatment of patients with multidrug-resistant and extensively drugresistant tuberculosis using new drugs and developed chemotherapy regimens, as well as cellular technologies as a method of additive therapy. Based on the cohort analysis, the effectiveness of treatment was assessed using new and re-profiled antituberculosis drugs, including Bedaquiline and Delamanid. A method of autologous transplantation of multipotent mesenchymal stromal cells was developed, which was included into the complex therapy of patients. Preliminary results of the conducted studies testify to the high effectiveness of new antituberculosis treatment regimens. Autologous transplantation of multipotent mesenchymal stromal cells against the background of individualized chemotherapy speeds up the conversion of sputum and ultimately significantly improves the final results of treatment of patient. Despite the fact that cellular technologies in the treatment of tuberculosis are not widely used at present, these methods aimed at eliminating the causative agent of tuberculosis and the regeneration of damaged lung tissue will be in great demand in the future, primarily because of the significant advantage compared with the use of antituberculosis drugs means – the absence of development of resistance of mycobacteria tuberculosis. 

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The authors declare that there are no conflicts of interest present.