By the method of atomic emission spectrometry with inductively coupled plasma, the content of macro and microelements in the blood plasma of 35 practically healthy people living in the Northern region of Azerbaijan and in the Nizhny Novgorod region of the Russian Federation was studied as well as of 23 patients with pulmonary tuberculosis with different phases of the disease. The elemental homeostasis of the blood plasma did not significantly differ depending on the region of residence, except for the potassium level (by 1.3 times greater for Russians) and strontium (by 10 times higher among the inhabitants of the Northern region of Azerbaijan). In patients with focal pulmonary tuberculosis, there were no significant differences in the content of elements in the blood plasma. With pulmonary tuberculosis, accompanied by decomposition processes, the content of calcium, copper, zinc and iron in blood plasma significantly increases in comparison with healthy people. Analysis of the level of these macro- and microelements can be used to determine the transition of the early form of pulmonary tuberculosis to infiltrative and/or cavernous forms, in which the patient becomes epidemiologically dangerous to others.
Radiation imaging techniques, bacterioscopy, cultural and genetic differential methods are used to diagnose pulmonary tuberculosis [
In connection with the foregoing, the purpose of this study was a comparative analysis of the level of macro and microelements of blood plasma of practically healthy people living in Azerbaijan and Russia , and an assessment of the violations of the mineral homeostasis of blood plasma in various forms of pulmonary tuberculosis.
Investigation was carried out in April 2016. Blood plasma was studied in 35 practically healthy people living in the Northern rural region of Azerbaijan (Guba district) (15 people aged 33 - 60) and living in the Nizhny Novgorod region of the Russian Federation (20 people 29 - 58 years), comparable in gender and age. Blood samples were also analyzed for 23 patients who had not previously undergone anti-tuberculosis treatment: 16 men (16 - 57 years) and 7 women (34 - 56 years) living in Guba district of Azerbaijan. 60% of patients were characterized by a far-reaching tuberculosis process in the phase of decay: infiltrative and cavernous forms. 40% of patients had one- or two-sided focal pulmonary tuberculosis.
Analysis of the level of macro- and microelements was carried out using atomic-emission spectrometry with inductively coupled plasma on an iSAP6300Duo spectrometer (Thermo Scientific, the USA). Statistical processing of the results was carried out using the BIOSTAT software package. When assessing the array of data on the biochemical parameters of patients using the Shapiro-Wilk test, the normality of the distribution was not confirmed, and that is why the non-parametric statistics methods were used to assess the significance of differences with the control group: Mann-Whitney and Kolmogorov-Smirnov tests.
When comparing the data on the elemental homeostasis of the blood plasma of practically healthy people living in Azerbaijan and the Russian Federation, a statistically significant difference in the level of potassium (almost by 1.3 times greater among Russians) and strontium (by 10 times higher among residents of the northern region of Azerbaijan) (
In patients with pulmonary tuberculosis, the levels of calcium, copper, iron and zinc in the blood significantly increased (
Different forms of tuberculosis differ in their biochemical and physiological characteristics, and that is why a comparative analysis of the level of micro- and macronutrients in the blood plasma of patients with initial and infiltrative, cavernous forms was carried out. It was shown that with pulmonary tuberculosis accompanied by decomposition processes, the content of calcium, copper, zinc and iron in blood plasma significantly increases in comparison with healthy people, while in patients with focal pulmonary tuberculosis such a difference was not found (Figures 1(a)-(d)).
There are known humoral compounds promoting the development of hypercalcemia: prostaglandins, transforming growth factors, a number of cytokines
Actually healthy people, Russia | Actually healthy people, Azerbaijan | Patients with pulmonary tuberculosis, Azerbaijan | ||
---|---|---|---|---|
Macroelements | Na, mkg/ml | 3400.50 ± 58.00 | 2800.00 ± 100.00 | 2860.00 ± 40.00 |
K, mkg/ml | 1232.70 ± 42.15 | 940.34 ± 34.64▲ | 572.00 ± 120.80 | |
Ca, mkg/ml | 79.50 ± 2.13 | 89.67 ± 3.18 | 93.40 ± 1.86* | |
Mg, mkg/ml | 16.5 ± 0.98 | 24.33 ± 1.85 | 22.80 ± 0.37 | |
Microelements | Al, mkg/ml | <0.2 | <0.2 | <0.2 |
Ba, mkg/ml | <0.04 | <0.04 | <0.04 | |
Co, mkg/ml | <0.06 | <0.06 | <0.06 | |
Cr, mkg/ml | <0.04 | <0.04 | <0.04 | |
Cu, mkg/ml | 0.95 ± 0.09 | 0.87 ± 0.06 | 1.23 ± 0.93* | |
Fe, mkg/ml | 1.21 ± 0.08 | 1.05 ± 0.05 | 1.46 ± 0.11* | |
Li, mkg/ml | <0.04 | <0.04 | <0.04 | |
Ni, mkg/ml | <0.1 | <0.1 | <0.1 | |
Se, mkg/ml | <0.7 | <0.7 | <0.7 | |
Sr, mkg/ml | 0.06 ± 0.006 | 0.62 ± 0.16▲ | 0.88 ± 0.31 | |
V, mkg/ml | <0.1 | <0.1 | <0.1 | |
Zn, mkg/ml | 0.56 ± 0.01 | 0.69 ± 0.07 | 1.60 ± 0.57* | |
Mo, mkg/ml | <0.07 | <0.07 | <0.07 |
▲: differences with indicators of practically healthy people living in Russia are reliable (p < 0.05); *: differences with the parameters of the control group (practically healthy people living in Azerbaijan) are reliable (p < 0.05).
(IL-1, IL-4, IL-6, TNF-alpha and TNF-β), which function due to activation of osteoclasts [
According to modern ideas [
Iron is important not only for providing the body with oxygen (hemoglobin, myoglobin), but also for the functioning of the respiratory chain and the synthesis of ATP (cytochromes a, b, c), toxic detoxification processes (cytochrome P450), but also plays a role in immune reactions. Thus, iron is necessary for the activation of neutrophils and the realization of their functions, being a component of peroxygen-generating and nitroxide-generating enzymes, as well as an integral component of myeloperoxidase [
Zinc is involved in the processes of DNA synthesis and repair, tissue regeneration, immunogenesis, endocrine system functioning, etc. It is a competitive antagonist of calcium and magnesium, promoting endonuclease activity and prevents apoptosis [
The results obtained do not contradict the available literature data [
The revealed changes in the blood content of such elements as calcium, copper, iron, zinc cannot be used as an additional diagnostic sign for early detection of pulmonary tuberculosis, since at the early stage of this disease, no significant changes in their level in the blood are observed. The elemental homeostasis of the blood plasma did not significantly differ depending on the region of residence, except for the level of potassium (1.3 times greater for Russians) and strontium (10 times higher among the inhabitants of the northern region of Azerbaijan). However, the analysis of the level of the above macro- and microelements can be applied to determine the transition of the early form of pulmonary tuberculosis to infiltrative and/or cavernous forms of pulmonary tuberculosis, in which the disintegration of lung tissue occurs and the patient becomes epidemiologically dangerous to others.
The work was carried out at the expense of the regional government grant of the Nizhny Novgorod region (Russia) in the field of science and technology for 2016.
Obukhova, L., Erlykina, E., Aliyev, A., Chobanov, R., Pimenov, V., Evdokimov, I. and Sarvarov, A. (2017) Level of Macronutrients and Microelements of Blood Plasma in Different Forms of Pulmonary Tuberculosis. Journal of Biosciences and Medicines, 5, 81-87. https://doi.org/10.4236/jbm.2017.512009