Adv Gerontol. 2026;39(1):69-73. doi: 10.34922/AE.2026.39.1.007.
ABSTRACT
The most important socially significant disease is pulmonary tuberculosis, which is based on the development of granulomatous inflammation with the formation of fibrosis. In the elderly, it occurs with the features of pathomorphosis, due to the presence of comorbid pathology. The processes of development of coarse-fibrous connective tissue, sclerosis-fibrosis occur according to the general patterns with the involvement of the organ stroma, vessels and remodeling of the connective-tissue matrix, the study of which is impossible without the study of the relevant molecular markers. On the other hand, diagnosis and treatment are impossible without understanding the dynamics of the pathological process. Therefore, research aimed at predicting the development of pulmonary tuberculosis (especially in elderly patients) is undoubtedly relevant. The aim of the study – to create a prognostic model of the severity of the course of pulmonary tuberculosis in elderly patients. In the course of the study, the outcomes of treatment of 45 patients treated in Saint-Petersburg Research Institute of Phthisiopulmonology were analyzed. Based on the degree of activity of the tuberculous process by B.M.Ariel (1998), groups with pulmonary tuberculosis without progression and active inflammatory changes with progression were allocated. Quantitative assessment of the expression of signaling molecules (TIMP-1, NGF, CD44, CD51, CD68, CD83, Vit D) was performed using immunohistochemical morphometry and computer analysis of microscopic images. The prediction model was constructed using logistic regression. In the course of the study, the activity of monoclonal antibodies for the corresponding signaling molecules was studied: TIMP-1, NGF, CD44, CD51, CD68, CD83, Vit D, statistically significant differences in the relative area of expression of the following biological markers were established: NGF, CD68, CD83 depending on the degree of tuberculosis activity. Logistic regression was used to create a model for predicting the course of the tuberculosis process. Based on the numerical values of molecular markers (NGF, CD-68, and CD-83), a logistic regression equation was obtained that allows for the association of the severity of the disease with the levels of the markers. The sensitivity of the model was 85,7%, and the specificity was 87,5%. Thus, the obtained regression model based on the expression of molecular markers NGF, CD-68, and CD-83 allows for the prediction of the severity of pulmonary tuberculosis in elderly patients, which will enable the control of treatment in these patients.
PMID:42150026 | DOI:10.34922/AE.2026.39.1.007
