BLOOD PLASMA VITAMIN-D BINDING PROTEIN CONTENT IN CHILDREN AND ADOLESCENTS, PATIENTS WITH VARIOUS FORMS OF LUNG TUBERCULOSIS
The dynamics plasma changes of the vitamin D binding protein (VDB) was evaluated by the enzyme immunoassay method. The analysis was carried out in 49 patients with destructive forms (n = 13) and mediastinum lymph node tuberculosis (MTBLN) / focal forms of tuberculosis (n = 27). The M. tuberculosis (MT) infected group was consisted of 9 patients who had contact with patients with tuberculosis and positive skin tests. The study showed that before the initiation of specific antituberculosis chemotherapy, the plasma level of vitamin D binding protein did not statistically differ between the groups of patients with destructive tuberculosis and «small forms» of respiratory tuberculosis and group of MT infected patients. The specific chemotherapy also did not affect the plasma level vitamin D binding protein during 3 and 6 months of evaluation. We found differences in the plasma vitamin D binding protein level in the subgroups included in the «small» forms of tuberculosis of the respiratory system. It was shown that the plasma VDB content in patients with MTBLN before the start of treatment was significantly higher in comparison with the group of infected MT (1.77 ± 0.1 mg / ml and 1.5 ± 0.04 mg / ml, P = 0.08415, respectively). Vitamin D binding protein in MTBLN patients was also significantly higher than in patients with focal tuberculosis at 0, 3 and 6 months of specific treatment (0 mo. – 1,77 ± 0,1 and 1,5 ± 0,08, Р = 0,0456; 3 mo. -1.77 ± 0.05 mg / ml and 1.4 ± 0.08 mg / ml, P = 0.04702 and 6 mo. – 1.9 ± 0.09 mg / ml and 1.46 ± 0.07 mg / ml, P = 0.00230, respectively). It should be assumed that the VDB binds an excess amount of calcitriol, which regulates the balance of TGF-β1 in MTBLN patients.