The Proportion of Long-chain Fatty Aldehydes and Acids in Bronchial Lavage as a Marker of Treatment Outcomes in Pulmonary Tuberculosis.

BACKGROUND

Improving the effectiveness of pulmonary tuberculosis (TB) treatment is one of the main objectives of the healthcare system in Russia. The aim of this study was to search for a relationship between the composition of long-chain fatty acids and aldehydes detected in bronchial lavage samples from patients with TB and the features of the TB infection during the treatment.

METHODS

This study included 262 patients with pulmonary TB with varying treatment durations and different drug sensitivity profiles of the pathogen. Patients' samples were collected during routine bronchoscopy using the minilavage technique. Each sample was examined for Mycobacterium tuberculosis by standard laboratory methods and for long-chain fatty acids and aldehydes by gas chromatography-mass spectrometry analysis.

RESULTS

We found that a higher proportion of aldehydes (18:1d9a, 18:1d11a, and i17:0a) and monounsaturated fatty acids (20:1d9 and 20:1d11) in bronchial lavage samples was associated with worse treatment outcomes (presence of bacterial shedding and cavities at the time of sampling and 6 months later), as well as with smoking and the M. tuberculosis Beijing genotype. In contrast, favorable treatment outcomes were associated with an increased proportion of saturated fatty acids, including branchedchain fatty acids (i16:0, a17:0, 17:0, a15:0, and i15:0).

CONCLUSION

The identified marker profile may have prognostic value and warrants further prospective validation.