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https://doi.org/10.14300/mnnc.2019.14010

Ultrastructural features of the components of aerogematic lung barrier at fibro -cavernous tuberculosis

[Original research] [Experimental medicine]
Elena Petrovna Golubinskaya; Tatyana Grigorievna Filonenko; Julianna Arkadevna Yermola; Anatoly Vladimirovich Kubyshkin; Margarita Alekseevna Kalfa; Alina Vitalevna Gerashchenko; Tatyana Vadimovna Kramar; Elizaveta Sergeevna Ageeva;

A morphological assessment of 163 fragments of the cavity’s wall and pericavernous lung tissue of the dead or operated on patients with verified fibro-cavernous pulmonary tuberculosis with both bacterial excretion and clinical abacillation was carried out using the transmission electron microscopy method. It has been established that in cases of active tuberculosis, destructive processes in the cavern wall and pericavernosal zone predominate. It’s accompanied by an intensification of lymphohistiocytic activity, increasing of interstitial and intracellular edema, loosening of the basal membranes, uncontrolled increasing of hemocapillary permeability and subsequent organization of exudates. The stabilization of the tuberculous process is accompanied by sclerosis and interstitial fibrosis with the formation of the alveolar-capillary block, dystrophic processes in endotheliocytes and alveolar epithelial cells, chemotaxis of fibroblasts and activation of their synthetic collagen activity. It seems that the prevention of progressive fibrotic remodeling of the pulmonary parenchyma should be based on pathogenetically substantiated target therapy, which provides normalization of the functional activity of endothelium cells and the aerohematic barrier of the lungs, and sanogenetic support of the surfactant structure.

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Keywords: fibrous-cavernous tuberculosis, alveolocytes, endothelial cells, aerohematic barrier, electron microscopy