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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">antibiotics</journal-id><journal-title-group><journal-title xml:lang="ru">Антибиотики и Химиотерапия</journal-title><trans-title-group xml:lang="en"><trans-title>Antibiot Khimioter = Antibiotics and Chemotherapy</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0235-2990</issn><publisher><publisher-name>ООО «Издательство ОКИ»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.37489/0235-2990-2021-66-9-10-30-38</article-id><article-id custom-type="elpub" pub-id-type="custom">antibiotics-857</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯ И ПРАКТИКА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>GUIDELINES FOR PRACTITIONERS</subject></subj-group></article-categories><title-group><article-title>Влияние полиморфных маркеров гена NAT2 на эффективность и безопасность лечения пациентов с впервые выявленным туберкулёзом лёгких по динамике показателей эритроцитарного звена периферической крови</article-title><trans-title-group xml:lang="en"><trans-title>Influence of the NAT2 gene polymorphic markers on the effectiveness and safety of treatment in patients with newly diagnosed pulmonary tuberculosis based on peripheral red blood cell dynamics</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4811-7801</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Краснова</surname><given-names>Н. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Krasnova</surname><given-names>N. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Краснова Наталия Михайловна — к. м. н., доцент</p><p>SPIN-код: 8703-8169. Scopus Author ID: 57205162915</p><p>Якутск</p></bio><bio xml:lang="en"><p>Natalia M. Krasnova — Ph. D. in medicine</p><p>SPIN: 8703-8169. Scopus Author ID: 57205162915</p><p>Yakutsk</p></bio><email xlink:type="simple">krasnova14@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ефременко</surname><given-names>С. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Efremenko</surname><given-names>S. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ефременко Софья Геннадьевна</p><p>Якутск</p></bio><bio xml:lang="en"><p>Sofia G. Efremenko — phthisiologist</p><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0187-280X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Евдокимова</surname><given-names>Н. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Evdokimova</surname><given-names>N. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Евдокимова Надежда Евстафьевна — врач фтизиатр</p><p>SPIN-код: 1169-5154</p><p>Якутск</p></bio><bio xml:lang="en"><p>Nadezhda E. Evdokimova — phthisiologist</p><p>SPIN: 1169-5154</p><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4213-2901</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Филиппова</surname><given-names>О. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Filippova</surname><given-names>O. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Филиппова Ольга Ивановна</p><p>SPIN-код: 4293-2220</p><p>Якутск</p></bio><bio xml:lang="en"><p>Olga I. Filippova — Head of the Department for Patients with Respiratory Tuberculosis</p><p>SPIN: 4293-2220</p><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0941-8633</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чертовских</surname><given-names>Я. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Chertovskikh</surname><given-names>Y. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Чертовских Яна Валерьевна</p><p>SPIN-код: 8485-9530</p><p>Якутск</p></bio><bio xml:lang="en"><p>Yana V. Chertovskikh — Head of the Personalized Medicine Center</p><p>SPIN code: 8485-9530</p><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6116-5720</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Алексеева</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Alekseeva</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Алексеева Елизавета Александровна</p><p>SPIN-код: 8918-7035</p><p>Якутск</p></bio><bio xml:lang="en"><p>Elizaveta A. Alekseeva — biologist</p><p>SPIN: 8918-7035</p><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7717-9174</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Татаринова</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Tatarinova</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Татаринова Ольга Викторовна</p><p>SPIN-код: 3346-0980</p><p>Якутск</p></bio><bio xml:lang="en"><p>Olga V. Tatarinova — D.Sc. in medicine</p><p>SPIN: 3346-0980</p><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Готовцева</surname><given-names>А. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Gotovtseva</surname><given-names>A. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Готовцева Анна Ивановна</p><p>SPIN-код: 4490-6953</p><p>Якутск</p></bio><bio xml:lang="en"><p>Anna I. Gotovtseva — Ph. D. in medicine</p><p>SPIN-code: 4490-6953</p><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Прокопьев</surname><given-names>Е. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Prokopev</surname><given-names>E. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Прокопьев Егор Спиридонович</p><p>SPIN-код: 8046-5639</p><p>Якутск</p></bio><bio xml:lang="en"><p>Egor S. Prokopev — Ph. D. in medicine</p><p>SPIN-code: 8046-5639</p><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9210-3407</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кравченко</surname><given-names>А. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Kravchenko</surname><given-names>A. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кравченко Александр Фёдорович</p><p>SPIN-код: 3188-6796. Scopus Author ID: 7202732143</p><p>Якутск</p></bio><bio xml:lang="en"><p>Alexander F. Kravchenko — D. Sc. in medicine</p><p>SPIN: 3188-6796. Scopus Author ID: 7202732143</p><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5094-3742</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Венгеровский</surname><given-names>А. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Vengerovskiy</surname><given-names>A. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Венгеровский Александр Исаакович</p><p>SPIN-код: 8818-0543. Scopus Author ID: 6602839346</p><p>Томск</p></bio><bio xml:lang="en"><p>Alexander I. Vengerovskiy — D. Sc. in medicine</p><p>SPIN code: 8818-0543. Scopus Author ID: 6602839346</p><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4496-3680</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сычев</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Sychev</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сычёв Дмитрий Алексеевич — д .м. н., профессор, член-корр. РАН, ректор</p><p>SPIN-код: 4525-7556. Scopus Author ID: 7801389135</p><p>Москва</p></bio><bio xml:lang="en"><p>Dmitry A. Sychev — D. Sc. in medicine, Professor, CorrespondingMember of the RAS</p><p>SPIN code: 4525-7556. Scopus Author ID: 7801389135</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Медицинский институт «Северо-Восточный федеральный университет им. М. К. Аммосова»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>M. K. Ammosov North-East Federal University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Научно-практический центр «Фтизиатрия» им. Е. Н. Андреева»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>E. N. Andreev Phthisiology Scientific and Practical Center</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Республиканская клиническая больница № 3</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Republican Clinical Hospital No. 3</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Сибирский государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Siberian State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>Российская медицинская академия непрерывного профессионального образования</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Medical Academy of Continuing Professional Education</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>02</day><month>01</month><year>2022</year></pub-date><volume>66</volume><issue>9-10</issue><fpage>30</fpage><lpage>38</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; ООО «Издательство ОКИ», 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">ООО «Издательство ОКИ»</copyright-holder><copyright-holder xml:lang="en">ООО «Издательство ОКИ»</copyright-holder><license xlink:href="https://www.antibiotics-chemotherapy.ru/jour/about/submissions#copyrightNotice" xlink:type="simple"><license-p>https://www.antibiotics-chemotherapy.ru/jour/about/submissions#copyrightNotice</license-p></license></permissions><self-uri xlink:href="https://www.antibiotics-chemotherapy.ru/jour/article/view/857">https://www.antibiotics-chemotherapy.ru/jour/article/view/857</self-uri><abstract><sec><title>Обоснование</title><p>Обоснование. Индивидуальная восприимчивость больных туберкулёзом к действию изониазида обусловлена присутствием в геноме аллельных вариантов гена фермента N-ацетилтрансферазы 2 (NAT2). Количественные и качественные изменения в периферической крови позволяют диагностировать заболевание, оценить его тяжесть, служат ориентиром эффективности и безопасности противотуберкулёзной терапии.</p><p>Цель — установить взаимосвязь между типом ацетилирования и динамикой показателей эритроцитарного звена периферической крови, определить влияние скорости ацетилирования при участии NAT2 на эффективность и безопасность лечения пациентов с впервые выявленным туберкулёзом лёгких, проживающих в Республике Саха (Якутия).</p><p>Методы — в исследование включены 146 пациентов с различными формами впервые выявленного туберкулёза лёгких. Пациенты принимали внутрь изониазид, рифампицин, пиразинамид, этамбутол. Генотипирование проводили методом полимеразной цепной реакции в режиме реального времени.</p></sec><sec><title>Результаты</title><p>Результаты. У быстрых и промежуточных ацетиляторов после курса химиотерапии повышались концентрация и содержание гемоглобина в эритроцитах (p&lt;0,05). В группе промежуточных ацетиляторов снижалась частота анемий по сравнению с частотой у быстрых и медленных ацетиляторов (p=0,013). Установлена отрицательная корреляция между абсолютным количеством эритроцитов и медленным типом ацетилирования (p=0,017). У пациентов с быстрым типом ацетилирования возрастали индексы RDW-CV и RDW-SD (p&lt;0,05).</p></sec><sec><title>Выводы</title><p>Выводы. При лечении пациентов с промежуточным типом ацетилирования адекватный терапевтический эффект достигался при приёме противотуберкулёзных средств в стандартных дозах. При быстром и медленном типах ацетилирования необходима коррекция дозы противотуберкулёзных средств. Генотипирование по гену фермента NAT2 пациентов с туберкулёзом лёгких позволяет подобрать оптимальную дозу противотуберкулёзных средств, в частности дозу изониазида.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Background</title><p>Background. Individual sensitivity to isoniazid in tuberculosis patients is determined by the presence of N-acetyltransferase 2 (NAT2) enzyme gene allelic variants in genome. Evaluation of quantitative and qualitative alterations in peripheral blood can be used for diagnosis, disease severity estimation, or as a clue for estimation of anti-tuberculosis chemotherapy effectiveness and safety.</p></sec><sec><title>Aim</title><p>Aim: Find associations between acetylation type and peripheral red blood cell (RBC) dynamics; determine the effect of NAT2 acetylation rate on the effectiveness and safety of treatment in patients with newly identified pulmonary tuberculosis (TB) residing in the Sakha Republic (Yakutia).</p></sec><sec><title>Methods</title><p>Methods. This study included 146 patients with various clinical forms of newly diagnosed pulmonary TB. Oral isoniazid, rifampicin, pyrazinamide, and ethambutol were administered patients. Genotyping was performed via real time PCR.</p></sec><sec><title>Results</title><p>Results. Rapid and intermediate acetylators showed an increase in hemoglobin concentrations and RBC erythrocyte hemoglobin content by the end of chemotherapy (P&lt;0.05). Incidence of anemia was lower in intermediate acetylators, compared to rapid or slow acetylators (P=0.013). Negative correlation was established between absolute RBC count and slow acetylation type (P=0.017). Patients with rapid acetylation type showed increased RBC distribution width indexes RDW-CV and RDW-SD (P&lt;0.05).</p></sec><sec><title>Conclusions</title><p>Conclusions. An adequate therapeutic effect was achieved with standard doses of anti-TB medications in patients with intermediate acetylation type. Rapid and slow acetylators required anti-TB medication dose correction. Genotyping for NAT2 gene in patients with pulmonary TB enables clinicians to choose the optimal dose of anti-TB medications, specifically, isoniazid dose.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>туберкулёз</kwd><kwd>изониазид</kwd><kwd>N-ацетилтрансфераза 2 (NAT2)</kwd><kwd>тип ацетилирования</kwd><kwd>эритроциты</kwd><kwd>эритроцитарные индексы</kwd><kwd>анемия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>tuberculosis</kwd><kwd>isoniazid</kwd><kwd>N-acetyltransferase 2 (NAT2)</kwd><kwd>acetylation type</kwd><kwd>erythrocytes</kwd><kwd>red blood cell index</kwd><kwd>anemia</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Туберкулёз у взрослых. Клинические рекомендации. Москва; 2020. Доступно по: https://cr.minzdrav.gov.ru/schema/16_1. Ссылка активна на 24.09.2021.</mixed-citation><mixed-citation xml:lang="en">Tuberculosis in adults. Clinical guidelines. 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