The association of active pulmonary tuberculosis and bronchial obstruction
prolongs further parnechymal destruction, while its detection and treatment
on time prevent irreversible changes in the airways and consecutive
significant functional limitations of the respiratory system, which are very
similar to those in chronic obstructive pulmonary disease; however, despite
some analogies in the pathogenesis, clinical and functional manifestations,
these two entities can not be equated, but should be differentiated in time.
Risk factors for development of bronchial obstruction in active pulmonary
tuberculosis are of the multifactor nature, and the matrix
metalloproteinase-system could be a key to the future solutions of
etiopathogenic and therapeutic models. Bronchial obstruction in active
pulmonary tuberculosis is often the initial manifestation of an unrecognized
chronic obstructive pulmonary disease, and a consequent, significant,
functional impairment of the respiratory system that has developed on the
site of extensive parenchymal destruction and intense systemic inflammatory
response during reparative processes, which, in the absence of risk factors
for chronic obstructive pulmonary disease, change the normal architecture of
respiratory system and its proper function. The administration of
bronchodilators by the Global Initiative for Chronic Obstructive Lung Disease
strategy represents a good way in systemic and objective therapeutic approach
to these patients, while the results in the application of current
questionnaires on life quality of patients with chronic obstructive pulmonary
disease and asthma indicate positive experience, as well as conventional
indicator of treatment outcomes. Therefore, the existing strategies for
control and treatment of tuberculosis should consider the fact that only
microbiological cure of patients with concomitant airway obstruction is not a
sufficient and effective approach to the prevention of further potential,
chronic disruption of their health.
Pulmonary Tuberculosis and Delay in Anti-Tuberculous Treatment Are Important Risk Factors for Chronic Obstructive Pulmonary Disease
