[Morpho-functional changes of surfactant system in pulmonary tuberculosis].

A complex study of different cellular and extracellular surfactant elements in the dynamics of the spontaneous course of generalized tuberculosis was made in 240 guinea-pigs and 77 patients with different forms of active pulmonary tuberculosis by using electron microscopy, biochemistry, and physical chemistry. A diagnostic scheme was proposed for life-time assessment of surfactant in bronchoalveolar lavage specimens. Three degrees of changes in surfactant were identified; 1) adaptive rearrangement of its elements developing in local surfactant damages; 2) significantly impaired type 2 alveolocyte production of surfactant, which affects its biochemical composition and capacity of forming characteristic structures; 3) common morphological, biochemical, surface-active signs of surfactant decompensation, profound metabolic disturbances, alveolar epithelial destruction with cleared alveolocytes found in the lavage.