In modern conditions, the problems of tuberculosis of the respiratory system and chronic obstructive pulmonary disease are highly relevant. Tuberculosis remains high among the population. During its course, the frequency of common destructive forms, the number of patients with multiple and extensive drug resistance of mycobacteria, and comorbid conditions in which pulmonary tuberculosis is combined with immunodeficiency and respiratory pathology increased. Chronic tobacco intoxication and chronic obstruction in the lungs increase the activity of tuberculosis inflammation, contribute to the development of common forms of pulmonary tuberculosis, accompanied by abundant bacterial excretion and destruction of lung tissue. In patients with comorbid pathology, pronounced clinical manifestations of the disease, deep functional disorders in the respiratory system and homeostatic balance of the organism are determined. Chronic tobacco intoxication and chronic obstruction in the bronchi have a significant impact on the processes of atherogenesis, systemic inflammation, endothelial dysfunction and the formation of cardiovascular pathology. These phenomena contribute to insufficient treatment efficiency, the formation of pronounced residual changes in the respiratory organs, a decrease in the quality and life expectancy of patients, a high frequency of exacerbation (relapse) and pose a threat to the spread of tuberculosis. In patients with comorbid pathology, cardiovascular complications, dyslipidemia and atherogenesis appear much more often, which are predictors of early disability and premature death.

The influence of the systemic inflammatory response on the adaptive mechanisms and the state of homeostasis of the body in patients with respiratory tuberculosis against the background of chronic obstructive pulmonary disease is considered. It has been established that respiratory tuberculosis and chronic obstructive pulmonary disease are widespread among the population and are important causes of bronchopulmonary morbidity and mortality. Chronic obstructive pulmonary disease is determined in one third of newly diagnosed patients with respiratory tuberculosis. The combined course of respiratory tuberculosis and chronic obstructive pulmonary disease is a mutually aggravating condition. Comorbid pathology is much more difficult, accompanied by severe intoxication, disintegration of lung tissue and bacterial excretion. Biomarkers and the severity of the systemic inflammatory response are of great clinical and diagnostic value in chronic obstructive pulmonary disease. It was determined that the systemic inflammatory response in chronic obstructive pulmonary disease is characterized by endothelial dysfunction of the vascular wall, significant changes in white blood cells, changes in the protein spectrum of the blood, and lipid metabolism disorders. The manifestations of systemic inflammation and endothelial dysfunction, characteristic of chronic obstructive pulmonary disease, in patients with respiratory tuberculosis, aggravate the course of both diseases. The comorbid state is also characterized by a change in the lipid profile of patients, an increase in the content of total cholesterol and atherogenic fractions. These changes are interrelated with the state of adaptive mechanisms, homeostasis and reactivity of the organism. The state of homeostasis largely determines the development, course and outcome of pathological processes characteristic of tuberculous inflammation and inflammation in chronic obstructive pulmonary disease, and the increase in the effectiveness of the treatment is closely related to the restoration of homeostatic balance and reactivity of the body. The availability of methods for determining the homeostatic balance of the body in clinical practice, with their high information content, allows a personalized approach to the management of patients with comorbidity.

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In modern conditions, chronic tobacco intoxication and chronic obstructive pulmonary disease are widespread and affect the health and life expectancy of patients. Among patients with tuberculosis, chronic tobacco intoxication and COPD are also widespread. Against the background of smoking and chronic obstructive pulmonary disease in patients with tuberculosis of the respiratory system, bronchial obstruction, hypoxemia, impaired capillary pulmonary blood flow, and a decrease in the diffusion capacity of the lungs are determined. A comorbid state is accompanied by the development of oxidative stress, systemic inflammation, endothelial dysfunction. Such changes in combination with dyslipidemia contribute to the development of multifocal atherogenesis, systemic arterial hypertension and the rapid development of cardiovascular pathology