Regional Lymphotropic Therapy in Combination with Low Level Laser Therapy for Treating Multi-Drug-Resistant Tuberculosis

Oksana Dogorova; Ekaterina Pavlova, PhD*; Maria Vinokurova, PhD, ScD

Republic Research-and-Practice Center for Tuberculosis; Yakutsk, the Republic of Sakha, Russia

*Corresponding author: Еkaterina Pavlova, PhD. Republic Research-and-Practice Center for Tuberculosis, Yakutsk, the Russian Federation. Email:

Published: March 16, 2016. DOI: 10.21103/Article6(1)_ShC1


With the growing incidence of Multi-Drug-Resistant Tuberculosis (MDR-TB) in newly identified patients, novel multimodality treatment methods are needed, aimed at reducing the time to sputum conversion and cavity healing, which would be applicable in MDR cases.

Our experimental treatment consisted of the following: 1) chemotherapy based on the drug sensitivity profile, 2) local laser irradiation therapy for 25 days, and lymphotropic administration of isoniazid (to subcutaneous tissue in alternating locations: underarm area; fifth intercostal space along the sterna border; subclavian area where the first rib meets the sternum) in a daily dose of 10mg/kg 5 times a week. This treatment was significantly more effective in newly detected destructive MDR-TB versus the standard Category IV regimen for MDR-TB in terms of reduced time for sputum culture conversion and cavity healing, estimated to be 6 months after initiation of treatment. 

multi-drug-resistant tuberculosis; laser irradiation therapy; lymphotropic therapy; isoniazid.
  1. Bhagwanani NS1, Bhatia CC1, Sharma N1, Hemvani N1, Chitnis DS1.Low level nitrogen laser therapy in pulmonary tuberculosis.Laser Ther. 2015;24(3):209-14.
  2. Wright A, Zignol M, Van Deun A, Falzon D, Gerdes SR, Feldman K,, et al.; Global Project on Anti-Tuberculosis Drug Resistance Surveillance. Epidemiology of antituberculosis drug resistance 2002-07: an updated analysis of the Global Project on Anti-Tuberculosis Drug Resistance Surveillance. Lancet 2009; 373(9678):1861–73.
  3. World Health Organization (WHO). Multidrug and extensively drug-resistant TB (M/XDR-TB): 2010 global report on surveillance and response. Geneva, Switzerland: WHO, 2010. (WHO/HTM/TB/2010.3).
  4. Vinokurova MK, Alexandrov VL, Yakovleva LP, Oshchepkova NM. Trends in the development of the epidemiological situation of tuberculosis in the Republic Sakha (Yakutia) in 2004-2011. YAKUT MEDICAL JOURNAL. 2013;(1):58-63. [Article in Russian].
  5. Katiyar SK, Bihari S, Prakash S, Mamtani M, Kulkarni H. A randomised controlled trial of high-dose isoniazid adjuvant therapy for multidrug-resistant tuberculosis. Int J Tuberc Lung Dis. 2008;12(2):139–45. [PubMed]
  6. PIH guide to medical management of multidrug-resistant tuberculosis. Boston: Partners in Health; 2003. [15 March 2014]. http://www​​/entry/pih-guide-to-the-medical-management-of-multidrug-resistant-tuberculosis/
  7. Rom WN, Garay SM, editors. Tuberculosis. Philadelphia: Lippincott Williams & Wilkins; 2004.
  8. Companion Handbook to the WHO Guidelines for the Programmatic Management of Drug-Resistant Tuberculosis. WHO Guidelines Approved by the Guidelines Review Committee. Geneva: World Health Organization; 2014.
  9. Ramachandran G, Swaminathan S. Role of pharmacogenomics in the treatment of tuberculosis: a review. Pharmgenomics Pers Med. 2012; 5:89–98.
  10. Gavriliev SS, Vinokurova MK, Illarionov TS. Individualized chemotherapy for pulmonary tuberculosis. Yakutsk; 2003. [in Russian].
  11. Gavriliev SS, Vinokurova MK, Mordovskaya LI. Semiconductor lasers for phthisiatry. New treatment technology. Novosibirsk; 2004. [in Russian].
  12. Puri MM, Arora VK. Role of gallium arsenide laser irradiation at 890 nm as an adjunctive to anti-tuberculosis drugs in the treatment of pulmonary tuberculosis.Indian J Chest Dis Allied Sci. 2003; 45(1):19-23.
  13. MOH. Ministry of Health and Social Development of the Russian Federation. Order No 109  “On the improvement of TB control activities in the Russian Federation”; 2003. Available from:

The fully formatted PDF version is available

Download Article

Int J Biomed. 2016; 6(1):82-84. © 2016 International Medical Research and Development Corporation. All rights reserved.