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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.

Bronchial obstruction in the active tuberculosis with reference to our experiences