The frequency and nature of adaptive reactions were studied by the procedure described by L. Kh. Garkavi in 308 patients with destructive pulmonary tuberculosis in relation to the carriage of different combinations of genetic markers. Reactions of the stress type were most frequently established in patients with caseous pneumonia and fibrocavernous tuberculosis (60.9+/-10.1 and 56.4+/-7.9%, respectively). Stress was significantly often seen in patients who carried unfavorable and relatively unfavorable combinations of genetic markers (66.6+/-8.2 and 42.8+/-3.7%, respectively) and their change during treatment was insignificant. At the same time, patients with a carriage of favorable and relatively favorable combinations of genetic markers showed adequate reactions of training and activation. The nature of adaptive reactions correlated with the pattern of pulmonary tuberculosis and the level of biochemical inflammatory markers.