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Underlying host risk factors for nontuberculous mycobacterial lung disease

Edward D Chan1, Michael D Iseman

  • 1Denver Veterans Affairs Medical Center, Denver, Colorado, USA. chane@njhealth.org

Seminars in Respiratory and Critical Care Medicine
|March 6, 2013
PubMed

Insights

Nontuberculous mycobacteria (NTM) lung disease primarily affects individuals with underlying conditions like bronchiectasis or immunosuppression. Certain individuals, including postmenopausal women with slender builds, show increased susceptibility to NTM infections.

Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Microbiology

Background:

  • Nontuberculous mycobacteria (NTM) are ubiquitous environmental microbes.
  • NTM cause chronic lung infections, but only a small fraction of exposed individuals develop disease.
  • This suggests underlying host factors influence susceptibility.

Purpose of the Study:

  • To review evidence linking specific underlying disorders to nontuberculous mycobacteria lung disease.
  • To examine predisposing factors in postmenopausal women with slender body habitus.

Main Methods:

  • Literature review of clinical and experimental studies.
  • Analysis of epidemiological data on NTM lung disease prevalence.
  • Synthesis of evidence on host susceptibility factors.

Main Results:

  • Preexisting conditions like bronchiectasis, COPD, and immunosuppression significantly increase NTM lung disease risk.
  • Specific conditions include α-1-antitrypsin anomalies, pneumoconiosis, and pulmonary alveolar proteinosis.
  • Immunosuppressive states (anti-TNF biologics, transplantation, HIV) are major risk factors.
  • Postmenopausal women with slender body habitus show a notable predisposition.

Conclusions:

  • NTM lung disease development is strongly influenced by host susceptibility.
  • Identifying and managing underlying conditions is crucial for prevention and treatment.
  • Further research into the specific vulnerabilities of certain populations, like slender postmenopausal women, is warranted.

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