[Nontuberculous mycobacterial infections].

Area of Science:

• Immunology
• Infectious Diseases
• Rheumatology

Background:

• Nontuberculous mycobacteria (NTM) are environmental microbes with increasing incidence of human infection.
• Host susceptibility, exposure frequency/duration, and immune status influence NTM disease risk.
• Conditions like rheumatoid arthritis (RA) and immunosuppressive therapies elevate NTM infection risk.

Purpose of the Study:

• To review the complex immune response to NTM infections.
• To examine intrinsic and iatrogenic factors predisposing individuals to NTM disease.
• To specifically focus on the role of rheumatoid arthritis in NTM susceptibility.

Main Methods:

• Literature review of NTM pathogenesis and host-pathogen interactions.
• Analysis of immune pathways involving key cytokines (IL-12, TNF-α, IFN-γ).
• Examination of the impact of targeted immunotherapies, particularly TNF inhibitors, on NTM risk.

Main Results:

• The immune response to NTM involves intricate interplay of phagocytes and lymphoid cells, regulated by IL-12, TNF-α, and IFN-γ.
• TNF inhibitors disrupt these critical immune pathways, significantly increasing NTM infection risk.
• Rheumatoid arthritis is identified as a significant risk factor for NTM infections.

Conclusions:

• Understanding the immune response to NTM is crucial for managing infections in susceptible populations.
• Rheumatoid arthritis and TNF-targeted therapies necessitate careful consideration of NTM infection risk.
• Further research into host-pathogen interactions can inform preventative and therapeutic strategies for NTM disease.