[Nontuberculous mycobacterial infections]

A Nowag1,2, M Platten3,4, G Plum2

  • 1Klinische Infektiologie, Labor Dr. Wisplinghoff, Horbeller Straße 18-20, 50858, Köln, Deutschland.

Insights

Nontuberculous mycobacterial (NTM) infections are increasing globally. This review explores how rheumatoid arthritis and TNF inhibitor therapies impact NTM susceptibility and immune responses.

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.

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