Unraveling Mycobacterium abscessus: Pathogenesis and host immune dynamics

The worldwide trend shows a continuous increase in pulmonary infections caused by nontuberculous mycobacteria (NTM), with Mycobacterium abscessus (M. abscessus) emerging as a major concern as the most common rapidly growing opportunistic pathogen. It poses a substantial risk, causing severe respiratory, skin, and mucosal infections, especially among patients suffering from chronic pulmonary disease and cystic fibrosis (CF). The diverse virulence factors and complex resistance mechanisms of M. abscessus create formidable challenges in clinical management. As pivotal effectors in innate immunity, macrophages are essential in initiating immune responses against M. abscessus and constitute a central component of the host immune network. A thorough insight into how M. abscessus interacts with the host's immune defense is crucial for deepening our understanding of this infection. This review summarizes the pathogenic mechanisms and host immune responses to M. abscessus, with the goal of providing insights into the escalating challenges posed by this increasingly virulent and resistant pathogen.