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International Journal of Molecular... Jan 2022Cytokine receptors are critical regulators of the antimycobacterial immune response, playing a key role in initiating and coordinating the recruitment and activation of... (Review)
Review
Cytokine receptors are critical regulators of the antimycobacterial immune response, playing a key role in initiating and coordinating the recruitment and activation of immune cells during infection. They recognize and bind specific cytokines and are involved in inducing intracellular signal transduction pathways that regulate a diverse range of biological functions, including proliferation, differentiation, metabolism and cell growth. Due to mutations in cytokine receptor genes, defective signaling may contribute to increased susceptibility to mycobacteria, allowing the pathogens to avoid killing and immune surveillance. This paper provides an overview of cytokine receptors important for the innate and adaptive immune responses against mycobacteria and discusses the implications of receptor gene defects for the course of mycobacterial infection.
Topics: Adaptive Immunity; Animals; Cytokines; Humans; Immunity, Innate; Mutation; Mycobacterium Infections; Receptors, Cytokine; Signal Transduction
PubMed: 35163035
DOI: 10.3390/ijms23031112 -
Clinics in Chest Medicine Mar 2022Patients with bronchiectasis are at high risk for nontuberculous mycobacteria (NTM) disease and suspicion should be high in the setting of worsening respiratory symptoms... (Review)
Review
Patients with bronchiectasis are at high risk for nontuberculous mycobacteria (NTM) disease and suspicion should be high in the setting of worsening respiratory symptoms and disease progression on imaging. Meeting the case definition for NTM disease does not equal a decision to treat; risk and benefits of therapy should be discussed with patients. When treatment is initiated, a multidrug regimen should be used and selected based on susceptibility testing from a reliable laboratory. Monotherapy or macrolide-fluoroquinolone dual therapy should never be used. After discontinuation of therapy, ongoing mycobacterial sputum culture surveillance is needed, as infection relapse is common.
Topics: Anti-Bacterial Agents; Disease Progression; Humans; Laboratories; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria
PubMed: 35236564
DOI: 10.1016/j.ccm.2021.11.007 -
Infectious Disease Clinics of North... Jun 2020Biologic therapies have revolutionized the treatment of immune-mediated inflammatory diseases but are associated with an increased risk of serious and opportunistic... (Review)
Review
Biologic therapies have revolutionized the treatment of immune-mediated inflammatory diseases but are associated with an increased risk of serious and opportunistic infections, including tuberculosis and nontuberculous mycobacterial disease. Despite this increased risk, the overall risk-benefit ratio remains favorable with appropriate screening and risk assessment. Further population-based studies are needed to establish the risk of tuberculosis and nontuberculous mycobacterial disease with the new biologics. This article highlights the incidence and drug-specific risk of tuberculous and nontuberculous mycobacterial infection in the setting of biologics, screening and prevention, and treatment of latent tuberculosis in this setting.
Topics: Biological Products; Endemic Diseases; Humans; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Tuberculosis; Tumor Necrosis Factor-alpha; United States
PubMed: 32444014
DOI: 10.1016/j.idc.2020.02.011 -
BMJ Case Reports Mar 2022SummaryHabitual cough suppression leading to non-tuberculous mycobacteria infections and bronchiectasis has been reported. We present a case of a 55-year-old woman with...
SummaryHabitual cough suppression leading to non-tuberculous mycobacteria infections and bronchiectasis has been reported. We present a case of a 55-year-old woman with a chronic history of cough with mild expectoration and frequent lower respiratory tract infections, remitting with antibiotic therapy and other supportive measures. She also reported habitual cough suppression for several years. She was eventually diagnosed with Mycobacterium avium complex (MAC) positive right middle lobe bronchiectasis-Lady Windermere syndrome and obstructive sleep apnoea (OSA), causing disabling symptoms limiting her daily activities. We aim to highlight two key issues-diagnosing MAC infections in a tuberculosis endemic country, and OSA and its long-term clinical implications.
Topics: Bronchiectasis; Cough; Female; Humans; Middle Aged; Mycobacterium Infections, Nontuberculous; Mycobacterium avium Complex; Mycobacterium avium-intracellulare Infection; Nontuberculous Mycobacteria
PubMed: 35256362
DOI: 10.1136/bcr-2021-246285 -
Hand (New York, N.Y.) Jul 2022Hand infections caused by mycobacteria are relatively uncommon compared to infections caused by other pathogens; therefore, much of the available literature consists of... (Review)
Review
BACKGROUND
Hand infections caused by mycobacteria are relatively uncommon compared to infections caused by other pathogens; therefore, much of the available literature consists of case reports and limited case series. Broadly categorized into tuberculous and nontuberculous mycobacterial (NTM) infections, both tuberculous and NTM infections are typically insidious with long incubation periods and with the ability to remain dormant for prolonged periods.
METHODS
We reviewed the most current literature on the epidemiology, presentations, treatment methods, and resistance patterns of mycobacterial infections of the hand focusing on the indications and outcomes of nonoperative as well as operative interventions.
RESULTS
The worldwide burden of tuberculosis remains high and while the overall rate of new diagnosis drug resistant tuberculosis has been on the decline some regions of the world have demonstrated staggeringly high resistance rates to first-line tuberculosis therapies. Signs and symptoms of mycobacterial hand infection are typically inconsistent, and highly dependent on the specific structures of the hand that are affected; therefore, these infections may mimic other infections of the hand like tenosynovitis, joint space infections, and cutaneous infections. The main stay of treatment remains antimycobacterial therapies including but not limited to rifampin, isoniazid, pyrazinamide, and ethambutol.
CONCLUSIONS
The complications associated with mycobacterial hand infections can be significant. Prompt evaluation, including a thorough history to evaluate for potential exposures to infectious sources, followed by appropriate antibiotic choice and duration, with surgical management as needed, is key to reducing the chance that patients experience lasting effects of the infection.
Topics: Anti-Bacterial Agents; Hand; Humans; Mycobacterium Infections, Nontuberculous; Tenosynovitis; Tuberculosis
PubMed: 32940064
DOI: 10.1177/1558944720940064 -
CMAJ : Canadian Medical Association... Oct 2023
Topics: Female; Humans; Adolescent; Mycobacterium bovis; Mycobacterium Infections, Nontuberculous; Lymphadenitis
PubMed: 37903520
DOI: 10.1503/cmaj.230700-f -
Clinics in Chest Medicine Dec 2022Nontuberculous mycobacteria (NTM) are important pathogens, with a longitudinal prevalence of up to 20% within the cystic fibrosis (CF) population. Diagnosis of NTM... (Review)
Review
Nontuberculous mycobacteria (NTM) are important pathogens, with a longitudinal prevalence of up to 20% within the cystic fibrosis (CF) population. Diagnosis of NTM pulmonary disease in people with CF (pwCF) is challenging, as a majority have NTM infection that is transient or indolent, without evidence of clinical consequence. In addition, the radiographic and clinical manifestations of chronic coinfections with typical CF pathogens can overlap those of NTM, making diagnosis difficult. Comprehensive care of pwCF must be optimized to assess the true clinical impact of NTM and to improve response to treatment. Treatment requires prolonged, multidrug therapy that varies depending on NTM species, resistance pattern, and extent of disease. With a widespread use of highly effective modulator therapy (HEMT), clinical signs and symptoms of NTM disease may be less apparent, and sensitivity of sputum cultures further reduced. The development of a disease-specific approach to the diagnosis and treatment of NTM infection in pwCF is a research priority, as a lifelong strategy is needed for this high-risk population.
Topics: Humans; Cystic Fibrosis; Drug Therapy, Combination; Leprostatic Agents; Nontuberculous Mycobacteria; Mycobacterium Infections, Nontuberculous
PubMed: 36344075
DOI: 10.1016/j.ccm.2022.06.010 -
Seminars in Respiratory and Critical... Dec 2019Over the past decade, the incidence of nontuberculous mycobacterial (NTM) infection has been increasing in cystic fibrosis patients. Along with this have come a host of... (Review)
Review
Over the past decade, the incidence of nontuberculous mycobacterial (NTM) infection has been increasing in cystic fibrosis patients. Along with this have come a host of complications and burdens to patients that threaten longevity and quality of life. The two main constituents of NTM pulmonary disease, complex (MAC) and , are notoriously difficult to treat with suboptimal clinical responses and are accompanied by high treatment burdens for patients. This review aims to summarize the current knowledge of NTM epidemiology, pathogenesis, professional society guidelines for diagnosis and treatment, and the efficacy of current management recommendations, with attention to cystic fibrosis patients. We go on to examine drugs of emerging but unknown efficacy in clinical use to provide a comprehensive assessment of the current state of management of NTM for cystic fibrosis patients.
Topics: Cystic Fibrosis; Humans; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Risk Factors; Treatment Outcome
PubMed: 31659731
DOI: 10.1055/s-0039-1693706 -
Journal of Cosmetic Dermatology Apr 2023Injection lipolysis is used for body and face contouring due to its minimal invasiveness and cost-effectiveness, but related complications such as nontuberculous... (Review)
Review
BACKGROUND
Injection lipolysis is used for body and face contouring due to its minimal invasiveness and cost-effectiveness, but related complications such as nontuberculous mycobacterium infection significantly affect its clinical application.
AIMS
This study aimed to review the literature on NTM infection after injection lipolysis.
METHODS
We conducted a literature review of scientific journals published in Medline and PubMed up to September 2022 on patients with NTM skin and soft tissue infections. We used the keywords: nontuberculous mycobacterium, infection, injection lipolysis, and lipolytic solution in various combinations with the Boolean operators AND, OR, and NOT. Only articles available in English and full version publications were considered for this review. Here, we reviewed the relevant mechanisms and drugs for injectable lipolysis and analyzed the possible correlation between NTM infection and injection lipolysis. We also summarize methods for the diagnosis and treatment of NTM infections and present some perspectives on this therapy.
RESULTS
Many patients with NTM infections had a history of fat-related surgery or therapy. NTM infection after injection lipolysis may be related to inadequate disinfection and sterilization of injection equipment and clinical procedures, the unqualified medication itself and free fatty acids released during injection lipolysis. Currently, diagnosis and treatment of NTM infection after lipolysis injections remains challenging.
CONCLUSIONS
Injection lipolysis represents a helpful option for local fat reduction. Doctors should strictly abide by the aseptic operation standards and use qualified products for there is a correlation between skin and soft tissue infection of nontuberculous mycobacterium and injection lipolysis. Providers should understand the mechanism, indications, and associated risks of injection lipolysis when injecting fat-dissolving drugs to reduce localized fat.
Topics: Humans; Nontuberculous Mycobacteria; Soft Tissue Infections; Lipolysis; Mycobacterium Infections, Nontuberculous; Skin
PubMed: 36606392
DOI: 10.1111/jocd.15591 -
Current Opinion in Pulmonary Medicine Nov 2021Nontuberculous mycobacteria (NTM) are challenging infections among people with cystic fibrosis (pwCF) as the source, modes of transmission, and best practices for... (Review)
Review
PURPOSE OF REVIEW
Nontuberculous mycobacteria (NTM) are challenging infections among people with cystic fibrosis (pwCF) as the source, modes of transmission, and best practices for diagnosis and treatment are not known. Investigators have defined aspects of NTM infection that are unique to the CF population, as well as features shared with other conditions at risk. This review describes recent advances in our understanding of NTM infection among pwCF.
RECENT FINDINGS
The presence of dominant circulating clones of Mycobacterium abscessus within the CF community worldwide continue to be described, as well as pathogen phenotypes that could evoke greater environmental fitness and infectivity. The risk of direct or indirect transmission between pwCF remains an active focus of investigation, with divergent findings and conclusions reached in a site-specific fashion. Derived largely from studies in non-CF populations, new clinical guidelines are now available. A wide variety of agents are in preclinical development or early phase trials with promising findings, and new therapeutic targets have been identified as our understanding of the complex biology of NTM continues to expand.
SUMMARY
Significant challenges remain in the fight against NTM, however, recent advances in our understanding of the genetics, epidemiology and pathophysiology of pulmonary NTM infection in pwCF are leading efforts to improve clinical care.
Topics: Cystic Fibrosis; Humans; Mycobacterium Infections, Nontuberculous; Mycobacterium abscessus; Nontuberculous Mycobacteria; Phenotype
PubMed: 34431787
DOI: 10.1097/MCP.0000000000000816