The New Frontier of Host-Directed Therapies for Mycobacterium avium Complex

Abstract

Mycobacterium avium complex (MAC) is an increasingly important cause of morbidity and mortality, and is responsible for pulmonary infection in patients with underlying lung disease and disseminated disease in patients with AIDS. MAC has evolved various virulence strategies to subvert immune responses and persist in the infected host. Current treatment for MAC is challenging, requiring a combination of multiple antibiotics given over a long time period (for at least 12 months after negative sputum culture conversion). Moreover, even after eradication of infection, many patients are left with residual lung dysfunction. In order to address similar challenges facing the management of patients with tuberculosis, recent attention has focused on the development of novel adjunctive, host-directed therapies (HDTs), with the goal of accelerating the clearance of mycobacteria by immune defenses and reducing or reversing mycobacterial-induced lung damage. In this review, we will summarize the evidence supporting specific adjunctive, HDTs for MAC, with a focus on the repurposing of existing immune-modulatory agents targeting a variety of different cellular pathways. We also highlight areas meriting further investigation.

Application of Precise Positioning for Sputum Expectoration in ICU Patients with Pulmonary Infection

“…Precise positioning for sputum expectoration is a nursing operation that focuses on expectoration in the specific location and range of sputum accumulation area, atelectasis area, or lung lesions based on dynamic combination of lung ultrasound examination results, which can be targeted for sputum removal and more effectively remove sputum in the infected area, thus reducing the severity of PI. In addition, by reducing sputum accumulation, it can promote lung recruitment maneuvers and further improve PF [ 13 , 14 ]. In this study, the sputum volume was less, and the respiratory frequency and CPIS score were lower in the observation group versus the control group after 7 days of intervention, indicating that the application of precise positioning for sputum expectoration for the nursing of ICU patients with PI could reduce the sputum excretion and the severity of PI.…”

Personalised Medicine for Tuberculosis and Non-Tuberculous Mycobacterial Pulmonary Disease

“…Engineered bacteriophage therapy in a patient with CF and disseminated drug-resistant M. abscessus infection was recently found to result in improvement in pulmonary function, liver function and dermatological lesions [94]. A range of other host-directed therapeutic strategies have been described for TB and NTM-PD, including targeting various components of the adaptive and innate immune responses [95][96][97].…”

Autophagy and Host Defense in Nontuberculous Mycobacterial Infection

“…hominissuis, and M. intracellulare subsp. chimaera are the most common causes of NTM pulmonary diseases (NTM-PD), which are more emerging (1)(2)(3). Mycobacteroides abscessus (Mabc) is another frequently encountered pathogen that causes NTM-PD (4)(5)(6).…”