Treatable Traits and Challenges in the Clinical Management of Non-tuberculous Mycobacteria Lung Disease in People with Cystic Fibrosis

Overview

Journal Respir Res

Specialty Pulmonary Medicine

Date 2023 Dec 16

PMID 38104098

Authors

Andrea Gramegna

Sofia Misuraca

Andrea Lombardi

Chiara Premuda

Ivan Barone

Margherita Ori

Francesco Amati

Mariangela Retucci

Erica Nazzari

Gianfranco Alicandro

Maurizio Ferrarese

Luigi Codecasa

Alessandra Bandera

Stefano Aliberti

Valeria Dacco

Francesco Blasi

Affiliations

Soon will be listed here.

Abstract

Introduction: Over the last ten years an increasing prevalence and incidence of non-tuberculous mycobacteria (NTM) has been reported among patients with cystic fibrosis (CF) Viviani (J Cyst Fibros, 15(5):619-623, 2016). NTM pulmonary disease has been associated with negative clinical outcomes and often requires pharmacological treatment. Although specific guidelines help clinicians in the process of diagnosis and clinical management, the focus on the multidimensional assessment of concomitant problems is still scarce.

Main Body: This review aims to identify the treatable traits of NTM pulmonary disease in people with CF and discuss the importance of a multidisciplinary approach in order to detect and manage all the clinical and behavioral aspects of the disease. The multidisciplinary complexity of NTM pulmonary disease in CF requires careful management of respiratory and extra-respiratory, including control of comorbidities, drug interactions and behavioral factors as adherence to therapies.

Conclusions: The treatable trait strategy can help to optimize clinical management through systematic assessment of all the aspects of the disease, providing a holistic treatment for such a multi-systemic and complex condition.

Citing Articles

Development of allergic bronchopulmonary aspergillosis in a patient with nontuberculous mycobacterial-pulmonary disease successfully treated with dupilumab: A case report and literature review.

Onozato R, Miyata J, Asakura T, Namkoong H, Asano K, Hasegawa N Respirol Case Rep. 2024; 12(7):e01432.

PMID: 38988827 PMC: 11233258. DOI: 10.1002/rcr2.1432.

References

Viviani L, Harrison M, Zolin A, Haworth C, Floto R . Epidemiology of nontuberculous mycobacteria (NTM) amongst individuals with cystic fibrosis (CF). J Cyst Fibros. 2016; 15(5):619-23. DOI: 10.1016/j.jcf.2016.03.002. View

Martiniano S, Nick J, Daley C . Nontuberculous Mycobacterial Infections in Cystic Fibrosis. Thorac Surg Clin. 2018; 29(1):95-108. DOI: 10.1016/j.thorsurg.2018.09.008. View

LiPuma J . The changing microbial epidemiology in cystic fibrosis. Clin Microbiol Rev. 2010; 23(2):299-323. PMC: 2863368. DOI: 10.1128/CMR.00068-09. View

Ledson M, Tran J, Walshaw M . Prevalence and mechanisms of gastro-oesophageal reflux in adult cystic fibrosis patients. J R Soc Med. 1998; 91(1):7-9. PMC: 1296415. DOI: 10.1177/014107689809100103. View

Morrison C, Shaffer K, Araba K, Markovetz M, Wykoff J, Quinney N . Treatment of cystic fibrosis airway cells with CFTR modulators reverses aberrant mucus properties hydration. Eur Respir J. 2021; 59(2). PMC: 8859811. DOI: 10.1183/13993003.00185-2021. View

Borowitz D, Robinson K, Rosenfeld M, Davis S, Sabadosa K, Spear S . Cystic Fibrosis Foundation evidence-based guidelines for management of infants with cystic fibrosis. J Pediatr. 2009; 155(6 Suppl):S73-93. PMC: 6324931. DOI: 10.1016/j.jpeds.2009.09.001. View

Jaques R, Shakeel A, Hoyle C . Novel therapeutic approaches for the management of cystic fibrosis. Multidiscip Respir Med. 2020; 15(1):690. PMC: 7706361. DOI: 10.4081/mrm.2020.690. View

Chan E, Iseman M . Slender, older women appear to be more susceptible to nontuberculous mycobacterial lung disease. Gend Med. 2010; 7(1):5-18. DOI: 10.1016/j.genm.2010.01.005. View

Balfour-Lynn I, Dinwiddie R . Role of corticosteroids in cystic fibrosis lung disease. J R Soc Med. 1996; 89 Suppl 27:8-13. PMC: 1295619. View

10.

Ricotta E, Prevots D, Olivier K . CFTR modulator use and risk of nontuberculous mycobacteria positivity in cystic fibrosis, 2011-2018. ERJ Open Res. 2022; 8(2). PMC: 8995538. DOI: 10.1183/23120541.00724-2021. View

11.

Kim Y, Yoon J, Ryu J, Yang B, Chung S, Kang H . Gastroesophageal Reflux Disease Increases Susceptibility to Nontuberculous Mycobacterial Pulmonary Disease. Chest. 2022; 163(2):270-280. DOI: 10.1016/j.chest.2022.08.2228. View

12.

Bryant J, Grogono D, Greaves D, Foweraker J, Roddick I, Inns T . Whole-genome sequencing to identify transmission of Mycobacterium abscessus between patients with cystic fibrosis: a retrospective cohort study. Lancet. 2013; 381(9877):1551-60. PMC: 3664974. DOI: 10.1016/S0140-6736(13)60632-7. View

13.

Wang J, Lin H, Lin H, Chung C, Chen L, Huang K . Associations between Diabetes Mellitus and Nontuberculous Mycobacterium-Caused Diseases in Taiwan: A Nationwide Cohort Study. Am J Trop Med Hyg. 2021; 105(6):1672-1679. PMC: 8641322. DOI: 10.4269/ajtmh.20-1441. View

14.

Havermans T, Willem L . Prevention of anxiety and depression in cystic fibrosis. Curr Opin Pulm Med. 2019; 25(6):654-659. DOI: 10.1097/MCP.0000000000000617. View

15.

Ward N, Stiller K, Holland A . Exercise and Airway Clearance Techniques in Cystic Fibrosis. Semin Respir Crit Care Med. 2022; 44(2):209-216. DOI: 10.1055/s-0042-1758729. View

16.

Al-Momani H, Perry A, Jones R, Bourke S, Doe S, Perry J . Nontuberculous mycobacteria in gastrostomy fed patients with cystic fibrosis. Sci Rep. 2017; 7:46546. PMC: 5402269. DOI: 10.1038/srep46546. View

17.

Campbell J, Chan E, Falzon D, Trajman A, Keshavjee S, Leung C . Low Body Mass Index at Treatment Initiation and Rifampicin-Resistant Tuberculosis Treatment Outcomes: An Individual Participant Data Meta-Analysis. Clin Infect Dis. 2022; 75(12):2201-2210. DOI: 10.1093/cid/ciac322. View

18.

Pauwels A, Blondeau K, Mertens V, Farre R, Verbeke K, Dupont L . Gastric emptying and different types of reflux in adult patients with cystic fibrosis. Aliment Pharmacol Ther. 2011; 34(7):799-807. DOI: 10.1111/j.1365-2036.2011.04786.x. View

19.

Alicandro G, Bisogno A, Battezzati A, Bianchi M, Corti F, Colombo C . Recurrent pulmonary exacerbations are associated with low fat free mass and low bone mineral density in young adults with cystic fibrosis. J Cyst Fibros. 2013; 13(3):328-34. DOI: 10.1016/j.jcf.2013.11.001. View

20.

Eakin M, Bilderback A, Boyle M, Mogayzel P, Riekert K . Longitudinal association between medication adherence and lung health in people with cystic fibrosis. J Cyst Fibros. 2011; 10(4):258-64. PMC: 3114200. DOI: 10.1016/j.jcf.2011.03.005. View