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首页> 外文期刊>Clinical infectious diseases >Disease Progression in Patients With Nontuberculous Mycobacterial Lung Disease of Nodular Bronchiectatic (NB) Pattern: The Roles of Cavitary NB and Soluble Programmed Death Protein-1
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Disease Progression in Patients With Nontuberculous Mycobacterial Lung Disease of Nodular Bronchiectatic (NB) Pattern: The Roles of Cavitary NB and Soluble Programmed Death Protein-1

机译：Disease Progression in Patients With Nontuberculous Mycobacterial Lung Disease of Nodular Bronchiectatic (NB) Pattern: The Roles of Cavitary NB and Soluble Programmed Death Protein-1

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Background In patients with nodular bronchiectatic (NB) nontuberculous mycobacterial lung disease (NTM-LD), risk factors for disease progression have not been clearly investigated. The roles of cavitary NB and soluble programmed death protein-1 (sPD-1), an immune-related biomarker, in the disease course of NB NTM-LD remain unknown. Methods Patients with NB NTM-LD were enrolled from 2 medical centers in 2014-2020. We identified cavitary NB, measured sPD-1 levels, and analyzed factors associated with cavitary NB and predictors for disease progression of NB NTM-LD. Results Of 120 cases of NB NTM-LD, 87 (72.5) were caused by Mycobacterium avium complex. sPD-1 levels were lower in 13 (10.8) patients with cavitary NB than in noncavitary patients (P = .020). Over 1.41 +/- 1.43 years of follow-up, 12 (92.3) patients in the cavitary and 66 (61.7) in the noncavitary group developed disease progression (P = .032). In multivariable analysis, body mass index (BMI kg/m(2); adjusted hazard ratio aHR, .895 95 confidence interval, .811-.988), sputum smear grade (aHR, 1.247 1.014-1.534), cavitary NB (aHR, 2.008 1.052-3.834), and sPD-1 (per 10-pg/mL increase; aHR, .889 .816-.967) were predictive for disease progression. Notably, sPD-1 showed a dose-dependent association with disease progression (sPD-1 53.7 pg/mL). Conclusions Patients with NB NTM-LD and low sPD-1, low BMI, high smear grade, and cavitary NB were at high risk for disease progression. sPD-1 was low in patients with cavitary NB phenotype and dose-responsively associated with disease progression. In patients with NTM-LD of nodular bronchiectatic (NB) pattern, cavitary NB was associated with a low level of soluble programmed death protein-1 (sPD-1). Aside from cavitary NB, sPD-1 had a dose-response association with risk of disease progression of NB NTM-LD.

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