a Division of Respiratory Medicine, Department of Medicine , Karolinska University Hospital , Stockholm , Sweden.
b Vall d'Hebron Institute of Research (VHIR), Respiratory Disease Department , Hospital Universitari Vall d'Hebron (HUVH) , Barcelona , Spain.
Expert Rev Respir Med. 2017 Dec;11(12):977-989. doi: 10.1080/17476348.2017.1386563. Epub 2017 Oct 10.
The number of patients with pulmonary disease caused by non-tuberculous mycobacteria (NTM) is increasing globally. Poor resistance against infections, for example, due to pre-existing lung diseases, immune deficiency and immune-modulating treatment, predisposes the population to developing pulmonary NTM disease. The incidence of pre-existing lung diseases such as chronic obstructive pulmonary disease and bronchiectasis has also increased. NTM disease diagnosis is often delayed due to non-specific symptoms. The therapeutic arsenal is limited and adherence to treatment guidelines is often low since the treatment regimens are complex, lengthy and side effects are common. Thus, current disease management is far from satisfactory and needs to be improved. Areas covered: This review provides an overview of the current knowledge of NTM infections and includes pathogenesis, disease patterns, epidemiology, disease management, unmet needs and future perspectives. Expert commentary: NTM disease is becoming more prevalent, in part with our increased awareness and improved diagnostic methods. However, our understanding of the disease pathogenesis is limited and treatment decisions are challenging, with difficult to employ drug regimens. Optimal management requires collaboration between healthcare providers, patients and expert centers.
全球范围内，由非结核分枝杆菌（NTM）引起的肺部疾病患者数量正在增加。由于先前存在的肺部疾病、免疫缺陷和免疫调节治疗等原因，导致机体抗感染能力较差，使人群易患肺部 NTM 疾病。先前存在的肺部疾病（如慢性阻塞性肺疾病和支气管扩张症）的发病率也有所增加。由于症状不具有特异性，NTM 疾病的诊断常常被延误。治疗方案有限，而且由于治疗方案复杂、冗长且常见副作用，患者对治疗指南的遵从性往往较低。因此，目前的疾病管理远远不能令人满意，需要加以改进。涵盖领域：本篇综述概述了 NTM 感染的现有知识，包括发病机制、疾病模式、流行病学、疾病管理、未满足的需求和未来展望。专家评论：NTM 疾病的发病率正在上升，部分原因是我们对该病的认识提高了，诊断方法也得到了改善。然而，我们对疾病发病机制的了解有限，且治疗决策具有挑战性，难以采用药物治疗方案。最佳管理需要医疗保健提供者、患者和专家中心之间的合作。
