Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, 20122, Milan, Italy.
Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy.
Respir Res. 2023 Dec 16;24(1):316. doi: 10.1186/s12931-023-02612-1.
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.
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.
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.
在过去十年中,囊性纤维化(CF)患者中非结核分枝杆菌(NTM)的患病率和发病率不断上升。Viviani(J Cyst Fibros,15(5):619-623,2016)已经发现 NTM 肺部疾病与负面临床结果相关,并且通常需要药物治疗。尽管特定指南有助于临床医生进行诊断和临床管理,但对伴随问题的多维评估仍很少关注。
本综述旨在确定 CF 患者中 NTM 肺部疾病的可治疗特征,并讨论多学科方法的重要性,以便检测和管理疾病的所有临床和行为方面。CF 中 NTM 肺部疾病的多学科复杂性需要仔细管理呼吸和呼吸外问题,包括控制合并症、药物相互作用和行为因素,如对治疗的依从性。
可治疗特征策略可通过系统评估疾病的所有方面来帮助优化临床管理,为这种多系统和复杂的疾病提供整体治疗。