Wang Jia, Lee Sunhee
Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA.
Pathogens. 2025 May 13;14(5):472. doi: 10.3390/pathogens14050472.
Nontuberculous mycobacteria (NTMs) are increasingly being recognized as opportunistic pathogens in clinical practice because of their innate resistance to antimicrobial treatment and the widespread increase in multidrug-resistant strains on a global scale. NTMs pose a tremendous infection management challenge, especially in individuals with pre-existing lung conditions, as well as those who are immunocompromised. NTMs' capability to evade or suppress the immune responses of their host is a key feature that makes them a cause of persistent chronic infection. Autophagy, an essential cellular defense mechanism that delivers and breaks down intracellular materials in lysosomes, protects the host from mycobacterial infection. Initial studies have revealed encouraging therapeutic strategies that augment endogenous autophagic mechanisms or block harmful host responses, thus having the potential to decrease intracellular mycobacterial infection, including that caused by multidrug-resistant strains. This review discusses how NTMs can evade autophagic mechanisms and considers the possibilities of using autophagy-inducing agents to develop novel therapeutic strategies to combat NTM infection.
非结核分枝杆菌（NTMs）在临床实践中越来越被视为机会性病原体，因为它们对抗菌治疗具有固有抗性，且全球范围内多重耐药菌株广泛增加。NTMs给感染管理带来了巨大挑战，尤其是对于已有肺部疾病的个体以及免疫功能低下者。NTMs逃避或抑制宿主免疫反应的能力是使其成为持续性慢性感染病因的一个关键特征。自噬是一种重要的细胞防御机制，可在溶酶体中递送并分解细胞内物质，保护宿主免受分枝杆菌感染。初步研究揭示了一些令人鼓舞的治疗策略，这些策略可增强内源性自噬机制或阻断有害的宿主反应，从而有可能减少细胞内分枝杆菌感染，包括由多重耐药菌株引起的感染。本综述讨论了NTMs如何逃避自噬机制，并考虑了使用自噬诱导剂开发对抗NTM感染新治疗策略的可能性。
