Predictive biomarker for prognosis of nontuberculous mycobacteria lung disease

2022 Fiscal Year Final Research Report

• Project/Area Number: 17K16067
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Respiratory organ internal medicine
• Research Institution: Department of Clinical Research, National Hospital Organization Kyoto Medical Center
• Principal Investigator: Fujita Kohei 独立行政法人国立病院機構(京都医療センター臨床研究センター), 展開医療研究部, 研究員 (10790876)
• Project Period (FY): 2017-04-01 – 2023-03-31
• Keywords: 肺非結核性抗酸菌症 / 肺MAC症 / 気管支拡張症 / フレイル / 抗菌ペプチド / サーファクタントプロテイン / 基本チェックリスト / HADS質問票

Outline of Final Research Achievements

This study was conducted to compare the difference in frailty and the expression of inflammatory biomarkers between patients with NTM-LD and bronchiectasis (BE). Patients suspected of having NTM-LD were prospectively recruited, and 33 were diagnosed with NTM and 36 were diagnosed with BE based on the results of bronchoscopy. Measurements of hCAP/LL-37, SP-A, SP-D were performed in BALF and serum. In addition, the Kihon Checklist (KCQ) and HADS questionnaire were used to assess the frailty. The results showed that in both the KCQ and HADS, NTM patients had significantly lower scores and were more frail than BE patients. In biomarker analysis, hCAP/LL-37 and SP-D in BALF were significantly higher in NTM patients, whereas serum hCAP/LL-37 was significantly lower in NTM patients. These results indicate that even in mild NTM disease, they are already in a frail state. Biomarker analysis revealed that inflammation in the lung local was stronger in NTM patients than in the systemic body.

Free Research Field

呼吸器感染症

Academic Significance and Societal Importance of the Research Achievements

本研究において、診断に気管支鏡検査を要するような軽症の肺非結核性抗酸菌症患者においても、診断時点で既にフレイルな状態にあることが判明した。またその炎症は全身より局所において強く生じていることが判明した。肺NTM症は中高年に多い疾患であり、臨床医は肺非結核性抗酸菌症の患者の診療において、軽症であっても既にフレイルな状態にあることを認識し、早急な治療介入に加えて、呼吸リハビリや生活・社会環境の整備を意識した診療を行っていく必要がある。