In:
Clinical Infectious Diseases, Oxford University Press (OUP), Vol. 75, No. 2 ( 2022-08-25), p. 239-247
Abstract:
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/m2]; 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 ≤23.5 pg/mL; aHR, 3.306 [1.664–6.567]; sPD-1: 23.6–53.7 pg/mL; aHR, 2.496 [1.390–4.483] ) compared with the reference (sPD-1 & gt;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.
Type of Medium:
Online Resource
ISSN:
1058-4838
,
1537-6591
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2022
detail.hit.zdb_id:
2002229-3
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