The Role of NRF2 in Mycobacterial Infection

The incidence of pulmonary nontuberculous mycobacterial (NTM) infection is increasing worldwide, and its clinical outcomes with current chemotherapies are unsatisfactory. The incidence of tuberculosis (TB) is still high in Africa, and the existence of drug-resistant tuberculosis is also an important issue for treatment. To discover and develop new efficacious anti-mycobacterial treatments, it is important to understand the host-defense mechanisms against mycobacterial infection. Nuclear erythroid 2 p45-related factor-2 (NRF2) is known to be a major regulator of various antioxidant response element (ARE)-driven cytoprotective gene expressions, and its protective role has been demonstrated in infections. However, there are not many papers or reviews regarding the role of NRF2 in mycobacterial infectious disease. Therefore, this review focuses on the role of NRF2 in the pathogenesis of Mycobacterium tuberculosis and Mycobacterium avium infection.

The Tumor Necrosis Factor Alpha and Interleukin 6 Auto-paracrine Signaling Loop Controls Mycobacterium avium Infection via Induction of IRF1/IRG1 in Human Primary Macrophages

The prevalence of lung diseases caused by nontuberculous mycobacteria, such as Mycobacterium avium , is increasing in countries where tuberculosis is not endemic, most likely because of an aging population that is immunocompromised from underlying disease or immunosuppressive therapy. Our study contributes to the understanding of mycobacterial survival and killing in human macrophages and, more broadly, to the impact of immunometabolism during infection.

Disseminated Mycobacterium simiae and Mycobacterium avium infection causing an immune reconstitution inflammatory syndrome in a female patient with HIV infection

This case study discusses the management of a disseminated Mycobacterium simiae and Mycobacterium avium infection causing an immune reconstitution inflammatory syndrome in a 52-year-old woman with HIV infection. Disseminated M. avium infections have extensively been described in HIV patients; however, reports of infections with M. simiae are rare. Treatment of M. simiae infections is challenging due to its high rates of natural drug resistances, and thus far, no standard treatment regimen exists.

Preliminary Seroepidemiological Investigation Regarding Mycobacterium Avium Infection in Wild Boars and Foxes

The present study aimed at identifying Mycobacterium avium seroprevalence in wild boars (Sus scrofa) and red foxes (Vulpes vulpes) samples, from the Eastern region of Romania, by using an indirect ELISA assay. A total of 367 wild animal samples were collected from eight counties: 275 wild boars sera samples from Iasi (n=209), Botosani (n=11), Bacau (n=17), Galati (n=27) and Covasna (n=11) and 92 fox samples of thoracic fluid from Iasi (n=30), Suceava (n=20), Neamt (n=19), Vaslui (n=11) and Galati (n=12). Specific antibodies were not detected in wild boar serum samples tested. From the fox samples, one was positive (1.08%), originating from Galati County. Our results may be correlated with a reduced distribution of Mycobacterium avium subspecies in the environment and a low prevalence of infections caused by these bacteria in wild animals. The current assessment shows that foxes have a limited role in the epidemiology of nontuberculous mycobacterial infections.

Extrapulmonary Mycobacterium avium complex infections in immunocompetent patients

The Mycobacterium avium complex (MAC) includes ubiquitous bacteria that typically cause infection in immunocompromised patients. This paper reviews the presentation, diagnosis, pathogenesis, and treatment of extrapulmonary MAC infections in immunocompetent patients by compiling information from case reports identified by a PubMed search. Mycobacterium avium complex infections in immunocompetent patients can present primarily with extrapulmonary symptoms, and this makes the diagnosis of MAC infection in these patients more difficult. The American Thoracic Society has not established criteria for the diagnosis of extrapulmonary MAC infections; testing for MAC should be based on clinical suspicion or after the exclusion of all other causative agents. Methods of testing should include molecular and biochemical tests, since these tests provide more definitive identification than routine cultures. Extrapulmonary presentations usually respond well to macrolide based multi-drug regimens started as soon as a MAC infection is identified. Key words: Mycobacterium avium, infection, diagnosis, treatment