validation of soluble programmed death-1 in predicting progression of nodular-bronchiectatic form of nontuberculous mycobacterial lung disease: a multi-country research

Conditions: Nontuberculous Mycobacterial Lung Disease

Summary: the incidence of nontuberculous mycobacterial lung disease (ntm-ld) is increasing worldwide and in eastern asia. ntm-ld leads significant morbidity and mortality, around 25% within 5 years, but the treatment rate is low because the course of ntm-ld is indolent, especially in nodular-bronchiectatic (nb) form. however, there is no biomarker proven for predicting the progression in nb form of ntm-ld. recently, it has been reported that the ratio of membrane-form programmed death-1 (pd-1) expressed t cells increased in patients with ntm-ld and it was associated with disease severity and progression. the mechanism has been speculated as a "immune exhaustion". in contrast to pd-1 expressed in cell membrane, soluble-form pd-1 is another biomarker that can be easily detected in serum. we recently reported that soluble pd-1 significantly correlated with cavitary lesion and disease progression in patients with nb-form ntm-ld in taiwan. however, this has not been validated in other countries and ethnicities. furthermore, the usefulness of soluble pd-1 in diagnosis and predicting mortality warrants further studies.

the incidence of nontuberculous mycobacterial lung disease (ntm-ld) is increasing worldwide and in eastern asia. ntm-ld leads significant morbidity and mortality, around 25% within 5 years, but the treatment rate is low because the course of ntm-ld is indolent, especially in nodular-bronchiectatic (nb) form. however, there is no biomarker proven for predicting the progression in nb form of ntm-ld. recently, it has been reported that the ratio of membrane-form programmed death-1 (pd-1) expressed t cells increased in patients with ntm-ld and it was associated with disease severity and progression. the mechanism has been speculated as a "immune exhaustion". in contrast to pd-1 expressed in cell membrane, soluble-form pd-1 is another biomarker that can be easily detected in serum. we recently reported that soluble pd-1 significantly correlated with cavitary lesion and disease progression in patients with nb-form ntm-ld in taiwan. however, this has not been validated in other countries and ethnicities. furthermore, the usefulness of soluble pd-1 in diagnosis and predicting mortality warrants further studies. moreover, it is worthwhile to measure soluble pd-1 in bronchoalveolar lavage to explore local immune pathogenesis of ntm-ld. therefore, we apply this project to investigate the role of soluble pd-1 in ntm-ld through a multi-country cooperation.

Eligibility criteria:
inclusion criteria: * age ≥ 20 years * ntm-ld: (n=250) diagnosis is made on the basis of the guidelines produced by the american thoracic society.patients have pulmonary symptoms with identified chest image and fit with the microbiology criteria. * ntm pulmonary colonizers and others: (n=100) those without fulfilling the diagnostic criteria but having at least one set of positive sputum for mac or patients infected with ntm other than mac species. * pulmonary tuberculosis (tb): (n=100) those with respiratory specimen culture positive for mycobacterium tuberculosis or typical tb pulmonary pathology. * healthy control (n=50) exclusion criteria: * patients who have acquired immunodeficiency syndrome