Table 1_Lung microbial dysregulation and TNF inhibition are associated with worsened nontuberculous mycobacterial lung disease.docx

The host factors contributing to the heightened susceptibility and severity of NTMPD in elderly individuals are poorly understood. Prior studies have reported increased incidence of NTMPD in individuals receiving immune modulatory biologics such as anti-TNF and JAK-STAT inhibitors.

Moreover, we recently described that age-related changes in the lung microbiome, notably the loss of a main commensal Tropheryma species, may contribute to increased severity. Therefore, in this study we explore the hypothesis that TNF-inhibition and a disrupted lung microbiome are key factors associated with poor NTMPD outcomes.</p>Methods<p>Young (4–7 years old) rhesus macaques were either pretreated with: (1) nebulized amikacin and vancomycin to disrupt the lung microbiome; (2) the TNF inhibitor Inflectra to suppress Th1 responses; or (3) left untreated.