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Ancillary treatment of patients with lung disease due to non-tuberculous mycobacteria: a narrative review.

Publication ,  Journal Article
Youssefnia, A; Pierre, A; Hoder, JM; MacDonald, M; Shaffer, MJB; Friedman, J; Mehler, PS; Bontempo, A; da Silva, FCN; Chan, ED
Published in: J Thorac Dis
September 2022

BACKGROUND AND OBJECTIVE: Non-tuberculous mycobacterial lung disease (NTM-LD) manifests with bronchiectasis, inflammatory bronchiolitis, nodules, and/or cavitation. Bronchiectasis is characterized by permanently dilated airways wherein mucus accumulates, creating a vicious cycle of chronic injurious inflammation and recurrent infections. While antibiotics are an important part of the treatment of NTM-LD, airway clearance techniques to mitigate this pathogenic mechanism of bronchiectasis as well as other ancillary measures are also important components of NTM-LD treatment. The objective of this contemporaneous Narrative Review is to emphasize the importance of such ancillary measures. METHODS: We searched PubMed for the key words of "airway clearance", "pulmonary rehabilitation", "nutrition", "swallowing dysfunction", "gastroesophageal reflux", "vestibular dysfunction", or "cochlear dysfunction" with that of "non-tuberculous mycobacterial lung disease", "bronchiectasis", or "respiratory disease". The bibliographies of identified articles were further searched for relevant articles not previously identified. Each relevant article was reviewed by one or more of the authors and a narrative review was composed. KEY CONTENT AND FINDINGS: Herein, we discuss five ancillary treatment measures that are pertinent to patients with bronchiectasis and NTM-LD: (I) airway clearance; (II) physical and pulmonary rehabilitation; (III) nutrition; (IV) diagnosis and mitigation of swallowing dysfunction and of gastroesophageal reflux disease (GERD); and (V) minimization of vestibular and cochlear dysfunction associated with some anti-NTM drugs. CONCLUSIONS: While antibiotics is often the central focus of treatment of NTM-LD, given its propensity for recurrent and recalcitrant infection, other ancillary measures to break the vicious cycle of injurious inflammation and infection should also be emphasized to optimize treatment success.

Duke Scholars

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Published In

J Thorac Dis

DOI

ISSN

2072-1439

Publication Date

September 2022

Volume

14

Issue

9

Start / End Page

3575 / 3597

Location

China

Related Subject Headings

  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Youssefnia, A., Pierre, A., Hoder, J. M., MacDonald, M., Shaffer, M. J. B., Friedman, J., … Chan, E. D. (2022). Ancillary treatment of patients with lung disease due to non-tuberculous mycobacteria: a narrative review. J Thorac Dis, 14(9), 3575–3597. https://doi.org/10.21037/jtd-22-410
Youssefnia, Artmis, Alicia Pierre, Jeffrey M. Hoder, Michelle MacDonald, Monica J. B. Shaffer, Jessica Friedman, Philip S. Mehler, Amanda Bontempo, Francisco C. N. da Silva, and Edward D. Chan. “Ancillary treatment of patients with lung disease due to non-tuberculous mycobacteria: a narrative review.J Thorac Dis 14, no. 9 (September 2022): 3575–97. https://doi.org/10.21037/jtd-22-410.
Youssefnia A, Pierre A, Hoder JM, MacDonald M, Shaffer MJB, Friedman J, et al. Ancillary treatment of patients with lung disease due to non-tuberculous mycobacteria: a narrative review. J Thorac Dis. 2022 Sep;14(9):3575–97.
Youssefnia, Artmis, et al. “Ancillary treatment of patients with lung disease due to non-tuberculous mycobacteria: a narrative review.J Thorac Dis, vol. 14, no. 9, Sept. 2022, pp. 3575–97. Pubmed, doi:10.21037/jtd-22-410.
Youssefnia A, Pierre A, Hoder JM, MacDonald M, Shaffer MJB, Friedman J, Mehler PS, Bontempo A, da Silva FCN, Chan ED. Ancillary treatment of patients with lung disease due to non-tuberculous mycobacteria: a narrative review. J Thorac Dis. 2022 Sep;14(9):3575–3597.

Published In

J Thorac Dis

DOI

ISSN

2072-1439

Publication Date

September 2022

Volume

14

Issue

9

Start / End Page

3575 / 3597

Location

China

Related Subject Headings

  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1103 Clinical Sciences