Role of Soluble T-Cell Immunoglobulin Mucin Domain-3 in Differentiating Nontuberculous Mycobacterial Lung Disease from Pulmonary Colonization

Sheng Wei Pan; Chin Chung Shu; Chang Ching Lee; Jia Yih Feng; Yu Jiun Chan; Yuh Min Chen; Wei Juin Su

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Role of Soluble T-Cell Immunoglobulin Mucin Domain-3 in Differentiating Nontuberculous Mycobacterial Lung Disease from Pulmonary Colonization

Sheng Wei Pan ^[1] ; Chin Chung Shu ^[2] ; Chang Ching Lee ^[1] ; Jia Yih Feng ^[3] ; Yu Jiun Chan ^[1] ; Yuh Min Chen ^[1] ; Wei Juin Su ^[1]
1. [1] Taipei Veterans General Hospital
  
  Taipei Veterans General Hospital
  
  Taiwán
2. [2] National Taiwan University
  
  National Taiwan University
  
  Taiwán
3. [3] School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 58, Nº. 7, 2022, págs. 547-553
Idioma: inglés
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Resumen
- Background Differentiating between nontuberculous mycobacterial lung disease (NTM-LD) and pulmonary NTM colonization (NTM-Col) is difficult. Compared with healthy controls, patients with NTM-LD generally present immune tolerance along with increased expressions of T-cell immunoglobulin mucin domain-3 (TIM-3) and programmed cell death-1 (PD-1) on T lymphocytes. However, the role of soluble TIM-3 (sTIM-3) and soluble PD-1 (sPD-1) in differentiating NTM-LD from NTM colonization (NTM-Col) remains unclear.
  
  Methods Patients with NTM-positive respiratory samples and controls were enrolled from 2016 to 2019. Patients were classified into NTM-Col and NTM-LD groups. Levels of sTIM-3, sPD-1, soluble PD-ligand-1 (sPD-L1), and TIM-3 expression were measured. Factors associated with NTM-LD were analyzed by logistical regression.
  
  Results TIM-3 expression on CD4+ and CD8+ T lymphocytes were highest in NTM-LD group, followed by NTM-Col, and control (P = .017 and P = .011 for trend). sTIM-3 elevated in the NTM-Col group compared with the NTM-LD and control groups (856.3 ± 518.7 vs. 595.3 ± 352.6 pg/mL, P = .009; vs. 437.0 ± 267.4 pg/mL, P < .001). Levels of soluble PD-1 and its ligand were similar among groups. Among the 79 NTM-positive patients, sTIM-3 was associated with NTM-LD (100-pg/mL increase, adjusted odds ratio (aOR) 0.658 [95% CI, 0.502–0.864], P = .003). Patients with ≥2 risk factors (sTIM-3 ≤ 530 pg/mL, BMI ≤ 22.5, and radiographic score ≥5) were 13 times more likely to exhibit NTM-LD than those without (aOR 13.234 [2.983–58.709], P = .001).
  
  Conclusions sTIM-3 was an independent factor for differentiating NTM-LD from NTM-Col, suggesting the immunologic role of sTIM-3 in NTM-LD pathogenesis. By assessing sTIM-3 levels and other risk factors, physicians may be able to identify NTM-LD cases in a simplified manner.