Evidence map›Paper›PMID 27007918›Full record

ReviewBMC medicine2016

'"Why me, why now?" Using clinical immunology and epidemiology to explain who gets nontuberculous mycobacterial infection.

M Alexandra Lake, Lyn R Ambrose, Marc C I Lipman, David M Lowe

Open access · goldAbstract readEditorialReview
In one paragraph

Review in BMC medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 82 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
82citing papers in PubMed, 1 pooled it
10.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

82 citing papers in PubMed, 1 synthesis or guideline pooled it, 133 citations in OpenAlex.

  1. Pooled it
  2. Macrolide-resistantJournal of clinical tuberculosis and other mycobacterial diseases · 2026
    Review
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Case Report: SuspectedFrontiers in medicine · 2026
    Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Cell Death Mechanisms inPathogens (Basel, Switzerland) · 2025
    Review
  15. Extrapulmonary Comparisons BetweenInfection and drug resistance · 2025
    Review
  16. Article
  17. Toward better cures forClinical microbiology reviews · 2024
    Review
  18. Biochip-Based Identification of Mycobacterial Species in Russia.International journal of molecular sciences · 2024
    Article
  19. Article
  20. Article

22 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

M Alexandra LakeRoyal Free London NHS Foundation Trust, London, UK.
Lyn R AmbroseInstitute of Immunity and Transplantation, University College London, Royal Free Campus, Pond Street, London, NW3 2QG, UK.
Marc C I LipmanRoyal Free London NHS Foundation Trust, London, UK.
David M LoweRoyal Free London NHS Foundation Trust, London, UK. d.lowe@ucl.ac.uk.
University College London · GBThe Royal Free Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe prevalence of nontuberculous mycobacterial (NTM) disease is rising. An understanding of known risk factors for disease sheds light on the immunological and physical barriers to infection, and how and why they may be overcome. This review focuses on human NTM infection, supported by experimental and in vitro data of relevance to the practising clinician who seeks to understand why their patient has NTM infection and how to further investigate. DISCUSSION: First, the underlying immune response to NTM disease is examined. Important insights regarding NTM disease susceptibility come from nature's own knockouts, the primary immune deficiency disorders. We summarise the current knowledge surrounding interferon-gamma (IFNγ)-interleukin-12 (IL-12) axis abnormalities, followed by a review of phagocytic defects, T cell lymphopenia and rarer genetic conditions known to predispose to NTM disease. We discuss how these define key immune pathways involved in the host response to NTM. Iatrogenic immunosuppression is also important, and we evaluate the impact of novel biological therapies, as well as bone marrow transplant and chemotherapy for solid organ malignancy, on the epidemiology and presentation of NTM disease, and discuss the host defence dynamics thus revealed. NTM infection and disease in the context of other chronic illnesses including HIV and malnutrition is reviewed. The role of physical barriers to infection is explored. We describe how their compromise through different mechanisms including cystic fibrosis, bronchiectasis and smoking-related lung disease can result in pulmonary NTM colonisation or infection. We also summarise further associations with host factors including body habitus and age. We use the presented data to develop an over-arching model that describes human host defences against NTM infection, where they may fail, and how this framework can be applied to investigation in routine clinical practice.

Indexed as

Disease SusceptibilityHumansMaleMycobacterium Infections, NontuberculousNontuberculous MycobacteriaPrevalenceRisk FactorsBronchiectasisCystic fibrosisHost defenceImmune responseInterferon gammaInterleukin 12Nontuberculous mycobacteriaPrimary immune deficiency

Identifiers

PMID27007918
PMCPMC4806462
OpenAlexW2311702156

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.