Increased risk of mycobacterial infections in autoimmune diseases

Patients with autoimmune diseases are at significantly increased risk of infections caused by Mycobacterium Tuberculosis (TB) and Nontuberculous Mycobacteria (NTM). This heightened susceptibility arises from both intrinsic immune dysregulation and the immunosuppressive therapies used to control these conditions. Biologic agents, particularly TNF-α inhibitors, and high-dose corticosteroids impair key immune pathways. These therapies disrupt cell-mediated immunity, which is essential for controlling intracellular pathogens like mycobacteria. As a result, there is a substantial risk of reactivation of latent TB infection (LTBI).The intersection of immunosuppressive therapy, underlying immune dysfunction, and organ-specific damage creates a “perfect storm” for mycobacterial infections in autoimmune disease patients. Clear mechanistic understanding of the autoimmune condition, careful screening, prophylaxis, and clinical monitoring are essential to mitigate these risks. 1. Immunosuppressive Therapies (Biologic agents, particularly TNF-α inhibitors, and high-dose corticosteroids) and increased risks for susceptibility to mycobacterial infection2. Disease-Associated Immune Dysfunction (such as Systemic Lupus Erythematosus [SLE] and Rheumatoid Arthritis [RA]) and increased risks for susceptibility to mycobacterial infection3. Structural Lung Abnormalities (e.g., RA-associated interstitial lung disease, Sjögren’s syndrome) and increased risks for susceptibility to mycobacterial infection4. Management and Preventative strategies Topic editors: Vishwanath Venketaraman, Beatrice Saviola, Dhruv Desai, Pere-Joan Cardona Source: https://www.frontiersin.org/research-topics/83539/increased-risk-of-mycobacterial-infections-in-autoimmune-diseases