Nutrition in Nontuberculous Mycobacterial Infection
Research type
Research Study
Full title
Assessing nutritional factors contributing to disease in patients with nontuberculous mycobacterial infection
IRAS ID
207341
Contact name
Cecilia O'Kane
Contact email
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Lung infection with non-tuberculous mycobacteria "NTM" (bacteria that are related to, but distinct from, TB) is becoming more common. This probably reflects the increasing population age, but also the increasing numbers of older people surviving with structurally damaged lungs, and the widespread use of inhaled steroids to treat chronic obstructive pulmonary disease (COPD). Current treatment regimens are unsatisfactory, being poorly tolerated and frequently not eradicating the bacteria, leaving patients with untreated progressive bacterial lung infection. Weight loss and loss of muscle bulk are common in this cohort of patients, but also in other patients with chronic inflammatory lung disease like emphysema. Failure to stabilise weight is associated with poorer outcome in NTM infection. The mechanisms driving weight loss and loss of muscle tissue are not clear. Leptin is a hormone that regulates appetite, but which also modulates immune responses and which has been shown to enhance killing of some bacteria. It falls rapidly with starvation and this fall is thought to pre-dispose persons to infection. Ghrelin is a hormone that induces appetite and stimulates food intake; it falls with bacterial infection. The immunomodulatory role of ghrelin and leptin during the pathophysiology of NTM infection is unknown. GDF-15 is a marker in blood that drives muscle loss in the critically ill. Inhibiting its activity can reduce muscle loss in experimental model of illness. Understanding if GDF-15 drives muscle loss in NTM lung disease may help us identify mechanisms of sparing muscle during this infection.
In this pilot study we aim to assess nutritional markers (BMI, muscle bulk, skin fat thickness), leptin, ghrelin and markers driving muscle loss in patients with NTM lung disease and compare these with both healthy controls and age, gender matched controls with chronic lung disease but no NTM infection.REC name
HSC REC B
REC reference
16/NI/0236
Date of REC Opinion
15 Dec 2016
REC opinion
Further Information Favourable Opinion