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The project in which we are engaged is highly relevant to women’s health, pulmonary nontuberculous mycobacterial disease (PNTM). This condition is due to infection with ubiquitous environmental NTM, found in water and soil around the world. However, over the last 2 decades, there has been a dramatic growth in cases of PNTM in North American Caucasian post-menopausal women. We have been studying this disease for over 10 years in NIAID, and have assembled a large cohort and enrolled them in the first-ever prospective study of the natural history, phenotype, and genetics of this disorder. One of the most important findings is that the epidemiology of this infection in the current era is overwhelmingly skewed toward older women, 80-96% in several studies.
Our studies have included pulmonary, cardiac, immune, and anthropometric measures. We are now moving into interventional studies: we have an IRB-approved study of systemic cytokine therapy, looking at bronchoalveolar proteomic and transcriptional endpoints; we are submitting a study of mefloquine in the treatment of refractory NTM infection; and we have established a national consortium to develop and disseminate studies in PNTM, the Nontuberculous Mycobacterial Consortium.
In view of the above track record in these significant health issues in women, we are very committed to providing mentorship to a fellow in this area. It combines infectious disease, pulmonary, genetics, and women’s health in a single disease that is emerging, important, and vastly understudied.
