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Non-tuberculous mycobacteria (NTM) can cause debilitating skin and soft tissue infections (SSTI). NTM SSTI incidence rises with an aged population and increased use of immunosuppression. These infections require treatment with multiple antibiotics for a minimum of 4-6 months. Still, non-response or worsening of skin lesions occurs frequently, because antibiotics fail or too much inflammation occurs.
Arjan van Laarhoven, Lisa Kurver (both Internal medicine), Juul van den Reek (Dermatology), Mumin Ozturk (Mhlanga lab) and their team hypothesize that differences in the patients’ immune systems, so-called ‘patient endotypes’, drive these diverging treatment courses. Currently, the involved immune processes in the skin are not identified for NTM SSTI. In addition, it is unknown what antibiotic concentrations in the skin are needed to kill the NTM.
Funded for 500 k€ by the LEO foundation, the team will investigate the individual immune response in the skin of NTM SSTI patients by measuring gene expression in individual cells, and how these cells interact. They will compare this to the immune cells in the patients’ blood and will use the combined information to understand how patients differ in their immune response to the infection.
After eight weeks of antibiotic treatment, a second biopsy will be taken, in which measurement of the number of live mycobacteria, changes in local skin immune responses and drug concentrations of azithromycin will be measured. By providing targets for optimizing treatment with both antibiotics and anti-inflammatory or immunostimulating drugs, this project aims to improve the outlook for NTM SSTI patients. A PhD candidate position is now open for this study.
Non-Tuberculous Mycobacterial Skin and Soft Tissue Infections: Using a Site-of-Disease Approach to Understand Pathophysiology and Improve Outcome
Research team
- Infectious diseases and lab Experimental Internal Medicine: Lisa Kurver, Reinout van Crevel and Arjan van Laarhoven (Radboudumc) and Hannelore Bax (Erasmus MC)
- Prof. Mhlanga’s lab: Mumin Ozturk
- Dermatology: Juul van den Reek (Radboudumc) and Colette van Hees (Erasmus MC)
- Plastic Surgery: Claire van Houdt
- Pharmacy: Lindsey te Brake
