The Role of Autophagy during Nontuberculous Mycobacterial Infection

Nontuberculous mycobacteria (NTM)-including Mycobacterium abscessus and M. avium complex-are emerging as major causes of pulmonary diseases worldwide.Treatment is hindered by the intrinsic resistance of most NTM to many antibiotics.Developing novel therapeutics, therefore, requires a better understanding of the host defense mechanisms against NTM.Autophagy is a lysosomedependent pathway that degrades large macromolecular aggregates, damaged organelles, and intracellular pathogens.However, compared with M. tuberculosis, a major pathogen for human tuberculosis, the role of autophagy in NTM infection is far less well elucidated.This review explores the current understanding of autophagy-mediated host autophagy responses affecting NTM pathogenesis and intracellular homeostasis, as well as highlights several candidate agents that stimulate host autophagy and lysosomal activity to combat NTM infections.Elucidating these mechanisms could facilitate the development of more effective therapeutics for these increasingly prevalent infections.