Profesionales médicos

May 17, 2025

Tuberculosis (TB) is caused by the Mycobacterium tuberculosis (Mtb) bacilli, which is the leading infectious disease killer in the world and affects large numbers of minorities and underserved populations in the U.S. Patricio Escalante, M.D., M.S., a pulmonologist, sleep medicine and critical care specialist at Mayo Clinic in Rochester, Minnesota, and his research team are studying novel diagnostic methods to accurately detect and predict the trajectory of the latent form of TB infection. Latent TB infection is the most common form of Mtb infection, and it’s also the most challenging to diagnose and predict its disease outcome.

Nontuberculous mycobacteria (NTM) lung diseases are emergent infections that also affect many people in the U.S. and around the world. Mycobacterium avium complex (MAC) lung disease is the most common NTM lung infection. MAC lung disease particularly affects postmenopausal women and patients with underlying structural lung disease and remains very challenging to treat with antibiotics. Dr. Escalante's research team also is studying biological markers of disease progression and predictors of treatment response in patients with MAC lung disease. These research efforts are supported by an R01 grant from the National Institute of Allergy and Infectious Diseases.

Accumulated evidence shows that sex also can play an important role in susceptibility to infectious diseases including MAC lung infections. However, the effect of estrogen and hormonal changes during menopause on host immune response against MAC infection in the human lung remains unknown. The hypothesis of Dr. Escalante and his research team is that postmenopausal women are more susceptible to MAC-LD due to the immune dysfunction and/or lack of inflammatory mediators associated with postmenopausal hormonal changes, which in turn can facilitate lung infections with this environmental bacteria.

With the support of an internal grant from Mayo Clinic, Dr. Escalante's laboratory team at Mayo Clinic Thoracic Research Disease Unit is studying the effect of estrogen on immune response induced by MAC infection in vitro using a mouse model and human blood samples. Specifically, the team will assess the effects of estradiol on inflammatory mediators and genes associated with host immune response against MAC infection by studying infected mice and blood immune cells from patients and healthy volunteers in the presence or absence of estradiol. Researchers also will compare the course of infection, inflammatory mediators and bacterial burden between males, females and ovariectomy female mice in the presence and absence of estradiol using a promising new mouse model of MAC lung disease.

One goal of the study is to determine the relationship between endogenous estrogen exposure and the risk of MAC lung disease in postmenopausal women. Researchers also hope to improve understanding of the impact of estrogen on MAC lung disease onset and progression. If successful, this newly designed mouse model of MAC lung disease would also help identify new therapeutic targets that could be studied with novel preventive and treatment interventions in the future — benefiting postmenopausal women at risk of these difficult-to-treat lung infections.

The research team's efforts are a collaborative and innovative effort with other investigators in the U.S. seeking to identify specific biological markers of progression and protection in latent TB infection and NTM lung infections using Mayo Clinic's state-of-the-art laboratory methods and research tools. This research is significant because it is expected to advance the understanding of disease protection and progression in mycobacterial infections. The goal is to translate the results of this ongoing research into better diagnostic tests and predictors to optimize individualized treatments for patients. Ultimately, these new laboratory tests and predictors will help healthcare professionals and people find better ways to control TB and NTM infections in the community, and in turn, improve the health of minority groups, women's health and global health.

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