Neutrophils and oxidative stress markers may be a useful indicator for initiating chemotherapy in NTM patients

Background: The number of nontuberculous mycobacterial lung disease (NTM) is rapidly increasing. Its natural history seems to be complicated, and it is sometimes difficult to decide when chemotherapy (CT) should be started. Our previous study showed that the increase of total cell counts and neutrophil percentages in bronchoalveolar lavage fluid (BALF) were related to the commencement of CT. Neutrophils produce reactive oxygen species, leading to the increase of oxidative stress. Aims: To elucidate whether oxidative stress as well as neutrophils are useful indicators to initiate CT in NTM patients. Methods: Between June 2016 and January 2019, 69 subjects that underwent diagnostic bronchoscopy were included. According to the finding of bronchoscopy, subjects were divided into NTM group and No-NTM group. NTM group were subdivided into Treatment group (NTM-T) and Observation group (NTM-O). We measured serum d-ROM as a marker of oxidants and serum BAP as a marker of antioxidants through a spectrophotometric procedure (FRAS4). Results: Total cell counts as well as neutrophil percentages in BALF were the highest in NTM-T group (P Conclusions: The current study suggested that the predominance of neutrophil in BALF and/or serum oxidative stress markers seemed to be a potential indicator to initiate CT in NTM patients.