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Chinese Journal of Antituberculosis ›› 2026, Vol. 48 ›› Issue (1): 121-130.doi: 10.19982/j.issn.1000-6621.20250292

• Original Articles • Previous Articles     Next Articles

Causal effects of gut microbiota on non-tuberculous mycobacterial lung infection: a bidirectional two-sample mendelian randomization study

Tan Xiao1, Li Fangping1, Zhang Qian2, Zhang Meijia1()   

  1. 1Clinical Pharmacy Department, Weifang NO.2 People’s Hospital, Shandong Province, Weifang 261041, China
    2College of Pharmacy, Inner Mongolia Medical University, Hohhot 010110, China
  • Received:2025-07-17 Online:2026-01-10 Published:2025-12-31
  • Contact: Zhang Meijia E-mail:meijia865@163.com
  • Supported by:
    Weifang Municipal Health Commission Research Project(WFWSJK-2025-209);Weifang Science and Technology Development Plan Project(2025YX065)

Abstract:

Objective: To assess the causal direction between gut microbiota and non-tuberculous mycobacteria lung infection (NTM-LI). Methods: This study used a bidirectional two-sample Mendelian randomization (MR). Genome-wide association studies (GWAS) data of gut microbiota and NTM-LI were obtained from the GWAS Catalog and the FinnGen databases, respectively. Instrumental variables (IV) were selected based on genome-wide significance thresholds, linkage disequilibrium analysis, and weak instrumental variable screening. The primary causal effect assessed using the inverse-variance weighted (IVW) method, supplemented by using MR-Egger, weighted median, simple mode, and weighted mode methods. Heterogeneity, sensitivity, and horizontal pleiotropy were evaluated using Cochran’s Q test, leave-one-out analysis, MR-Egger intercept test, and MR-PRESSO, respectively. Reverse MR analysis followed the same protocol. Results: IVW analysis revealed that changes in the abundance of specific gut microbiota taxa were significantly associated with the risk of NTM-LI. Odoribacter laneus (OR=1.798, 95%CI: 1.017-3.180, P=0.044), Desulfovibrio piger (OR=1.508, 95%CI: 1.069-2.128, P=0.019) and Blautia hansenii (OR=2.487, 95%CI: 1.222-5.062, P=0.012) could increase the risk of NTM-LI. Conversely, Turicibacteraceae (OR=0.570, 95%CI: 0.343-0.949, P=0.031), RUG420 sp900317985 (OR=0.153, 95%CI: 0.036-0.649, P=0.011), Firmicutes E (OR=0.084, 95%CI: 0.009-0.814, P=0.033), Enteroscipio (OR=0.386, 95%CI: 0.197-0.756, P=0.006), and CAG-145 sp000435615 (OR=0.575, 95%CI: 0.357-0.927, P=0.023) could reduce the risk of NTM-LI. No significant heterogeneity, horizontal pleiotropy, and outlier interference was detected. Furthermore, reverse MR analysis did not support effect of NTM-LI on gut microbiota composition. Conclusion: This MR analysis reveals a potential causal relationship between specific gut microbiota and NTM-LI. Targeted modulation of these specific gut microbial taxa holds promise as a novel intervention strategy for the prevention and treatment of NTM-LI.

Key words: Gut microbiota, Mycobacterium infections, Lung diseases, Causality, Mendelian randomization

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