The study shows that different types of non‑TB mycobacteria infect immune cells to varying degrees, and some of them can protect themselves from the natural antibacterial peptide LL‑37 by using special fats in their cell walls.

Comparisons of infectivity among the clinically important nontuberculous mycobacteria (NTM) species have not been explored in great depth. Rapid-growing mycobacteria, including <i>Mycobacterium abscessus</i> and <i>M. porcinum</i>, can cause indolent but progressive lung disease. Slow-growing members of the <i>M. avium</i> complex are the most common group of NTM to cause lung disease, and molecular approaches can now distinguish between several distinct species of <i>M. avium</i> complex including <i>M. intracellulare</i>, <i>M. avium</i>, <i>M. marseillense</i>, and <i>M. chimaera</i>. Differential infectivity among these NTM species may, in part, account for differences in clinical outcomes and response to treatment; thus, knowing the relative infectivity of particular isolates could increase prognostication accuracy and enhance personalized treatment. Using human macrophages, we investigated the infectivity and virulence of nine NTM species, as well as multiple isolates of the same species. We also assessed their capacity to evade killing by the antibacterial peptide cathelicidin (LL-37). We discovered that the ability of different NTM species to infect macrophages varied among the species and among isolates of the same species. Our biochemical assays implicate modified phospholipids, which may include a phosphatidylinositol or cardiolipin backbone, as candidate antagonists of LL-37 antibacterial activity. The high variation in infectivity and virulence of NTM strains suggests that more detailed microbiological and biochemical characterizations are necessary to increase our knowledge of NTM pathogenesis.