The incidence of three granulomatous response diseases—sarcoidosis, tuberculosis, and non-tuberculous mycobacterial pulmonary disease—differ markedly in African–Americans versus Caucasians. In reviewing a large compendium of non-cystic-fibrosis bronchiectasis, we noted that complicating infection with non-tuberculous mycobacteria was relatively infrequent among individuals of African–American descent, confirming previous observations of their inherent resistance. Disease-specific variance among African–Americans in the efficacy of their granulomatous response suggests a nexus, a mediating, immunological mechanism. Environmentally conditioned selection of SLC11A1 (Nramp1) alleles may account for this ethnic variance.
Natural resistance-associated macrophage protein 1
Non-tuberculous mycobacterial pulmonary disease
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Conflict of interest
Drs. Reich and Kim declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
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