{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T16:15:57Z","timestamp":1772208957528,"version":"3.50.1"},"reference-count":102,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:00:00Z","timestamp":1551225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3,18]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Lung disease due to nontuberculous mycobacteria (NTM) occurs with disproportionate frequency in postmenopausal women with a unique phenotype and without clinically apparent predisposing factors. Dubbed \u2018Lady Windermere syndrome\u2019, the phenotype includes low body mass index (BMI), tall stature and higher than normal prevalence of scoliosis, pectus excavatum and mitral valve prolapse. Although the pathomechanism for susceptibility to NTM lung disease in these patients remains uncertain, it is likely to be multi-factorial. A role for the immunomodulatory consequences of oestrogen deficiency and altered adipokine production has been postulated. Altered levels of adipokines and dehydroepiandrosterone have been demonstrated in patients with NTM lung disease. Case reports of NTM lung disease in patients with hypopituitarism support the possibility that altered endocrine function influences disease susceptibility. This paper catalogues the evidence for immunomodulatory consequences of predicted endocrine changes in Lady Windermere syndrome, with emphasis on the immune response to NTM. Collectively, the data warrant further exploration of an endocrine link to disease susceptibility in Lady Windermere syndrome.<\/jats:p>","DOI":"10.1111\/cei.13265","type":"journal-article","created":{"date-parts":[[2019,1,30]],"date-time":"2019-01-30T04:35:59Z","timestamp":1548822959000},"page":"28-38","source":"Crossref","is-referenced-by-count":15,"title":["Exploring immunomodulation by endocrine changes in Lady Windermere syndrome"],"prefix":"10.1093","volume":"196","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2612-2447","authenticated-orcid":false,"given":"M R","family":"Holt","sequence":"first","affiliation":[{"name":"Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia"},{"name":"Gallipoli Medical Research Institute, Greenslopes Private Hospital, Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J J","family":"Miles","sequence":"additional","affiliation":[{"name":"Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W J","family":"Inder","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia"},{"name":"Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0686-171X","authenticated-orcid":false,"given":"R M","family":"Thomson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia"},{"name":"Gallipoli Medical Research Institute, Greenslopes Private Hospital, Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,2,27]]},"reference":[{"key":"2021121023245157900_cei13265-bib-0001","doi-asserted-by":"crossref","first-page":"67","DOI":"10.3389\/fmicb.2018.00067","article-title":"Phylogenomics and comparative genomic studies robustly support division of the genus Mycobacterium into an emended genus Mycobacterium and four novel genera","volume":"9","author":"Gupta","year":"2018","journal-title":"Front Microbiol"},{"key":"2021121023245157900_cei13265-bib-0002","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.ccm.2014.10.003","article-title":"Environmental sources of nontuberculous mycobacteria","volume":"36","author":"Falkinham","year":"2015","journal-title":"Clin Chest Med"},{"key":"2021121023245157900_cei13265-bib-0003","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1164\/rccm.200604-571ST","article-title":"An official ATS\/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases","volume":"175","author":"Griffith","year":"2007","journal-title":"Am J Respir Crit Care Med"},{"key":"2021121023245157900_cei13265-bib-0004","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.ccm.2014.10.002","article-title":"Epidemiology of human pulmonary infection with nontuberculous mycobacteria: a review","volume":"36","author":"Prevots","year":"2015","journal-title":"Clin Chest Med"},{"key":"2021121023245157900_cei13265-bib-0005","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ccm.2014.10.001","article-title":"Pathogenesis and risk factors for nontuberculous mycobacterial lung disease","volume":"36","author":"Honda","year":"2015","journal-title":"Clin Chest Med"},{"key":"2021121023245157900_cei13265-bib-0006","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1378\/chest.101.6.1605","article-title":"Mycobacterium avium complex pulmonary disease presenting as an isolated lingular or middle lobe pattern. 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