{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T08:06:08Z","timestamp":1784880368046,"version":"3.55.0"},"reference-count":23,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Nontuberculous mycobacterial pulmonary disease (NTM-PD) has been associated with myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA)-positive ANCA-associated vasculitis (AAV). However, clinical factors associated with MPO-ANCA positivity in patients with NTM-PD remain unclear. This study determined the frequency of MPO-ANCA positivity among tested patients with NTM-PD and explored the clinical factors associated with MPO-ANCA positivity. Methods: This study retrospectively analyzed patients aged \u226515 years old with NTM-PD who were treated at Tokyo Shinagawa Hospital and underwent MPO-ANCA testing between April 2020 and March 2024. Clinical data, including nontuberculous mycobacterial species, serum Mycobacterium avium complex (MAC) antibody titers, radiographic findings, and nodule, infiltration\/consolidation, cavity, and ectasis scores, were collected from their electronic medical records. Patients were classified into MPO-ANCA-positive and negative groups, and clinical factors were compared. Results: Among 109 patients with NTM-PD, 49 underwent testing for MPO-ANCA and proteinase 3 (PR3)-ANCA. MPO-ANCA was positive in five patients (10.2%), whereas PR3-ANCA was positive in one (2.0%). Among the five MPO-ANCA-positive patients, three had MAC antibody titers above the upper limit of measurement (&gt;10 U\/mL), and one developed AAV with biopsy-proven pauci-immune crescentic glomerulonephritis and mononeuritis multiplex. The MAC antibody titer was significantly higher in the MPO-ANCA-positive group than in the MPO-ANCA-negative group [10.0 (3.89\u201310.0) vs. 1.92 (0.19\u20136.19) U\/mL, p = 0.038]. Conclusions: MPO-ANCA positivity was observed in a subset of tested patients with NTM-PD and was associated with higher MAC antibody titers. These findings suggest that chronic MAC-related antigen exposure or local pulmonary disease activity in NTM-PD may be associated with MPO-ANCA positivity.<\/jats:p>","DOI":"10.3390\/jcm15155794","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T07:36:13Z","timestamp":1784878573000},"page":"5794","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploratory Study of Clinical Factors Associated with MPO-ANCA Positivity in Nontuberculous Mycobacterial Pulmonary Disease"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9781-258X","authenticated-orcid":false,"given":"Hidenori","family":"Takahashi","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22, Higashi-Oi, Shinagawa-ku, Tokyo 140-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yugo","family":"Satake","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22, Higashi-Oi, Shinagawa-ku, Tokyo 140-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takumi","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22, Higashi-Oi, Shinagawa-ku, Tokyo 140-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kota","family":"Taguchi","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22, Higashi-Oi, Shinagawa-ku, Tokyo 140-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanako","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22, Higashi-Oi, Shinagawa-ku, Tokyo 140-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Nagamatsu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22, Higashi-Oi, Shinagawa-ku, Tokyo 140-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryutaro","family":"Hirose","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22, Higashi-Oi, Shinagawa-ku, Tokyo 140-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Toba","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22, Higashi-Oi, Shinagawa-ku, Tokyo 140-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mio","family":"Toyama-Kousaka","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22, Higashi-Oi, Shinagawa-ku, Tokyo 140-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0922-8656","authenticated-orcid":false,"given":"Shinichiro","family":"Ota","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22, Higashi-Oi, Shinagawa-ku, Tokyo 140-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miwa","family":"Morikawa","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22, Higashi-Oi, Shinagawa-ku, Tokyo 140-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaharu","family":"Shinkai","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tokyo Shinagawa Hospital, 6-3-22, Higashi-Oi, Shinagawa-ku, Tokyo 140-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1038\/s41572-020-0204-y","article-title":"ANCA-associated vasculitis","volume":"6","author":"Kitching","year":"2020","journal-title":"Nat. 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