JOURNAL OF BACTERIOLOGY AND VIROLOGY ISSN:1598-2467(Print) 2093-0429(Online)

Nontuberculous mycobacterial pulmonary disease (NTM-PD) is emerging as a global health threat and is challenging to treat because of its intrinsic resistance to multiple antibiotics. Neutrophils are the most abundant myeloid cells and serve as the principal cell type in the host’s innate immune response during infection. To date, neutrophil functions in NTM-PD have not been as extensively studied as those in tuberculosis. However, accumulating evidence suggests that neutrophils play a dual role: providing critical antimicrobial host defense, particularly during the early phase, while simultaneously contributing to pathological damage that promotes tissue destruction and structural abnormalities, such as bronchiectasis. This review provides a comprehensive overview of the paradoxical role of neutrophils in controlling innate immune defense and immunopathology during NTM infection. Further, we focused on the mechanism by which neutrophil extracellular traps serve as critical drivers of NTM pathogenesis. Furthermore, we examined the neutrophil profiles across various clinical stages in patients with NTM-PD, although the underlying mechanisms and clinical implications of these profiles remain to be fully elucidated. A deeper understanding of the precise mechanisms required to maintain the immunological balance between effective host immune defense and the prevention of pathological damage will pave the way for innovative therapeutic approaches to control NTM infections.