Approaching a diagnostic point-of-care test for pediatric tuberculosis through evaluation of immune biomarkers across the clinical disease spectrum.

Abstract

The World Health Organization (WHO) calls for an accurate, rapid, and simple point-of-care (POC) test for the diagnosis of pediatric tuberculosis (TB) in order to make progress "Towards Zero Deaths". Whereas the sensitivity of a POC test based on detection of Mycobacterium tuberculosis (MTB) is likely to have poor sensitivity (70-80% of children have culture-negative disease), host biomarkers reflecting the on-going pathological processes across the spectrum of MTB infection and disease may hold greater promise for this purpose. We analyzed transcriptional immune biomarkers direct ex-vivo and translational biomarkers in MTB-antigen stimulated whole blood in 88 Indian children with intra-thoracic TB aged 6 months to 15 years, and 39 asymptomatic siblings. We identified 12 biomarkers consistently associated with either clinical groups "upstream" towards culture-positive TB on the TB disease spectrum (CD14, FCGR1A, FPR1, MMP9, RAB24, SEC14L1, and TIMP2) or "downstream" towards a decreased likelihood of TB disease (BLR1, CD3E, CD8A, IL7R, and TGFBR2), suggesting a correlation with MTB-related pathology and high relevance to a future POC test for pediatric TB. A biomarker signature consisting of BPI, CD3E, CD14, FPR1, IL4, TGFBR2, TIMP2 and TNFRSF1B separated children with TB from asymptomatic siblings (AUC of 88%).

• Authors: Synne Jenum, S Dhanasekaran, Rakesh Lodha, Aparna Mukherjee, Deepak Kumar Saini, Sarman Singh, Varinder Singh, Guruprasad Medigeshi, Marielle C Haks, Tom H M Ottenhoff, Timothy Mark Doherty, Sushil K Kabra, Christian Ritz, Harleen M S Grewal
• Journal: Scientific reports (Sci Rep) Vol. 6 Pg. 18520 (Jan 04 2016) ISSN: 2045-2322 [Electronic] England
• PMID: 26725873 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers

Topics

• Biomarkers (blood)
• Child
• Cross-Sectional Studies
• Female
• Humans
• Male
• Mycobacterium tuberculosis (immunology)
• Point-of-Care Systems
• Tuberculosis (blood, diagnosis, immunology)