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

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  • 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
  • Ritz, Christian
  • Harleen M S Grewal

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%).

OriginalsprogEngelsk
Artikelnummer18520
TidsskriftScientific Reports
Vol/bind6
Antal sider11
ISSN2045-2322
DOI
StatusUdgivet - 2016

Bibliografisk note

CURIS 2016 NEXS 020

ID: 152994742