Diagnostic Potential of Novel Salivary Host Biomarkers as Candidates for the Immunological Diagnosis of Tuberculosis Disease and Monitoring of Tuberculosis Treatment Response.
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Diagnostic Potential of Novel Salivary Host Biomarkers as Candidates for the Immunological Diagnosis of Tuberculosis Disease and Monitoring of Tuberculosis Treatment Response.
BACKGROUND There is an urgent need for new tools for the early diagnosis of TB disease and monitoring response to treatment, particularly in resource-limited settings. We investigated the usefulness of the host marker detected in saliva as biomarker candidates for immunological diagnosis of TB disease and monitoring treatment response.
METHOD We prospectively collected saliva samples from 51 individuals who presented with signs and symptoms suggestive of TB disease in a health center in Cape Town, South Africa, prior to the establishment of a clinical diagnosis. Patients were then classified as having tuberculosis or other respiratory diseases (ORD), using a combination of clinical findings, radiological and laboratory. We evaluate the concentration of the marker 69 in the home side a saliva sample using a multiplex cytokine platform, and assess the diagnostic potential of these markers by the receiver operator characteristic (ROC) curve analysis, and general discriminant analysis.
RESULTS Of the 51 study participants, 18 (35.4%) were diagnosed with TB disease and 12 (23.5%) were HIV-infected. Only two of the 69 markers were evaluated hosts (IL-16 and IL-23) were diagnosed with TB disease individually with an area under the ROC curve ≥0.70.
A biosignature five markers consisting of IL-1β, IL-23, ECM-1, HCC1 and fibrinogen diagnosed TB disease with a sensitivity of 88.9% (95% CI, 76.7 to 99.9%) and specificity of 89.7 % (95% CI, 60.4 to 96.6%) after a leave-one-out cross validation, regardless of their HIV infection status. biosignatures eight markers performed with a sensitivity of 100% (95% CI, 83.2 to 100%) and a specificity of 95% (95% CI, 68.1 to 99.9%) in the absence of HIV infection. In addition, the concentration of 11 markers change during the treatment, suggesting that they may be useful in monitoring response to treatment of TB.
CONCLUSION We have identified a new saliva biosignatures that may be useful in the diagnosis of TB disease and monitoring response to treatment of TB. Our findings require further validation in larger studies before it could be considered biosignatures for point-of-care screening test development.
Diagnostic Potential of Novel Salivary Host Biomarkers as Candidates for the Immunological Diagnosis of Tuberculosis Disease and Monitoring of Tuberculosis Treatment Response.
Learning from epidemiological studies, clinical and immunology in Mycobacterium africanum to improve the current understanding of host-pathogen interactions, and for the development and evaluation of diagnostic, host-directed therapies, and vaccines for tuberculosis.
Mycobacterium africanum comprises two phylogenetic lineages in the Mycobacterium tuberculosis complex (MTBC). M. africanum first described and isolated in 1968 from Senegal sputum of patients with pulmonary tuberculosis (TB) and has been identified increasingly as an important cause of human tuberculosis, particularly prevalent in West Africa.
M. africanum limited geographical distribution, in contrast with comprehensive global distribution of other species of MTBC, requires an explanation. The available data suggest that M. africanum may also have important differences in transmission, pathogenesis and host-pathogen interactions, which may affect the evaluation of new TB intervention tools (diagnostics and vaccines) -they are being used and those under development.
Uneven geographical distribution and dissemination of MTBC species means that the research findings of individuals from one country or region can not be generalized across the continent. Thus, the generalization of data from previous research studies and ongoing in the MTBC may be inaccurate and inappropriate. A major rethink is needed about the design and structure of future clinical trials of new interventions. West, Central, East and Southern Africa EDCTP Networks of Excellence provides an opportunity to take forward this pan-African studies.
