Diagnostic performance of host protein signatures as a triage test for active pulmonary TB
Year: 2023
Type: article
Study design: Observational Study
Abstract: ABSTRACT The current four-symptom screen recommended by the World Health Organization (WHO) is widely used as screen to initiate diagnostic testing for active pulmonary tuberculosis (TB), yet the performance is poor especially when TB prevalence is low. In contrast, more sensitive molecular tests are less suitable for placement at primary care level in low-resource settings. In order to meet the WHO End TB targets, new diagnostic approaches are urgently needed to find the missing undiagnosed cases. Proteomics-derived blood host biomarkers have been explored because protein detection technologies are suitable for the point-of-care setting and could meet cost targets. This study aimed to find a biomarker signature that fulfills WHO’s target product profile (TPP) for a TB screening. Twelve blood-based protein biomarkers from three sample populations (Vietnam, Peru, and South Africa) were analyzed individually and in combinations via advanced statistical methods and machine learning algorithms. The combination of I-309, SYWC and kallistatin showed the most promising results to discern active TB throughout the data sets meeting the TPP for a triage test in adults from two countries (Peru and South Africa). The top-performing individual markers identified at the global level (I-309 and SYWC) were also among the best-performing markers at country level in South Africa and Vietnam. This analysis clearly shows that a host protein biomarker assay is feasible in adults for certain geographical regions based on one or two biomarkers with a performance that meets minimal WHO TPP criteria.
Source: Journal of Clinical Microbiology
DOI: 10.1128/jcm.00264-23
Authors: Lisa Koeppel, Claudia M. Denkinger, Romain Wyss, Tobias Broger, Novel N. Chegou, Jill M. Dunty, Kerry Scott, Tatiana Cáceres, Elloise Dutoit, Cesar Ugarte-Gil, Mark Nicol, Eduardo Gotuzzo, Paul L. A. M. Corstjens, Annemieke Geluk, Jayne Sutherland, George B. Sigal, Emmanuel Moreau, Audrey Albertini, Anna Mantsoki, Stefano Ongarello, Gerhard Walzl, Marta Fernandez Suarez
Institutions: Heidelberg University, FIND, University Hospital Heidelberg, German Center for Infection Research, South African Medical Research Council, Stellenbosch University, Universidad Peruana Cayetano Heredia, Instituto de Medicina Tropical Alexander von Humboldt, University of Cape Town, The University of Western Australia, Leiden University Medical Center, MRC Unit the Gambia
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funder: Medical Research Council
OpenAlex ID: W4386845227