Old biomarkers in tuberculosis management: are they still useful? a systematic review

Fusani, Lara; Tersigni, Chiara; Chiappini, Elena; Venturini, Elisabetta; Galli, Luisa

doi:10.1080/14787210.2021.1898945

Cited by 5 publications

(7 citation statements)

References 42 publications

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“…These four biomarkers are CRP, IL-6, IP-10, and TNF-α. CRP was the first to appear and is now in clinical use as an adjunct to the diagnosis of TB and to determine the efficacy of anti-TB therapy ( Fusani et al, 2021 ). IL-6 and IP-10 have considerable potential to diagnose tuberculosis, and biologic companies already exist to develop related products ( Zimmer et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Comprehensive Genetic Analysis of Tuberculosis and Identification of Candidate Biomarkers

Zhu

Wang

et al. 2022

Front. Genet.

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Purpose: The purpose of this study is to use the data in the GEO database to analyze, screen biomarkers that can diagnose tuberculosis, and verification of candidate biomarkers.Materials and methods: GSE158767 dataset were used to process WGCNA analysis, differential gene analysis, Gene ontology and KEGG analysis, protein-protein network analysis and hub genes analysis. Based on our previous study, the intersect between WGCNA and differential gene analysis could be used as candidate biomarkers. Then, the enzyme-linked immunosorbent assay was used to validate candidate biomarkers, and receiver operating characteristic was used to assess diagnose ability of candidate biomarkers.Results: A total of 412 differential genes were screened. And we obtained 105 overlapping genes between DEGs and WGCNA. GO and KEGG analysis showed that most of the differential genes were significantly enriched in innate immunity. A total of 15 hub genes were screened, and four of them were verified by Enzyme-linked immunosorbent assay. CCL5 performed well in distinguishing the healthy group from the TB group (AUC = 0.723). And CCL19 performed well in distinguishing the TB group from the ORD groups (AUC = 0.811).Conclusion: CCL19, C1Qb, CCL5 and HLA-DMB may play important role in tuberculosis, which indicated four genes may become effective biomarkers and could be conveniently used to facilitate the individual tuberculosis diagnosis in Chinese people.

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Section: Discussionmentioning

confidence: 99%

Comprehensive Genetic Analysis of Tuberculosis and Identification of Candidate Biomarkers

Zhu

Wang

et al. 2022

Front. Genet.

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“…also underlined the importance of CRP as a discrimination factor between culture-positive and culture-negative specimens ( 47 ). Moreover, CRP proved higher accuracy and specificity when evaluated as a TB case-finding test in comparison with WHO-4-SS ( 12 , 47 ). Although CRP does not identify drug resistance, its potential clinical relevance as a screening test in PTB patients and as a reliable tool in monitoring treatment outcomes justifies the concept of our study ( 48 ).…”

Section: Introductionmentioning

confidence: 94%

“…A sputum-smear negative and/or negative culture does not always exclude TB diagnosis and may lead to wrong TB management ( 7 – 9 ); this accelerated the use of Xpert Gene MTB/RIF automated rapid molecular assay, which is less sensitive than culture (92%), as a more sensitive method than sputum-smear microscopy for fast identification of PTB as well as rapid assessment of rifampicin susceptibility ( 6 , 10 , 11 ). However, available diagnostic tests and mycobacterial cultures are rather time-consuming compared to point-of-care tests and also require both logistical measures and experienced personnel in order to properly diagnose TB ( 12 , 13 ). Although GeneXpert MTB/RIF assay is preferred as a diagnostic tool in HIV-positive individuals due to higher sensitivity compared to smear microscopy and faster results compared to mycobacterial culture ( 14 ), it imposes various demands such as constant connection to electricity, proper temperature flow, and dedicated personnel to ensure installation functionality in comparison with rapid serological assays ( 13 , 15 ).…”

Section: Introductionmentioning

confidence: 99%

“…CRP can be measured semi-quantitatively using capillary blood or quantitatively from either venous or capillary blood through different immunoturbidimetric methods and rapid cost-effective quantified point-of-care tests (POC-CRP assays) that provide results in less than 5 min ( 31 , 36 – 38 ). Moreover, POC-CRP tests are easily interpretable by specialists and available worldwide in comparison with reference diagnosis standards ( 12 ). On the other hand, in order to correctly implement POC-CRP tests, the program requires a valid quality method, trained certified applicants, and continuous internal control based on distributors’ manuals ( 38 ).…”

Section: Introductionmentioning

confidence: 99%

“…In the past years, different types of studies have been published (retrospective, comparative, multi-center, and clinical trials) that claim the use of CRP as a TB screening test for TB (both pulmonary and extra-pulmonary), in various ethnicities, with several comorbid pathologies ( 12 , 41 – 45 ). This increased interest in CRP research has prompted us to evaluate through statistical analysis if CRP is an adequate screening tool, as a rule-out test.…”

Section: Introductionmentioning

confidence: 99%

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Screening performance of C-reactive protein for active pulmonary tuberculosis in HIV-positive patients: A systematic review with a meta-analysis

et al. 2022

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BackgroundTuberculosis (TB) is the leading infectious cause of mortality worldwide. In the last years, resistant strains of the etiological agent, Mycobacterium tuberculosis, have emerged, thus demanding more triage tests to identify active pulmonary TB (PTB) patients and to evaluate their disease severity. Therefore, acute-phase reaction serum tests are required for monitoring TB patients, among WHO symptom screening recommendations. C-reactive protein (CRP) is a non-specific inflammatory biomarker that has been recently proposed for TB screening and can be quantitatively analyzed through cost-effective point-of-care assays. A previous meta-analysis found CRP to be highly sensitive and moderately specific for active PTB with confirmed HIV infection.MethodsWe performed a meta-analysis update of diagnostic tests, pooling sensitivities, and specificities in order to assess the accuracy of CRP as a potential test for the screening of HIV-associated PTB in outpatients. We searched MEDLINE, Web of Science, and SCOPUS for eligible articles before 19 October 2021.ResultsWe identified 13 eligible studies with HIV-positive patients with PTB. At a CRP threshold of 10 mg/L, CRP pooled sensitivity was 87% (76%–93%) and pooled specificity was 67% (49%–81%), with an area under the curve (AUC) of 0.858. Using a CRP threshold of 8 mg/L, pooled sensitivity was 82% (72%–89%) and pooled specificity was 82% (67%–92%), with an AUC of 0.879. We found that CRP has a high sensitivity in the screening of PTB in HIV-positive outpatients, consistent with findings reported previously.ConclusionsRegardless of pooled specificity, better results were found using the CRP threshold of 8 mg/L as a test screening of PTB, meeting the need of further approaching specific TB diagnostic methods and reducing resource consumption.

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Differential activation of innate and adaptive lymphocytes during latent or active infection with Mycobacterium tuberculosis

Ruiz‐Sánchez

Castañeda-Casimiro

Cabrera-Rivera

et al. 2022

Microbiology and Immunology

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Most individuals infected with Mycobacterium tuberculosis (Mtb) have latent tuberculosis (TB), which can be diagnosed with tests (such as the QuantiFERON-TB Gold test [QFT]) that detect the production of IFN-γ by memory T cells in response to the Mtb-specific antigens 6 kDa early secretory antigenic target EsxA (Rv3875) (ESAT-6), 10 kDa culture filtrate antigen EsxB (Rv3874) (CFP-10), and Mtb antigen of 7.7 kDa (Rv2654c) (TB7.7). However, the immunological mechanisms that determine if an individual will develop latent or active TB remain incompletely understood. Here we compared the response of innate and adaptive peripheral blood lymphocytes from healthy individuals without Mtb infection (QFT negative) and from individuals with latent (QFT positive) or active TB infection, to determine the characteristics of these cells that correlate with each condition. In active TB patients, the levels of IFN-γ that were produced in response to Mtb-specific antigens had high positive correlations with IL-1β,

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Old biomarkers in tuberculosis management: are they still useful? a systematic review

Cited by 5 publications

References 42 publications

Comprehensive Genetic Analysis of Tuberculosis and Identification of Candidate Biomarkers

Comprehensive Genetic Analysis of Tuberculosis and Identification of Candidate Biomarkers

Screening performance of C-reactive protein for active pulmonary tuberculosis in HIV-positive patients: A systematic review with a meta-analysis

Differential activation of innate and adaptive lymphocytes during latent or active infection with Mycobacterium tuberculosis

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