Exploring the immune response against Mycobacterium tuberculosis for a better diagnosis of the infection

Tuberculosis (TB) still represents a monumental problem, with more than two million deaths every year worldwide. The current diagnostics for TB offer sub-optimal accuracy both for the active and the latent form of infection and are often based on technologies unaffordable in low-income settings. The tuberculin skin test was the first diagnostic based on an acquired immune response towards Mycobacterium tuberculosis (MTB). Advances in molecular and cellular biology and the elucidation of the mechanisms governing the relation between MTB and the human immune system form the basis for new and more accurate assays, potentially able to fill the gaps and limits of classical diagnostics. However, the process of validating new tests is still complex and hampered by specific questions regarding TB immunology and natural history. We present here a summary of the current approaches to validate new diagnostics based on the detection of immunological biomarkers of TB infection.