Immunodiagnosis of active tuberculosis

Area of Science:

• Immunology
• Infectious Diseases
• Diagnostic Development

Background:

• Active tuberculosis (TB) diagnosis requires improved tests for sensitivity and speed.
• Current immune-based tests are mainly for latent TB infection, not active disease, due to low sensitivity and inability to differentiate.
• An unmet clinical need exists for accurate point-of-care diagnostics for active TB.

Purpose of the Study:

• To review recent advancements in immune-based diagnostic tests for active TB.
• To evaluate the potential of these tests for ruling in or ruling out active TB at the point of care.

Main Methods:

• Review of recent studies on immune-based tests for active TB.
• Focus on second-generation Interferon-Gamma Release Assays (IGRAs).
• Exploration of newer platforms like systems serology and flow cytometry for measuring immune signatures.

Main Results:

• Second-generation IGRAs show potential for ruling out active TB, especially in low-prevalence settings.
• Advanced platforms can measure specific Mycobacterium tuberculosis (M.tb) immune signatures with high accuracy for active TB.
• Emerging immune signatures demonstrate potential for accurate active TB detection.

Conclusions:

• Immune-based diagnostics are evolving with potential for active TB rule-out and rule-in.
• Newer technologies offer improved accuracy for active TB detection.
• Crucial need for validation of promising tests in diverse clinical cohorts, including various TB presentations and differential diagnoses.