Urine NMR-based TB metabolic fingerprinting for the diagnosis of TB in children

Area of Science:

• Pediatric Infectious Diseases
• Metabolomics
• Biochemistry

Background:

• Tuberculosis (TB) significantly impacts child morbidity and mortality.
• Early diagnosis and treatment are critical for better outcomes in pediatric TB.
• Accurate diagnostic tools are needed for effective management of childhood TB.

Purpose of the Study:

• To investigate the utility of urine nuclear magnetic resonance (NMR)-based metabolomics for differentiating TB diagnostic certainty in children.
• To identify metabolic differences associated with varying levels of TB diagnosis in pediatric patients.
• To explore metabolomics as a potential tool for improving TB diagnosis and progression prediction in children.

Main Methods:

• Urine samples from 62 children with TB symptoms and 55 healthy children were analyzed.
• High- and low-field proton NMR platforms were used to obtain urine metabolic fingerprints.
• Pattern recognition techniques, including principal components analysis and partial least squares discriminant analysis, were applied.

Main Results:

• Significant differences in urine metabolic fingerprints were observed between children with confirmed/unconfirmed TB and those with unlikely TB (p=0.041, p=0.013).
• Children with unconfirmed TB and TB-compatible X-rays showed distinct metabolic profiles compared to those with non-pathological X-rays (p=0.009).
• Metabolic fingerprint variations correlated with diagnostic certainty in the pediatric TB population.

Conclusions:

• Urine metabolomics can reveal metabolic differences in children with varying diagnostic certainty of TB.
• These findings suggest metabolomics could enhance TB characterization and diagnosis in pediatric populations.
• Metabolomic profiling shows promise for improving TB progression prediction and diagnostic accuracy in children.