Advances in Isothermal Amplification for the Diagnosis of Tuberculosis

Detecting tuberculosis (TB) remains challenging in low-resource settings due to limited access to advanced diagnostic tools. The emergence of isothermal amplification techniques, such as loop-mediated isothermal amplification (LAMP), presents a promising solution for TB detection. Several isothermal amplification techniques, e.g., strand displacement amplification (SDA), helicase-dependent amplification (HDA), recombinase polymerase amplification (RPA), and rolling cycle amplification (RCA), have been attracting attention for development as point-of-care testing (POCT) in many diagnostic fields. The present review summarizes the most common isothermal amplification techniques for the detection of TB.

To collect the necessary information, we searched PubMed and Scopus for scientific evidence published from 2000 to September 2024, using the keywords loop-mediated isothermal amplification tuberculosis, strand displacement amplification tuberculosis, helicase-dependent amplification tuberculosis, recombinase polymerase amplification tuberculosis, rolling circle amplification tuberculosis, polymerase spiral reaction tuberculosis, cross-priming amplification tuberculosis, and multiple cross displacement amplification tuberculosis.

The methodologies of the most usual isothermal amplification techniques are addressed, as well as the advantages and limitations of the technique, highlighting applications in TB diagnosis. Exploring these advances addresses the principles of innovation in isothermal amplification, including their performance and applicability across diverse sample types. Some techniques have already been launched into routine TB diagnosis, while other promising tests are still being researched or evaluated. These techniques are easy to perform and provide results rapidly, enabling prompt treatment within a few hours. Isothermal amplification techniques may be one of the key molecular tools to fight TB in pursuit of the goals of the End TB strategy.