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Diagnosing Tuberculosis Infection: From the Host to the Pathogen.
Delia Goletti1, Alessandra Aiello2, Shruthi Chandran3
1National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome 00149, Italy delia.goletti@inmi.it.
Cold Spring Harbor Perspectives in Medicine
|January 20, 2026
Summary
Tuberculosis infection (TBI) affects a quarter of the global population. New diagnostic methods detecting Mycobacterium tuberculosis (Mtb) components, not just immune responses, show promise for improved TBI detection.
Area of Science:
- Infectious Diseases
- Immunology
- Diagnostics
Background:
- Tuberculosis (TB) remains a major global health concern.
- A quarter of the world's population harbors latent Tuberculosis Infection (TBI).
- Individuals with TBI face a 5%-10% lifetime risk of developing active TB disease.
Purpose of the Study:
- To review current diagnostic methods for TBI.
- To explore novel experimental approaches for TBI detection.
- To highlight the potential of detecting circulating bacillary components.
Main Methods:
- Review of existing diagnostic tools for TBI (interferon-γ release assays, skin tests).
- Exploration of emerging experimental assays targeting Mycobacterium tuberculosis (Mtb) components.
- Focus on detecting Mtb DNA, proteins, peptides, lipoglycans, and lipoprotein antigens.
Main Results:
- Current diagnostics rely on immune responses to Mtb.
- Experimental assays aim to directly detect bacillary components.
- These novel approaches could overcome limitations of current immunodiagnostic assays.
Conclusions:
- Direct detection of bacillary components offers potential alternatives or complements to current TBI diagnostics.
- Emerging assays targeting Mtb components require further research and clinical validation.
- Improved diagnostics are crucial for managing the global TB burden.
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