Toward a molecular microbial blood test for tuberculosis infection
Toward a molecular microbial blood test for tuberculosis infection
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DOI：
10.1016/j.ijid.2024.106988
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发表时间：
2024-04-01
影响因子：
8.4
通讯作者：
Tiwari，Divya
中科院分区：
文献类型：
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作者：
Martineau，Adrian R.;Chandran，Shruthi;Tiwari，Divya
如果不采取措施识别无症状结核患者，世界卫生组织到2050年结束全球结核病流行的目标就无法实现。并向他们提供干预措施，以减少疾病进展的风险，例如预防性抗菌药物治疗。这一战略的实施受到以下事实的限制：现有的结核分枝杆菌感染检测使用对结核分枝杆菌特异性抗原的免疫致敏作为感染的替代指标，对结核进展的阳性预测价值较低。一种检测结核分枝杆菌DNA的血液检测可以使预防性治疗针对有微生物证据的持续感染的个体。在这篇综述中，我们总结了结核分枝杆菌感染分子微生物血液检测的最新进展，并讨论了其结果与近期接触感染指数病例的成人免疫诊断检测结果不一致的可能解释。我们还提出了进一步发展结核分枝杆菌感染分子微生物血液检测的路线图，并强调该领域的研究潜力，为结核分枝杆菌感染的生物学提供新的见解，并提供新的工具，以支持控制全球结核流行的努力。
The World Health Organization's aim to end the global TB epidemic by 2050 cannot be achieved without taking measures to identify people with asymptomaticM. tuberculosis(Mtb) infection and offer them an intervention to reduce risk of disease progression, such as preventive antimicrobial therapy. Implementation of this strategy is limited by the fact that existing tests for Mtb infection, which use immunosensitisation to Mtb-specific antigens as a proxy for infection, have low positive predictive value for progression to TB. A blood test that detects Mtb DNA could allow preventive therapy to be targeted at individuals with microbiological evidence of persistent infection. In this review we summarise recent advances in the development of molecular microbial blood tests for Mtb infection, and discuss potential explanations for discordance between their results and those of immunodiagnostic tests in adults with recent exposure to an infectious index case. We also present a roadmap for further development of molecular microbial blood tests for Mtb infection, and highlight the potential for research in this area to provide novel insights into the biology of Mtb infection as well as yielding new tools to support efforts to control the global TB epidemic.