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ERJ Open Res. 2019 Feb 11;5(1). pii: 00115-2018. doi: 10.1183/23120541.00115-2018. eCollection 2019 Feb.

Biomarkers for tuberculosis: the case for lipoarabinomannan.

Author information

1
Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
2
ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.
3
Division of Infectious Diseases, Dept of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
4
Dept of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
5
Biopromic AB, Solna, Sweden.
6
Instituto Nacional de Saúde, Ministério da Saúde, Maputo, Mozambique.
7
Fundação Ariel Glaser Contra o SIDA Pediátrico, Maputo, Mozambique.
8
Dept of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
9
Dept of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA.

Abstract

Tuberculosis (TB) is considered the most onerous of infectious diseases according to recent reports from the World Health Organization. Available tests for TB diagnosis present severe limitations, and a reliable point-of-care (POC) diagnostic test does not exist. Neither is there a test to discern between the different stages of TB, and in particular to predict which patients with Mycobacterium tuberculosis infection and no clinical signs are more at risk of advancing to overt disease. We here review the usefulness of mycobacterial lipoarabinomannan (LAM) as a diagnostic marker for active and latent TB and, also, aspects of the immune response to LAM relevant to such tests. There is a high potential for urinary LAM-based POC tests for the diagnosis of active TB. Some technical challenges to optimised sensitivity of the test will be detailed. A method to quantify LAM in urine or serum should be further explored as a test of treatment effect. Recent data on the immune response to LAM suggest that markers for host response to LAM should be investigated for a prognostic test to recognise individuals at the greatest risk of disease activation.

Conflict of interest statement

Conflict of interest: M. Correia-Neves has nothing to disclose. Conflict of interest: G. Fröberg has nothing to disclose. Conflict of interest: L. Korshun has nothing to disclose. Conflict of interest: S. Viegas has nothing to disclose. Conflict of interest: P. Vaz reports receiving grants from the Ariel Foundation during the conduct of the study. Conflict of interest: N. Ramanlal reports receiving grants from the Ariel Foundation during the conduct of the study. Conflict of interest: J. Bruchfeld has nothing to disclose. Conflict of interest: B. Hamasur has nothing to disclose. Conflict of interest: P. Brennan has nothing to disclose. Conflict of interest: G. Källenius reports receiving grants from the Optimus Foundation during the conduct of the study and owns shares in TBDiadirect AB.

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