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Letter to the Editor
A new potential biomarker for childhood tuberculosis
  1. Tania Thomas1,
  2. Susanna Brighenti2,
  3. Jan Andersson2,
  4. David Sack3,
  5. Rubhana Raqib4
  1. 1University of Virginia, Charlottesville, Virginia, USA
  2. 2Center for Infectious Medicine (CIM), Karolinska Institutet, Stockholm, Sweden
  3. 3Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  4. 4International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
  1. Correspondence to Dr Rubhana Raqib, Nutritional Biochemistry Laboratory, Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka 1212, Bangladesh; rubhana{at}

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One of the major research areas for tuberculosis (TB) focuses not only on diagnostics but also on biomarkers that can provide prognostic data about the disease course and response to treatment. Although progress has been made, improved tests for paediatric TB are especially needed. Young children are at increased risk of progressing to TB after exposure, and may suffer from disseminated forms of the disease. Due to the paucibacillary nature of paediatric disease, the current armamentarium and future pipeline of TB diagnostics that largely rely on microbial growth and/or molecular detection are unlikely to demonstrate performance equivalent to that in adults. Thus, an accurate surrogate marker of disease may be crucial to improving the diagnosis of paediatric TB. We have tested and evaluated a novel B-cell assay called the antibodies in lymphocyte supernatant, or ALS, which has performed very well in diagnosing TB disease both in Asia1 2 and Africa (manuscript in preparation). Here, we report the performance of ALS as a biomarker in children with culture-confirmed TB.

The ALS assay is based on a principle similar to that of the enzyme-linked immunosorbent spot assay, measuring antibody-secreting cells in cultures of peripheral blood mononuclear cells (PBMCs). The ALS assay detects antibody secretion from in vivo activated plasma B …

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