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Screening for candidate biomarkers of TB in stimulated blood: another step in the quest for a test?
  1. Myrsini Kaforou
  1. Department of Infectious Disease, Faculty of Medicine, Imperial College London, London W2 1PG, UK
  1. Correspondence to Myrsini Kaforou, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London W2 1PG, UK; m.kaforou{at}

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It is estimated that each year approximately one-third of all tuberculosis (TB) cases remain either undiagnosed or unreported.1 Countries are intensifying their efforts to narrow the gaps between TB incidence and notifications through improving surveillance, diagnosis and access to healthcare. A major impediment in this effort is that diagnostic tests are not sufficiently sensitive or specific to accurately identify all TB cases. New tools are urgently needed for the diagnosis of TB to achieve global TB control.

The WHO considers non-sputum biomarker-based tests for rapidly diagnosing TB to be of utmost priority.1 Human host-based biomarkers have great potential, as they can enhance confirmatory diagnosis particularly in sputum negative and/or culture negative adult, and paediatric cases.2 In children, the paucibacillary nature of the disease and the more common extrapulmonary presentations are the main reasons why microbiological confirmation is achieved in only a small proportion of children that receive TB treatment.3

Host immune biomarkers have been widely used in tests for diagnosing TB infection, such as the interferon-gamma (IFN-γ) release assays (IGRAs), which are based on ex-vivo stimulation of host blood with Mtb-specific antigens. Stimulation of blood or host cells with Mtb antigens gives rise to amplified quantifiable antibody, cytokine or cellular immune responses (reviewed in the study of Yong et al 4).

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  • Funding This study was funded by Imperial College BRC and Wellcome Trust; Grand number (206508/Z/17/Z).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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