Deciphering metabolites in urine
One of the major barriers for good TB control is the lack of effective simple and inexpensive diagnostics. As a way to address this, we have identified a number of biomarkers in urine that can differentially diagnose TB patients from others with different respiratory diseases and healthy controls. Proof of concept studies using a bench-size low-field nuclear magnetic resonance (NMR) platform have already indicated that this approach has high sensitivity and specificity in the diagnosis of TB in adults and children.
With this project, we aim to develop a novel diagnostic solution for TB screening, but also to evaluate changes in the identified biomarker signature over time as a possible indicator of treatment response. Additionally, we want to explore novel signatures that detect the presence of TB drugs and could serve to monitor treatment adherence.
Being a non-sputum-based test, this approach could ease the future diagnosis of TB in children and HIV co-infected patients, which have difficulties in producing sputum, and also of extrapulmonary TB patients, from which sample extraction at the site of infection may be difficult. In addition, as multiple biomarker detection is combined in a single test, it would allow an increase in sensitivity optimizing its diagnostic capacity. Finally, this test could be implemented in all types of laboratories and health centers, bringing diagnosis closer to the patients.
To advance in making this a reality, we are currently conducting field evaluation studies to assess its performance in patients with drug-susceptible and drug-resistant TB. In addition, we are carrying out a multicenter study together with TBnet and we are working on the development of a point-of-care test.