Every year, over 8 million people develop tuberculosis and nearly 1.8 million die from it, despite extensive vaccination and drug treatment programmes. It is increasingly recognized that the diagnosis of tuberculosis, which relies heavily on century-old techniques, is one of the weakest links in the chain of tuberculosis control, hampering not just treatment but also the development of new drugs and vaccines. As a result, recent years have seen the initiation of large-scale studies aiming to identify biomarkers of Mycobacterium tuberculosis infection and disease. This review discusses initial results and future prospects for that work.
The key finding from recent work has been that no one factor seems able to explain the complex course of Mycobacterium tuberculosis infection. Multifactorial analyses have identified a variety of genes and proteins, mostly involved in bacterial persistence or host responses, that offer promise as biomarkers for different disease stages.
The challenge now is to validate the suggested biomarkers being described and then reduce them to clinical practice. If this can be done, it offers the possibility of greatly improved clinical management of tuberculosis, allowing segregation of patients and contacts into appropriate treatment regimens.
aStatens Serum Institute, Copenhagen, Denmark
bPfizer, New London, Connecticut, USA
cUniversity College London Medical School, London, UK
* Hanna Akuffo, Abraham Aseffa, Nigel Klein, Hannu Laang, Camille Locht, Denny Mitchison, Paranji Narayanan, Andrew Nunn, Ole Olessen, Phillip Onyebujoh, Tom Ottenhoff, Shreemanta Parida, Mahnaz Vahedi, and Dick van Soollingen
Correspondence to Professor T. Mark Doherty, Department of Infectious Disease Immunology, Statens Serum Institute, Artillerivej 5, 2300 Copenhagen, Denmark Tel: +45 32 68 38 44; fax: +45 32 68 30 35; e-mail: TMD@ssi.dk