Title | Mass Spectrometric Identification of Urinary Biomarkers of Pulmonary Tuberculosis. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Isa F, Collins S, Lee MHee, Decome D, Dorvil N, Joseph P, Smith L, Salerno S, Wells MT, Fischer S, Bean JM, Pape JW, Johnson WD, Fitzgerald DW, Rhee KY |
Journal | EBioMedicine |
Volume | 31 |
Pagination | 157-165 |
Date Published | 2018 May |
ISSN | 2352-3964 |
Keywords | Adolescent, Adult, Aged, Aged, 80 and over, Biomarkers, Humans, Mass Spectrometry, Middle Aged, Tuberculosis, Pulmonary |
Abstract | BACKGROUND: Tuberculosis (TB) is the leading infectious cause of death worldwide. A major barrier to control of the pandemic is a lack of clinical biomarkers with the ability to distinguish active TB from healthy and sick controls and potential for development into point-of-care diagnostics. METHODS: We conducted a prospective case control study to identify candidate urine-based diagnostic biomarkers of active pulmonary TB (discovery cohort) and obtained a separate blinded "validation" cohort of confirmed cases of active pulmonary TB and controls with non-tuberculous pulmonary disease for validation. Clean-catch urine samples were collected and analyzed using high performance liquid chromatography-coupled time-of-flight mass spectrometry. RESULTS: We discovered ten molecules from the discovery cohort with receiver-operator characteristic (ROC) area-under-the-curve (AUC) values >85%. These 10 molecules also significantly decreased after 60 days of treatment in a subset of 20 participants followed over time. Of these, a specific combination of diacetylspermine, neopterin, sialic acid, and N-acetylhexosamine exhibited ROC AUCs >80% in a blinded validation cohort of participants with active TB and non-tuberculous pulmonary disease. CONCLUSION: Urinary levels of diacetylspermine, neopterin, sialic acid, and N-acetylhexosamine distinguished patients with tuberculosis from healthy controls and patients with non-tuberculous pulmonary diseases, providing a potential noninvasive biosignature of active TB. FUNDING: This study was funded by Weill Cornell Medicine, the National Institute of Allergy and Infectious Diseases, the Clinical and Translational Science Center at Weill Cornell, the NIH Fogarty International Center grants, and the NIH Tuberculosis Research Unit (Tri-I TBRU). |
DOI | 10.1016/j.ebiom.2018.04.014 |
Alternate Journal | EBioMedicine |
PubMed ID | 29752217 |
PubMed Central ID | PMC6013777 |
Grant List | U19 AI111143 / AI / NIAID NIH HHS / United States T32 AI007613 / AI / NIAID NIH HHS / United States P30 CA008748 / CA / NCI NIH HHS / United States R24 TW007988 / TW / FIC NIH HHS / United States K24 AI098627 / AI / NIAID NIH HHS / United States KL2 TR000458 / TR / NCATS NIH HHS / United States D43 TW010062 / TW / FIC NIH HHS / United States |