About this Research Topic
Tuberculosis (TB) is an airborne infectious disease caused by the bacterium called Mycobacterium tuberculosis (Mtb) and remains a major global health threat. In 2015, 10.4 million new cases of active TB occurred, resulting in 1.8 million deaths around the world according to WHO report 2016. The control of TB has been further complicated by the emergence of multidrug-resistant (MDR) Mtb strains and the human immunodeficiency virus (HIV) epidemic. Thus, there is an urgent unmet medical need for development of a rapid and specific test to detect active Mtb infections in clinically diverse individuals and quickly assess Mtb treatment responses for emerging drug-resistant strains.
Detecting active TB cases and monitoring their responses to therapy are fraught with challenges, relying predominantly on microbiologic techniques that use sputum samples, including acid-fast Bacillus (AFB) smear microscopy and Mtb culturing, both of which have only moderate sensitivity and specificity and a long turnaround time. This is compounded by the fact that sputum samples are difficult to obtain after symptom improvement, and often are not diagnostically useful for extrapulmonary TB (EPTB) and childhood TB. The PCR-based GeneXpert MTB/RIF sputum assay was introduced to improve the speed and specificity of TB diagnosis, but this assay has poor sensitivity under low bacterial loads and cannot distinguish between viable and non-viable bacilli. Further diagnostic challenges exist when GeneXpert MTB/RIF sputum assay is used to monitor treatment efficacy, especially in patients co-infected with HIV and TB.
The Research Topic will focus on novel research approaches that are capable of diagnosing active TB cases from susceptible and resistant Mtb isolates while monitoring anti-TB treatment efficacy. The collection of articles will include, but not limited to, the following topics:
• Novel quantitative approaches, especially targeting Mtb antigen present in the peripheral blood (and/or serum) circulation or sputum samples to rapidly diagnose active cases in TB and monitor anti-tubercular treatment efficacy.
• Novel immunological approaches to distinguish between active TB cases from asymptomatic Mtb-infected individuals.
• New approaches for rapid resistance identification of Mtb isolates or differentiate Mtb complex from non-tuberculosis mycobacteria.
• Biomarkers, transcriptomic or proteomic profiles that correlate with specific TB prognosis and organ pathology.
Detecting active TB cases and monitoring their responses to therapy are fraught with challenges, relying predominantly on microbiologic techniques that use sputum samples, including acid-fast Bacillus (AFB) smear microscopy and Mtb culturing, both of which have only moderate sensitivity and specificity and a long turnaround time. This is compounded by the fact that sputum samples are difficult to obtain after symptom improvement, and often are not diagnostically useful for extrapulmonary TB (EPTB) and childhood TB. The PCR-based GeneXpert MTB/RIF sputum assay was introduced to improve the speed and specificity of TB diagnosis, but this assay has poor sensitivity under low bacterial loads and cannot distinguish between viable and non-viable bacilli. Further diagnostic challenges exist when GeneXpert MTB/RIF sputum assay is used to monitor treatment efficacy, especially in patients co-infected with HIV and TB.
The Research Topic will focus on novel research approaches that are capable of diagnosing active TB cases from susceptible and resistant Mtb isolates while monitoring anti-TB treatment efficacy. The collection of articles will include, but not limited to, the following topics:
• Novel quantitative approaches, especially targeting Mtb antigen present in the peripheral blood (and/or serum) circulation or sputum samples to rapidly diagnose active cases in TB and monitor anti-tubercular treatment efficacy.
• Novel immunological approaches to distinguish between active TB cases from asymptomatic Mtb-infected individuals.
• New approaches for rapid resistance identification of Mtb isolates or differentiate Mtb complex from non-tuberculosis mycobacteria.
• Biomarkers, transcriptomic or proteomic profiles that correlate with specific TB prognosis and organ pathology.
Keywords: Tuberculosis, diagnosis, prognosis, biomarker, drug-resistance
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.
