Роль биомаркеров мочи в диагностике туберкулеза легких (обзор)

Abstract

Diagnosis of tuberculosis (TB) based on sputum analysis has limitations for certain categories of patients (older adults, children, and people living with HIV). An alternative approach is a non-invasive urine-based method, which provides a large sample volume and a quick result. We searched for English-language publications from 2010 to 2021 in PubMed and Cochrane databases using the terms tuberculosis + urine + biomarkers. Papers on urine lipoarabinomannan testing were excluded as this topic has been sufficiently studied elsewhere. The reviewed publications cover more than 30 urine biomarkers used to diagnose TB and evaluate treatment effectiveness. Urine transrenal DNA extraction continues to be investigated, although its diagnostic sensitivity and specificity depend on the extraction method and patient’s HIV status. IP-10 is likely to be a non-specific inflammatory marker; however, its level correlates with TB/HIV status and may be useful for assessing TB treatment response. Further, the article shows the potential of metabolomic biomarkers and biosignatures for measuring the activity of TB infection and distinguishing it from other respiratory diseases. The number of reliable biomarkers predicting TB treatment outcomes is limited. Numerous untargeted studies have used mass spectrometry to detect metabolomic and proteomic biomarkers in urine. The publications are heterogeneous in design and methods; few studies have analysed the specificity and sensitivity of the diagnostic methods covered. In future, a combination of host and pathogen biomarkers could increase the sensitivity and specificity of TB diagnosis.