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Journal Article Review Epublish 11 citations

PubMed: 34760853 DOI: 10.3389/fped.2021.756043

Host-Based Biomarkers in Saliva for the Diagnosis of Pulmonary Tuberculosis in Children: A Mini-Review.

Front Pediatr 9:756043

Authors: Nisreen Khambati, Laura Olbrich, Jerrold Ellner, Padmini Salgame, Rinn Song, Else Margreet Bijker

Affiliations

  • Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom.
  • Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
  • German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany.
  • Department of Medicine, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, United States.
  • Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, United States.

Abstract

The diagnosis of pulmonary tuberculosis (TB) in children remains a significant challenge due to its paucibacillary nature, non-specificity of symptoms and suboptimal sensitivity of available diagnostic methods. In young children particularly, it is difficult to obtain high-quality sputum specimens for testing, with this group the least likely to be diagnosed, while most at risk of severe disease. The World Health Organization (WHO) has prioritized research into rapid biomarker-based tests for TB using easily obtainable non-sputum samples, such as saliva. However, the role of biomarkers in saliva for diagnosing TB in children has not been fully explored. In this mini-review, we discuss the value of saliva as a diagnostic specimen in children given its ready availability and non-invasive nature of collection, and review the literature on the use of host-based biomarkers in saliva for diagnosing active pulmonary TB in adults and children. Based on available data from adult studies, we highlight that combinations of cytokines and other proteins show promise in reaching WHO-endorsed target product profiles for new TB triage tests. Given the lack of pediatric research on host biomarkers in saliva and the differing immune response to TB infection between children and adults, we recommend that pediatric studies are now performed to discover and validate salivary host biosignatures for diagnosing pulmonary TB in children. Future directions for pediatric saliva studies are discussed, with suggestions for technologies that can be applied for salivary biomarker discovery and point-of-care test development.

MeSH

Infections, Sputum, Diagnosis, Child, Tuberculosis, Pulmonary, Biomarkers, Research, Point-Of-Care Systems, Point-Of-Care Testing

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