![]() Currently, papers related to pathogenesis and biomarkers are leading topics in the TB field, whereas the issue of TB treatments is the third most relevant ( Figure 1). The publication of the Mtb genome sequence in 1998 was fundamental for a better understanding of TB pathogenesis ( Cole et al., 1998), thenceforth, publications about TB have increased. Currently, LAM testing has some sensitivity-related disadvantages related to detecting and monitoring this antigen in urine and in peripheral blood. LAM is considered as a potential tool to be used as a biomarker for TB diagnosis. Lipoarabinomannan (LAM) is a cell wall glycolipid its structural core is inserted into the plasma membrane of Mtb. For instance, the Mycobacterium cell wall has integrated virulence factors that are upregulated and are helpful in avoiding the host immune response ( Bah et al., 2020). The biological success of Mtb is due to critical features that have provided an evolutionary advantage, such as the loss of the coding region of the TbD1 gene and resistance to oxidative stress and hypoxia ( Bottai et al., 2020).Ĭomponents of the Mtb structure are a source of antigens. Mtb is an intracellular pathogen highly adapted to humans, which seems to have developed several mechanisms to avoid the host immune response and to persist indefinitely in the organism ( Carranza and Chavez-Galan, 2019). The EndTB global project proposes that the design of new diagnosis methods or the improvement of the current diagnostic tests are a priority to accelerate the efforts to stop TB ( World Health Organization, 2015b). Risk factors such as diabetes mellitus, human immunodeficiency virus (HIV) co-infection, malnutrition, smoking, and alcoholism are associated with the development of TB ( Glaziou et al., 2018 Melsew et al., 2018). Older men and women represented nearly 88% of all cases ( World Health Organization, 2020). Currently, TB is a significant public health problem the last report of the World Health Organization (WHO) in 2019 informed there were 10 million people with TB worldwide. Historically it has also been known as scrofula, Pott’s disease, King’s Evil, phthisis, and consumption, among others ( Barberis et al., 2017). Tuberculosis (TB) is an infectious disease caused by the bacillus Mycobacterium tuberculosis (Mtb). Here, we revised the evidence that supports that LAM could be used as a tool for the development of new point-of-care tests for TB diagnosis, and we discussed the mechanisms that could contribute to the low sensitivity of diagnostic testing. Moreover, LAM can regulate the immune response in the host and can be found in the serum of TB patients, where it probably affects a wide variety of host cell populations, consequently influencing the quality of both innate and adaptive immune responses during TB infection. LAM has been suggested as a biomarker to develop diagnostic tests based on its identification in urine, and it is one of the most prominent candidates to develop point-of-care diagnostic test because urine samples can be easily collected. The World Health Organization has established that the design of new TB diagnostic methods is one of the priorities within the EndTB Strategy. This glycolipid is excreted as a soluble form in urine. Lipoarabinomannan (LAM) is a glycolipid that is a component of the cell wall of the bacillus Mycobacterium tuberculosis, the etiologic agent of TB. Tuberculosis (TB) is still a severe public health problem the current diagnostic tests have limitations that delay treatment onset. 2Laboratory of Immunomicrobiology, Department of Microbiology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico.1Laboratory of Integrative Immunology, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico.Julio Flores 1,2, Juan Carlos Cancino 2 and Leslie Chavez-Galan 1 *
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