Diagnosis and biomarkers for ocular tuberculosis: From the present into the future
Zhang Ludi, Ashita Ashish Sule, Ramar Perumal Samy, Ikhwanuliman Putera, Benjamin Schrijver, Paul Hutchinson, Jayantha Gunaratne, Indu Verma, Amit Singhal, Rina La Distia Nora, P. Martin van Hagen, Willem A. Dik, Vishali Gupta, Rupesh Agrawal
Abstract
targets, 3 studies on GeneXpert assay, 1 study on GeneXpert Ultra assay and 1 study for MTBDRplus assay for OTB. Specificity is overall improved but sensitivity is highly variable for NAATs (excluding uniplex PCR, Sp = 50-100%; Se = 10.5-98%) as compared to IGRA. We also found 3 transcriptomic studies, 6 proteomic studies, 2 studies on stimulation assays, 1 study on intraocular protein analysis and 1 study on T-lymphocyte profiling in OTB patients. All except 1 study evaluated novel, previously undiscovered biomarkers. Only 1 study has been externally validated by a large independent cohort. Future theranostic marker discovery by a multi-omics approach is essential to deepen pathophysiological understanding of OTB. Combined these might result in swift, optimal and personalized treatment regimens to modulate the heterogeneous mechanisms of OTB. Eventually, these studies could improve the current cumbersome diagnosis and management of OTB.