Flores Julio, Cancino Juan Carlos, Chavez-Galan Leslie
Laboratory of Integrative Immunology, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico.
Laboratory of Immunomicrobiology, Department of Microbiology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico.
Front Microbiol. 2021 Apr 15;12:638047. doi: 10.3389/fmicb.2021.638047. eCollection 2021.
Tuberculosis (TB) is still a severe public health problem; the current diagnostic tests have limitations that delay treatment onset. Lipoarabinomannan (LAM) is a glycolipid that is a component of the cell wall of the bacillus , the etiologic agent of TB. This glycolipid is excreted as a soluble form in urine. The World Health Organization has established that the design of new TB diagnostic methods is one of the priorities within the EndTB Strategy. 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. 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. 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.
结核病（TB）仍然是一个严重的公共卫生问题；目前的诊断测试存在局限性，会延迟治疗的开始。脂阿拉伯甘露聚糖（LAM）是一种糖脂，是结核病病原体——杆菌细胞壁的组成成分。这种糖脂以可溶形式排泄到尿液中。世界卫生组织已确定，设计新的结核病诊断方法是终结结核病战略的优先事项之一。基于尿液中LAM的鉴定，LAM已被提议作为开发诊断测试的生物标志物，并且它是开发即时诊断测试最突出的候选物之一，因为尿液样本易于收集。此外，LAM可调节宿主的免疫反应，并且在结核病患者的血清中也能发现，它可能会影响多种宿主细胞群体，从而影响结核病感染期间固有免疫和适应性免疫反应的质量。在此，我们回顾了支持LAM可作为开发结核病诊断新即时检测工具的证据，并讨论了可能导致诊断测试敏感性低的机制。
