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<p>A large proportion of individuals with tuberculosis (TB) are asymptomatic. The biological and inflammatory underpinnings of asymptomatic TB are unknown and may differ from symptomatic TB. We characterise blood transcriptomic and proteomic profiles in South African community screening vs. health facility-based triage cohorts. Asymptomatic TB shares core transcriptomic and proteomic features with symptomatic TB, including upregulation of innate, interferon and inflammatory pathways and downregulation of T and B cell pathways. Integration of transcriptomic and proteomic data from asymptomatic TB individuals identifies two distinct sub-clusters characterized by higher or lower bacterial burden, blood IFN-γ responses, BMI, and chest radiographic abnormalities, suggesting different disease severity. We identify a new blood transcriptomic signature of asymptomatic TB. However, diagnostic performance of transcriptomic and proteomic markers is weaker for asymptomatic TB than symptomatic TB, suggesting that policy development for community-based, asymptomatic TB screening should not adopt biomarkers developed for symptomatic TB triage without further optimization.</p>

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Inflammatory biomarkers of asymptomatic and symptomatic tuberculosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月25日

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  • Denis Awany,
  • Dominique T. Ariefdien,
  • Simon C. Mendelsohn,
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  • Humphrey Mulenga,
  • Sarah Nyangu,
  • Michele Tameris,
  • Tumelo Moloantoa,
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  • Fernanda Maruri,
  • Firdows Noor,
  • Ravindre Panchia,
  • Khuthadzo Hlongwane,
  • Kim Stanley,
  • Yuri F. van der Heijden,
  • Katie Hadley,
  • Andrew- Fiore Gartland,
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  • William Brumskine,
  • Keertan Dheda,
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  • Tahlia Perumal,
  • Neil Martinson,
  • Al Leslie,
  • Bernard Fourie,
  • Andriëtte Hiemstra,
  • Stephanus T. Malherbe,
  • Gerhard Walzl,
  • Kogieleum Naidoo,
  • Gavin Churchyard,
  • Novel N. Chegou,
  • Timothy R. Sterling,
  • Mark Hatherill,
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  • Thakiera Allie,
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  • Charity Dire,
  • Karen Dobos,
  • Stephany Norah Duda,
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  • Travis Harris,
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  • Lorraine Lichakane,
  • Ilze Louw,
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  • Habibullah Valley,
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  • Gian van der Spuy,
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  • Sivuyile Buhlungu,
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  • Tilagavathy Chinappa,
  • Eva Chung,
  • Michelle Chung,
  • Alessandro Companie,
  • Cara-Mia Corris,
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  • James Michael Jeleni,
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  • Simbarashe Mabwe,
  • Lauren Mactavie,
  • Johanna Thapelo Madikwe,
  • Octavia Mahkosazana Madikwev,
  • Rapontwana Letlhogonolo Maebana,
  • Nomsitho Magawu,
  • Malobisa Sylvester Magwasha,
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  • Vutlhari-I-Vunhenha Fairlord Manzini,
  • Nonhle Bridgette Maphanga,
  • Jabulisiwe Lethabo Maphanga,
  • Isholedi Samuel Maroele,
  • Omphile Petunia Masibi,
  • July Rocky Mathabanzini,
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  • Ellen Ditaba Matsane,
  • Lungile Mbata,
  • Siyabonga Mbatha,
  • Nyasha Karen Mhandire,
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  • Thuso Andrew Molefe,
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  • Frances Ratangee,
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  • Helen Veldtsman,
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摘要

A large proportion of individuals with tuberculosis (TB) are asymptomatic. The biological and inflammatory underpinnings of asymptomatic TB are unknown and may differ from symptomatic TB. We characterise blood transcriptomic and proteomic profiles in South African community screening vs. health facility-based triage cohorts. Asymptomatic TB shares core transcriptomic and proteomic features with symptomatic TB, including upregulation of innate, interferon and inflammatory pathways and downregulation of T and B cell pathways. Integration of transcriptomic and proteomic data from asymptomatic TB individuals identifies two distinct sub-clusters characterized by higher or lower bacterial burden, blood IFN-γ responses, BMI, and chest radiographic abnormalities, suggesting different disease severity. We identify a new blood transcriptomic signature of asymptomatic TB. However, diagnostic performance of transcriptomic and proteomic markers is weaker for asymptomatic TB than symptomatic TB, suggesting that policy development for community-based, asymptomatic TB screening should not adopt biomarkers developed for symptomatic TB triage without further optimization.