Host Biomarker Panel for Tuberculosis Diagnosis

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Solution Overview

Problem

Current diagnostic tools for tuberculosis (TB) are inadequate for early diagnosis and monitoring treatment response, especially in resource-poor settings, due to limitations such as unavailability, high costs, and inability to distinguish between live and dead bacteria, and existing immunodiagnostic tests are not suitable for point-of-care in resource-constrained environments.

Innovation Solution

A method using a panel of biomarkers, including neural cell adhesion molecule (NCAM) and other markers like ferritin, SAP, and IL-1β, detected in unstimulated blood samples to diagnose TB and differentiate it from latent infection, employing capture agents and indicators for accurate detection.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If culture-based assays (gold standard) are used for TB diagnosis, then diagnostic accuracy is improved, but availability and accessibility deteriorate due to unavailability in resource-poor settings and long turn-around time

Engineering Contradiction:
Improvediagnostic accuracyVSAvoidavailability and accessibility
Core Design Contradiction:
Measurement precisionVSEase of operation

Solution Approach 1:

The invention extracts the diagnostic function from complex culture-based systems to simpler immunodiagnostic tests that detect host immune responses (cytokines, antibodies, antigens) directly from patient samples. This extraction enables diagnosis without requiring sophisticated laboratory infrastructure, making it accessible in resource-poor settings while maintaining diagnostic accuracy through detection of specific immune markers associated with active TB.

Inventive Principle:
Principle #2Taking out (Extraction)

2Speed

If Xpert MTB/RIF test is used for TB diagnosis, then diagnostic speed and resistance detection are improved, but operating costs and infrastructure requirements worsen

Engineering Contradiction:
Improvediagnostic speedVSAvoidinfrastructure requirements
Core Design Contradiction:
SpeedVSDevice complexity

Solution Approach 1:

The invention employs disposable immunodiagnostic test devices (such as lateral flow assays, microplate ELISA kits) that detect TB-specific immune markers without requiring expensive molecular diagnostics infrastructure. These single-use devices eliminate the need for sophisticated laboratory equipment, trained personnel for complex operations, and expensive reagents, while providing rapid results at lower operational costs suitable for resource-constrained environments.

Inventive Principle:
Principle #27Cheap short-living objects (Disposable)

3Ease of operation

If smear microscopy is used for monitoring TB treatment response, then simplicity is improved, but ability to distinguish live from dead bacilli deteriorates

Engineering Contradiction:
ImprovesimplicityVSAvoidability to distinguish live from dead bacteria
Core Design Contradiction:
Ease of operationVSMeasurement precision

Solution Approach 1:

The invention introduces host immune markers (cytokines, antibodies, antigens) as intermediary indicators that reflect the presence of viable, metabolically active bacteria. Instead of directly observing bacteria (which cannot distinguish live from dead), the test detects immune responses that only occur in the presence of living pathogens, thereby providing indirect but accurate monitoring of treatment response while maintaining operational simplicity.

Inventive Principle:
Principle #24Intermediary (Mediator)

4Measurement precision

If IGRAs are used for TB diagnosis, then detection of MTB infection is improved, but ability to discriminate active disease from latent infection deteriorates

Engineering Contradiction:
Improvedetection of MTB infectionVSAvoiddiscrimination between active and latent infection
Core Design Contradiction:
Measurement precisionVSLoss of information

Solution Approach 1:

The invention segments the immune response into multiple distinct marker categories (pro-inflammatory cytokines like IL-6, TNF-alpha; antibodies against specific antigens; soluble antigens) that reflect different aspects of TB pathology. By measuring multiple segmented markers simultaneously, the test can distinguish the immune profile of active disease (with specific cytokine patterns and antibody responses) from latent infection (with different marker profiles), thereby recovering the discriminatory information lost in single-marker IGRAs.

Inventive Principle:
Principle #1Segmentation

5Measurement precision

If overnight culture-based assays are used for immunodiagnosis, then diagnostic capability is improved, but suitability for point-of-care deteriorates

Engineering Contradiction:
Improvediagnostic capabilityVSAvoidtime required for results
Core Design Contradiction:
Measurement precisionVSLoss of time

Solution Approach 1:

The invention employs pre-coated solid-phase capture agents (antibodies, antigens) on test devices that are prepared in advance. When patient samples are applied, the pre-positioned capture agents immediately bind target immune markers without requiring overnight incubation or complex preparation steps. This preliminary positioning of diagnostic elements enables rapid point-of-care testing while maintaining the diagnostic capability of detecting specific TB-related immune responses.

Inventive Principle:
Principle #10Preliminary action

Applied Scientific Principles

This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.

Function Achieved in This Case

This approach enables rapid, cost-effective, and accurate diagnosis of TB, distinguishing active TB from latent infection, and potentially monitoring treatment response, suitable for point-of-care in resource-poor settings using a kit or device for blood sample analysis.

Implementation Method 1

employing capture agents and indicators for accurate detection

Methodology Applied
Scientific EffectAntigen-antibody binding:

Data Source

PatentEP3443356B1Host biomarkers for immunodiagnosis and monitoring of tuberculosis disease
Publication Date: 2024.06.05 STELLENBOSCH UNIVERSITY
  • EP3443356B1 patent drawingFigure 1
  • EP3443356B1 patent drawingFigure 2
  • EP3443356B1 patent drawingFigure 3

AI summary

A method of diagnosing tuberculosis disease (TB) is provided. A blood sample from a subject is tested for NCAM and optionally also for other biomarkers such as ferritin, SAP, A2M, IL-22, CFH, ECM-1, IL-1 β, sCD4DL,IL-13, Apo-A-1, myoglobin, IL-12(p40), MIP-4, antithrombin III, GDF-15 and HCC1. A device and kit for performing the method are also provided.