Transcriptomic biomarkers for tuberculosis: Validation of NPC2 as a single mRNA biomarker to diagnose TB, predict disease progression, and monitor treatment response Journal Article


Authors: de Araujo, L. S.; Ribeiro‐Alves, M.; Wipperman, M. F.; Vorkas, C. K.; Pessler, F.; Féres Saad, M. H.
Article Title: Transcriptomic biomarkers for tuberculosis: Validation of NPC2 as a single mRNA biomarker to diagnose TB, predict disease progression, and monitor treatment response
Abstract: External validation in different cohorts is a key step in the translational development of new biomarkers. We previously described three host mRNA whose expression in peripheral blood is significantly higher (NPC2) or lower (DOCK9 and EPHA4) in individuals with TB compared to latent TB infection (LTBI) and controls. We have now conducted an independent validation of these genes by re‐analyzing publicly available transcriptomic datasets from Brazil, China, Haiti, India, South Africa, and the United Kingdom. Comparisons between TB and control/LTBI showed significant differential expression of all three genes (NPC2high p < 0.01, DOCK9low p < 0.01, and EPHA4low p < 0.05). NPC2high had the highest mean area under the ROC curve (AUROC) for the differentiation of TB vs. controls (0.95) and LTBI (0.94). In addition, NPC2 accurately distinguished TB from the clinically similar conditions pneumonia (AUROC, 0.88), non‐active sarcoidosis (0.87), and lung cancer (0.86), but not from active sarcoidosis (0.66). Interestingly, individuals progressing from LTBI to TB showed a constant increase in NPC2 expression with time when compared to nonprogressors (p < 0.05), with a significant change closer to manifestation of active disease (≤3 months, p = 0.003). Moreover, NPC2 expression normalized with completion of anti‐TB treatment. Taken together, these results validate NPC2 mRNA as a diagnostic host biomarker for active TB independent of host genetic background. Moreover, they reveal its potential to predict progression from latent to active infection and to indicate a response to anti‐TB treatment. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Keywords: treatment; biomarkers; rna; mycobacterium tuberculosis; transcription; tuberculosis; mrna; niemann–pick disease type c2; npc2
Journal Title: Cells
Volume: 10
Issue: 10
ISSN: 2073-4409
Publisher: MDPI  
Date Published: 2021-10-01
Start Page: 2704
Language: English
DOI: 10.3390/cells10102704
PROVIDER: scopus
PMCID: PMC8534371
PUBMED: 34685683
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Charles Vorkas
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