3-Gene-TB-SCORE Accuracy for Tuberculosis Disease Diagnosis Is Not Affected by Immune-Mediated Inflammatory Disease Comorbidity

Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains a major global health threat. Approximately one-quarter of the world’s population has an Mtb-specific immune response and are classified as having tuberculosis infection (TBI), with a lifelong 5–10% risk of developing TB disease....

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Published in:International journal of molecular sciences Vol. 26; no. 22; p. 10931
Main Authors: Petruccioli, Elisa, Alonzi, Tonino, Navarra, Assunta, Altera, Anna Maria Gerarda, Cuzzi, Gilda, Farroni, Chiara, Repele, Federica, Gualano, Gina, Lindestam Arlehamn, Cecilia S., Palmieri, Fabrizio, Salmi, Andrea, Vanini, Valentina, Goletti, Delia
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 12.11.2025
Subjects:
Accuracy
Adult
Aged
Analysis
BCG
BCG vaccines
Biomarkers
CD4-Positive T-Lymphocytes - immunology
Comorbidity
Development and progression
Disease
Diseases
Female
Genes
Health aspects
Humans
Immune response
Immunotherapy
Inflammation - immunology
Italy
Lymphocytes
Male
Massachusetts
Medical diagnosis
Middle Aged
Mycobacterium tuberculosis - immunology
Prospective Studies
Regression analysis
Rheumatoid arthritis
ROC Curve
T cells
Taiwan
Tuberculosis
Tuberculosis - diagnosis
Tuberculosis - epidemiology
Tuberculosis - genetics
Tuberculosis - immunology
Viral infections
Young Adult
Italy
Massachusetts
Taiwan
RNA
biomarkers
tuberculosis
diagnosis
TB-SCORE
TB
signatures
ISSN:1422-0067, 1661-6596, 1422-0067
Online Access:Get full text
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Summary:Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains a major global health threat. Approximately one-quarter of the world’s population has an Mtb-specific immune response and are classified as having tuberculosis infection (TBI), with a lifelong 5–10% risk of developing TB disease. This risk is elevated in individuals with immune-mediated inflammatory diseases (IMID) undergoing immunosuppressive therapies. To evaluate the diagnostic accuracy of the 3-gene TB-SCORE for TB disease in individuals within the TB spectrum, including those with TBI-IMID in a low TB endemic country, we prospectively enrolled 104 individuals with TB, TBI, TBI-IMID, and healthy donors. The 3-gene TB-SCORE and Mtb-specific response were evaluated and correlated with the participant’s clinical status. Patients with TB disease showed a significantly lower TB-SCORE compared to other cohorts. ROC analysis showed moderate diagnostic accuracy for TB disease (AUC 0.70–0.71). TB-SCORE was unaffected by IMID status or timing of Mtb exposure. Mtb-specific CD4+ T cells had no correlation to TB-SCORE. This is the first evaluation of TB-SCORE as a diagnostic tool for TB disease in a low-endemic setting. While further validation is needed, our findings support its potential as a biomarker for TB disease, even in complex clinical settings involving IMID.
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ISSN:1422-0067
1661-6596
1422-0067
DOI:10.3390/ijms262210931