Tuberculosis (TB) is the cause of roughly 1.5 million deaths each year, and represents a major global health crisis. Despite a growing burden, the diagnosis of TB is one of the largest barriers to effective disease control. Currently, those with a laboratory confirmed diagnosis of TB represent only 16% of the TB patient population.
Reviewing translation at the MRC Unit The Gambia  2014 Lack of access is a key factor, particularly as many of the highest burden countries are low income communities with poor infrastructure. This is exacerbated by the relatively slow speed of most current diagnostics, meaning that multiple visits are often needed for patients to receive a diagnosis. As a consequence, there has been a recent focus on the need to improve TB diagnosis, with experts estimating that just increasing test speed alone could save roughly 100,000 lives annually and increasing accessibility around a further 50,000 lives.

To this end, Dr Jayne Sutherland has worked to characterise key host markers present in the sputum of TB patients that can be used to distinguish between patients with TB and those with other respiratory diseases. These should allow development of low cost, robust and rapid diagnostic platforms suitable for very basic care settings using a non-invasive sample type.

MRC Technology has worked with Dr Sutherland to protect this work through a patent and to facilitate ongoing efforts to develop the diagnostic technology. The aim of this project will be to translate these key markers into a rapid and effective point-of-care diagnostic test, having a significant impact on global health. Dr Jayne Sutherland, Head, TB case-contact platform and the TB Immunology laboratory said, this work was initiated due to the fact that pulmonary TB is a lung-based disease, yet most current immune-based diagnostic tests for TB rely on responses generated in the circulation (ie the blood). In addition, blood samples need to be treated for at least 24 hours before detecting the same levels of host factors as in direct sputum samples. While there are DNA-based sputum tests available, these are not accurate in children and HIV+ adults whereas we found no influence on HIV co-infection on levels of our markers. MRCt have facilitated all the requirements for generation of a patent and made this an easy process to protect our ‘invention’. Once validated, we aim to develop a rapid, affordable (<£1/test), point-of-care test similar to that used for Malaria. This will have enormous public health benefits in Gambia and beyond.

The article was first published by MRC Technology, in the Reviewing translation at the MRC report: http://www.mrctechnology.org/wp-content/uploads/2015/04/Reviewing-trans…