The relevance of biomarkers for diagnosis, monitoring treatment response and immunity during tuberculosis infections

Tuberculosis (TB) is a leading cause of morbidity and mortality from a single infectious agent, despite being preventable and curable. Global health initiatives are still hindered by tuberculosis (TB) because of shortcomings in the effectiveness of vaccines, treatment monitoring, and diagnostic instruments available today. Breaking the cycles of Mycobacterium tuberculosis (Mtb) transmission and improving patient outcomes depend on early and accurate detection of active TB. For biomarker-based diagnostics, the World Health Organization has suggested target product profiles. Measurable indicators of biological states, or biomarkers, present encouraging opportunities to fill these gaps. Notwithstanding notable advancements, no single biomarker has yet met all the performance criteria necessary for clinical use. The several functions of biomarkers in tuberculosis are examined in this narrative review, with particular emphasis on their importance in early diagnosis, treatment response monitoring, disease progression prediction, and protective immunity assessment. We review current developments in the molecular, immunological, transcriptomic, proteomic and metabolomic domains, including multi-gene signatures and microRNAs that distinguish latent infection from active tuberculosis. We also further discuss biomarkers are related to immunological modulation, therapeutic targeting, and drug-resistant TB. It is possible to revolutionize TB care and expedite eradication efforts by integrating many biomarker signatures and rigorously validating them across populations and environments.