Can metabolomics improve tuberculosis diagnostics

With one third of the global human population suffering from tuberculosis (TB) in 2001, the disease was officially declared a worldwide emergency by the World Health Organization. Since then this disease has grown to epidemic proportions and the recent emergence of drug resistance, the rising incidence of HIV/TB co-infection, and the inability of the currently used vaccination, diagnostic and treatment protocols to control this pandemic, has made TB a research topic inviting urgent attention. The implementation of metabolomics, a relatively new research approach, which is defined as the study of all the small molecular weight compounds or metabolites in a system or sample, using highly sensitive and specific analytical techniques, shows promise in the quest to eradicate this disease. In this context, we describe here the advantages and limitations of the currently available TB diagnostic techniques, and the role that metabolomics has played in the identification of new biomarkers, not only leading to innovative approaches for TB diagnostics, but also to a better understanding of the intra-host changes induced by Mycobacterium tuberculosis infection and active disease.