{"doi":"10.3389/fimmu.2021.774043","title":"The Kynurenine/Tryptophan Ratio Is a Sensitive Biomarker for the Diagnosis of Pediatric Tuberculosis Among Indian Children","abstract":"Objectives: Pediatric tuberculosis (TB) remains difficult to diagnose. The plasma kynurenine to tryptophan ratio (K/T ratio) is a potential biomarker for TB diagnosis and treatment response but has not been assessed in children. Methods: We performed a targeted diagnostic accuracy analysis of four biomarkers: kynurenine abundance, tryptophan abundance, the K/T ratio, and IDO-1 gene expression. Data were obtained from transcriptome and metabolome profiling of children with confirmed tuberculosis and age- and sex-matched uninfected household contacts of pulmonary tuberculosis patients. Each biomarker was assessed as a baseline diagnostic and in response to successful TB treatment. Results: Despite non-significant between-group differences in unbiased analysis, the K/T ratio achieved an area under the receiver operator characteristic curve (AUC) of 0.667 and 81.5% sensitivity for TB diagnosis. Kynurenine, tryptophan, and IDO-1 demonstrated diagnostic AUCs of 0.667, 0.602, and 0.463, respectively. None of these biomarkers demonstrated high AUCs for treatment response. The AUC of the K/T ratio was lower than biomarkers identified in unbiased analysis, but improved sensitivity over existing commercial assays for pediatric TB diagnosis. Conclusions: Plasma kynurenine and the K/T ratio may be useful biomarkers for pediatric TB. Ongoing studies in geographically diverse populations will determine optimal use of these biomarkers worldwide.","journal":"Frontiers in Immunology","year":2022,"id":269894,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":14,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9513,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":326387,"name":"Mandar Paradkar","orcid":"0000-0001-9843-4656","position":1,"is_corresponding":false},{"id":933153,"name":"Henry Zhao","orcid":"0000-0002-4320-4287","position":2,"is_corresponding":false},{"id":326396,"name":"Vandana Kulkarni","orcid":"0000-0002-3488-2692","position":3,"is_corresponding":false},{"id":326397,"name":"Neeta Pradhan","orcid":"0000-0002-9696-3228","position":4,"is_corresponding":false},{"id":326391,"name":"Aarti Kinikar","orcid":"0000-0001-9466-1130","position":5,"is_corresponding":false},{"id":333925,"name":"Anju Kagal","orcid":"0000-0001-6182-6621","position":6,"is_corresponding":false},{"id":326403,"name":"Nikhil Gupte","orcid":"0000-0002-6688-2478","position":7,"is_corresponding":false},{"id":326404,"name":"Vidya Mave","orcid":"0000-0001-8509-4517","position":8,"is_corresponding":false},{"id":326405,"name":"Amita Gupta","orcid":"0000-0001-7036-2718","position":9,"is_corresponding":false},{"id":333926,"name":"Petros C. Karakousis","orcid":"0000-0003-1338-9206","position":10,"is_corresponding":false},{"id":333923,"name":"Jeffrey A. Tornheim","orcid":"0000-0002-1566-4622","position":0,"is_corresponding":true}],"reference_count":22,"raw_metadata":null,"created_at":"2026-07-19T00:27:22.602796Z","pmid":"35095848","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}