{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T03:28:45Z","timestamp":1791084525159,"version":"4.1.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"\n Background<\/jats:title>\n Osteoarticular tuberculosis (OATB) accounts for 10\u201315% of extrapulmonary TB cases and causes progressive bone destruction, neurological compromise, and persistent disability. No validated host-based framework currently identifies patients at high risk of complicated disease course at baseline, and the integrated role of cellular, cytokine, endothelial, and fibrinolytic axes in OATB has not been systematically characterized.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a prospective single-center observational study at Bukhara Regional Center of Phthisiopulmonology, Uzbekistan. Of 223 consecutive eligible adults with confirmed OATB, 115 met immunological-cohort criteria, with peripheral blood drawn before anti-tuberculosis chemotherapy.\n A priori<\/jats:italic>\n panel of 20 markers was quantified by flow cytometry and ELISA, covering lymphocyte subpopulations, cytokines, endothelial markers, fibrinolytic markers, and immunoglobulins. Pairwise correlation and ROC analyses with Youden-\n J<\/jats:italic>\n thresholding were performed against complicated versus uncomplicated course in 30 prognostic-subset patients.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Nine markers achieved high prognostic discrimination: sICAM-1 (0.89), IL-6 (0.88), sVCAM-1 (0.87), CD4\/CD8 (0.86), IP-10 (0.85), TNF-\u03b1 (0.84), CD95\n +<\/jats:sup>\n (0.83), IFN-\u03b3 (0.82), and PAI-1 (0.81), with sensitivities of 76.7\u201386.7% and specificities of 73.3\u201383.3%. These markers mapped onto three coupled pathophysiological axes \u2014 endothelial-fibrinolytic, pro-inflammatory cytokine, and Th1\/cellular with apoptotic priming converging in a plausible immunopathological pattern in complicated disease.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Nine individually high-performing baseline markers discriminate complicated from uncomplicated OATB with clinically useful accuracy, with endothelial-fibrinolytic markers contributing the highest AUC values. External validation in multi-center cohorts is the essential next step toward routine OATB risk stratification.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1866153","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:55:24Z","timestamp":1780030524000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Endothelial, cytokine, and Th1\/cellular host biomarkers discriminate complicated osteoarticular tuberculosis: a prospective single-center cohort study with ROC analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Shuhrat","family":"Bozorov","sequence":"first","affiliation":[{"name":"Bukhara State Medical Institute","place":["Bukhara, Uzbekistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bakhtiyor","family":"Khamdamov","sequence":"additional","affiliation":[{"name":"Bukhara State Medical Institute","place":["Bukhara, Uzbekistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isomiddin","family":"Usmanov","sequence":"additional","affiliation":[{"name":"Bukhara State Medical Institute","place":["Bukhara, Uzbekistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigora","family":"Faizullaeva","sequence":"additional","affiliation":[{"name":"Institute of Immunology and Human Genomics of the Academy of Sciences of the Republic of Uzbekistan","place":["Tashkent, Uzbekistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musharraf","family":"Shodiyeva","sequence":"additional","affiliation":[{"name":"Bukhara State Medical Institute","place":["Bukhara, Uzbekistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.827528","article-title":"Novel potential diagnostic serum biomarkers of metabolomics in osteoarticular tuberculosis patients: A preliminary study","volume":"12","author":"Chen","year":"2022","journal-title":"Front. 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