{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T16:59:35Z","timestamp":1774112375390,"version":"3.50.1"},"posted":{"date-parts":[[2026,3,19]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":51,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,3,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>\n                  Novel blood-based biomarkers for tuberculosis (TB) are needed to develop rapid, point-of-care diagnostics. We sought to use combined plasma metabolomics and high-density cytokine profiling to identify a biomarker signature that can differentiate pulmonary TB (PTB) from patients hospitalized with other respiratory diseases and ambulatory household contacts with TB symptoms. We analyzed plasma concentrations of 28 cytokines and 118 metabolites from 391 adults (\u226518 years) presenting with respiratory symptoms suggestive of TB, of which 187 had PTB confirmed by Xpert MTB and\/or\n                  <jats:italic>M. tuberculosis<\/jats:italic>\n                  sputum culture and 204 were controls in whom PTB was excluded. Our study identified a 5-marker signature (IFN.gamma, IL.22, IL.10, methionine and oxoproline) with an AUC of 0.97 (95% CI: 0.95\u20131.00) in the test set. The signature had 98% and 84% sensitivity at 70% and 98% specificity respectively, which meet WHO target product profiles for both non-sputum triage and diagnostic TB tests.\n                <\/jats:p>","DOI":"10.64898\/2026.03.18.26348671","type":"posted-content","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T21:25:17Z","timestamp":1773955517000},"source":"Crossref","is-referenced-by-count":0,"title":["Plasma multiomics distinguishes pulmonary tuberculosis from other respiratory infections"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3489-126X","authenticated-orcid":false,"given":"Zaynab","family":"Mousavian","sequence":"first","affiliation":[{"name":"Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Firdaus","family":"Nabeemeeah","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary M.","family":"Nellis","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neel R.","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA"},{"name":"Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Russell R.","family":"Kempker","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dean P.","family":"Jones","sequence":"additional","affiliation":[{"name":"Division of Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hadiya","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mojahidul","family":"Islam","sequence":"additional","affiliation":[{"name":"Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Magee","sequence":"additional","affiliation":[{"name":"Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Martinson","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa"},{"name":"Johns Hopkins University Center for TB Research, Baltimore, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashish A.","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey M.","family":"Collins","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2026032109150952000_2026.03.18.26348671v1.1","unstructured":"Organization WH. 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