Symposium 8 - APRC 2024

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Symposium 8：Precision Diagnosis of TB and LTBI: Non-sequencing-based Methods

Prompt diagnosis of TB and LTBI is urgent and could facilitate timely therapeutic intervention and minimizes community transmission, particularly when encountering the disruptions caused by the COVID-19 pandemic that resulted in a large global fall in the number of people newly diagnosed with TB and reported (i.e. officially notified) in 2020, compared with 2019. Thus, the development of new diagnostic tools to overcome the diagnostic obstacles of TB and LTBI caused by COVID-19 pandemic and to target ending TB in 2035 is crucial. This symposium will bring the information on the advancement of the diagnosis of TB and LTBI to the health professionals.

Date: Saturday, April 27, 2024 | Time: 14:50-16:20 (GMT+8)

Moderator: Dr. Masae Kawamura (USA) | Dr. Bo-Shiun Yan (Taiwan)

Time (GMT+8)	Topic	Speaker	Country / Region
14:50-15:20	The Advancement of AI-Augmented Imaging Technology in the Diagnosis of Pulmonary TB	Dr. Yu-Sen Lin	Taiwan
15:20-15:50	Precision Diagnosis of Tuberculosis: Empowering Personalized Healthcare with Nano and Micro Technologies	Dr. Tony Hu	USA
15:50-16:20	Immune Based Diagnosis of LTBI- Where We Are and Where We Are Going	Dr. Jennifer Ann Mendoza-Wi	Philippines

The Advancement of AI-Augmented Imaging Technology in the Diagnosis of Pulmonary TB

Abstract:
Recent breakthroughs in AI and TB diagnostics have revolutionized the field with the introduction of AI-augmented tools. These tools employ advanced machine learning algorithms to detect TB infections in chest X-rays, CT scans, and sputum samples. The use of deep learning allows these tools to analyze medical images and identify TB infections with remarkable precision. In addition to this, AI-augmented tools have been instrumental in the development of a virtual assistant for health workers. This has significantly improved the diagnosis of TB in remote areas, where access to medical facilities is limited, helping health workers diagnose TB quickly and accurately in low-resource settings. For example, the detection of acid-fast bacillus in TB smears by AI imaging system has been validated and published in the literature. These tools are designed to address the challenges posed by the COVID-19 pandemic, which has led to a decrease in the detection of new TB cases. In conclusion, the integration of AI in TB diagnostics is paving the way for early detection and effective treatment strategies, thereby contributing to the global fight against TB.

Dr. Yu-Sen Lin

Chairman & Professor | National Kaohsiung Normal University
Taiwan

Professional Experience:

Dr. Yu-Sen Eason Lin is the Chairman and Professor at the Graduate Institute of Knowledge Management, National Kaohsiung Normal University, TAIWAN. His research includes applying High Magnification Imaging in Tuberculosis and Cytology microscopy, enabling AI algorithms and machine learning for the early detection of TB and Metastatic Cancers at the cellular level.

Immune Based Diagnosis of LTBI- Where We Are and Where We Are Going

Abstract:
Precision diagnostic medicine occupies the frontline for the clinical campaign against disease. Historically, Tuberculosis is humanity’s leading infectious nemesis, in terms of morbidity/mortality. Today, ~25% of the global population harbors latent Mycobacterium tuberculosis (Mtb) infections, with risks for re-activation and spread through close contact. Despite grave impacts, scant research evaluates mechanisms or biomarkers to advance insights into tuberculosis diagnosis, activation, and progression, severely limiting clinical patient management, and perpetuating dire outcomes. Addressing these challenges, my team employs a variety of cutting-edge platforms, including high-resolution mass spectrometry, nanomaterial probes, and CRISPR to elucidate ultrasensitive and quantitative readouts. Translating these advances, we envision simple point-of-care assays, deployed into resource-limited endemic regions, allowing rapid diagnosis and precision guidance for therapeutics, augmenting global pandemic eradication efforts.

Dr. Tony Hu

Professor | Tulane University
USA

Professional Experience:

Dr. Tony Hu is a Professor in Biochemistry and Molecular Biology, Biomedical Engineering, and Microbiology at Tulane University. He is also the Weatherhead Presidential Chair in Biotechnology Innovation and founding Director of the Center for Intelligent Molecular Diagnostics at Tulane School of Medicine, and a fellow of American Institute of Medical and Biological Engineering (AIMBE). Dr. Hu’s research focuses on engineered multi-omics, nanomedicine, mechanism-driven biomarker discovery and assay development. His inventions are intended to serve as a model for the analysis of similar characteristics of infectious and malignant diseases to facilitate the development of a full spectrum of diagnostic, prognostic and treatment evaluation assays, and re-define the diagnostic criteria to differentiate disease stages using molecular tests as a long-term goal. His work has resulted in publications of over 150 high-impact papers on the journals such as Nature Nanotechnology, Nature Biomedical Engineering, Lancet Microbe, nature Communications, Science Advances, JCI, and PNAS, and 25 pat¬ent applications involving nanomedicine. Fourteen of those patents have been licensed by US-based or international companies. Dr. Hu’s lab has been consistently support¬ed by the DOD, NIH, Gates Foundation, WHO and other agencies.

Immune Based Diagnosis of LTBI- Where We Are and Where We Are Going

Abstract:
The difficulty in eliminating TB can be attributed to the diverse mechanisms of immune evasion and immune response manipulation by MTB. MTB can persist in the human body for years without causing clinical symptoms, leading to a condition known as latent tuberculosis infection (LTBI).

The Problem: Latent tuberculosis infection (LTBI) has become a major source of active tuberculosis (ATB). The two currently available classes of tests – tuberculin skin test (TST) and interferon-gamma release assay (IGRA) – require a competent immune response to accurately identify TB infection. However, a positive test result by either method is not, by itself, a reliable indicator of the risk of progression to TB disease. The diagnostic difficulties of LTBI include issues such as cost, detection time, sensitivity, and specificity.

Where We are: In 2015, WHO updated its recommendations on the use of TST and IGRA for the diagnosis of TB infection, and in 2022 issued a policy statement extending these recommendations to cover the use of new and updated versions of blood-based IGRA. Newer Mtb antigen-based skin tests (TBST) have been developed to measure the cell-mediated immunological response to Mtb specific antigens. Comparative studies have been done and there is emerging evidence that these tests may offer similar specificity to IGRA, and when compared with TST they may provide more reliable results in children and in people living with HIV. The new IGRA tests available will be discussed.

Where are we going: Machine learning (ML) in LTBI diagnosis? ML is becoming an important tool in the field of identifying and diagnosing LTBI. ML uses algorithmic training forming a structured knowledge system to provide personalized decision support and rapid diagnosis. It represents a promising approach to accurately discriminate and diagnose LTBI and ATB.

Dr. Jennifer Ann Mendoza-Wi

Past National Chairperson | Philippine Coalition Against Tb
Philippines

Professional Experience:

Dr. Wi is a practicing Pulmonologist, an educator and a strong advocate for a TB-FREE Philippines. She has led various chest societies in promoting lung health in the country through vaccination and health education programs for asthma, COPD, and lung malignancies. She is currently the Head of the APSR TB Assembly where she encourages the young pulmonologist to participate in researches and community service programs not only for TB but other lung diseases as well.

Dr. Bo-Shiun Yan

Associate Professor | National Taiwan University
Taiwan

Professional Experience:

Dr. Bo-Shiun Yan is an associate professor at the Institute of Biochemistry and Molecular Biology, National Taiwan University College of Medicine where he teaches a variety of courses in biochemistry and molecular biology. Dr. Yan’s research has been in the field of tuberculosis (TB), especially the pathogenesis of TB infection as well as host immunity to TB infection, since he began his postdoctoral training when he worked at Harvard School of Public Health. He has extensive experience in the fields of immunology, molecular biology, genetics and animal models of infectious diseases. His research primarily aims at the identification of genetic factors that contribute to host resistance to Mycobacterium tuberculosis (Mtb) infection, as well as the exploration of the underlying mechanisms by which these genes mediate host resistant phenotype. His studies have successfully identified several genetic factors that control host susceptibility/resistance to Mtb infection. In addition, through laboratory cooperation with clinicians from National Taiwan University Hospital, his research work has discovered the molecular mechanisms through which the host factors contribute to the TB pathogenesis, as well as extended the findings to other infectious diseases, such as influenza and COVID-19.

Dr. Masae Kawamura

Board Member and consultant (Qiagen and AGT) | Vital Strategies, QIAGEN and American Gene Technologies (AGT)
USA

Professional Experience:

L. Masae Kawamura, MD has been a tuberculosis (TB) clinician, researcher, advocate and international educator for more than 30 years. She served as San Francisco’s TB Controller, and Co-Principal Investigator of the Curry International TB Center, a CDC funded Center of Excellence from 1996 to the end of 2011. As a US TB Controller, she was appointed to the Federal Advisory Council for the Elimination of TB (ACET) for eight years, the last three as chair and was a member of numerous policy workgroups at both the federal and state level. From 2012 to the end of 2020, she worked at QIAGEN as their Senior Director of Scientific and Medical Affairs for TB immunodiagnostics and was on the global development team for new TB diagnostics and immunoassays. Currently, she remains an expert consultant on TB for QIAGEN, serves on the Board of Vital Strategies as a public health expert, and has recently joined American Gene Technologies as a consultant for their novel HIV gene therapy.

Symposium 8：Precision Diagnosis of TB and LTBI: Non-sequencing-based Methods

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