Revelation of metabolic pathways and potential targets associated with latent and active pulmonary tuberculosis via transcriptome and metabonomics analysis.

Tuberculosis (TB) is one of the world's top ten causes of mortality. Current diagnostic methods, primarily based on microbiology and Polymerase Chain Reaction (PCR), still lack the ability to accurately distinguish between latent and active TB, highlighting the urgent need for more precise diagnostic strategies. In recent years, transcriptomics and metabolomics have become increasingly popular in elucidating disease pathophysiology. In this study, we used an integrated multi-omics approach, combining non-targeted metabolomics and transcriptomics to examine blood samples from 39 clinical participants. Our results revealed that Valine, leucine and isoleucine biosynthesis, Linoleic acid metabolism and Purine metabolism were strongly associated with the progression of pulmonary tuberculosis (PTB) infection. Furthermore, we identified glycerophospholipid metabolism as a key pathway involved in PTB, and proposed ABCC6, ABCG1, and PLA2G4A as potential biomarkers for discriminating between active PTB and latent TB infection (LTBI).