A quadral biosignature of IFN-γ, IL-2, IL-12 and IP-10 increases the diagnostic potential for latent tuberculosis among diabetic patients in Uganda

This cross-sectional study investigated the impact of Type 2 diabetes mellitus on tuberculosis-specific immune responses and identified potential biomarkers for latent tuberculosis infection (LTBI). The study recruited 164 participants across four groups and found that diabetes impairs Th1, inflammatory, and regulatory cytokine responses during LTBI. A combined four-marker biosignature of IFN-γ, IL-2, IL-12 and IP-10 achieved superior diagnostic performance with 92% AUC, 76% sensitivity and 96% specificity for LTBI identification regardless of diabetes status, outperforming single-marker assays.