CHEST Guidelines-Xpert-Ultra-Is-Better-Than-Xpert,-but-Using-Biopsy

Xpert-Ultra-Is-Better-Than-Xpert,-but-Using-Biopsy

Pdf Summary

The document focuses on recent advancements in the study of microRNA (miRNA) in sarcoidosis and improvements in diagnosing tuberculosis (TB) using Xpert and Xpert-Ultra methods. In the context of sarcoidosis, there is limited research on miRNA expression, requiring more detailed investigations. Notably, Crouser et al. identified 60 differentially expressed miRNAs in lung tissue, some correlating with the sarcoidosis severity and potentially acting as biomarkers. Further research is essential to understand miRNA dysregulation in sarcoidosis pathogenesis.<br /><br />Exhaled breath condensate (EBC) has been used to detect miRNAs in patients with COPD and asthma, but its diagnostic reliability remains controversial. The work of Gabriela A. Hoefel and colleagues from the University of Newcastle emphasizes the need for more studies on miRNA roles and expressions in lung diseases to establish them as potential diagnostic tools.<br /><br />In TB diagnostics, a study highlights the superiority of Xpert-Ultra over Xpert in detecting Mycobacterium TB from pleural fluid, showing higher sensitivity rates (44.23% versus 19.23%). Although thoracoscopic biopsy is an invasive procedure, it provides more precise sample collection, potentially improving diagnostic accuracy compared to fluid samples. Moreover, thoracoscopy, despite its invasiveness, ensures precise pleura sampling and is beneficial when available, though accessibility and patient conditions limit its widespread use. The correspondence by Balamugesh Thangakunam and his team from Christian Medical College discusses these findings, underscoring the need for more studies to evaluate the potential of Xpert-Ultra in pleural biopsy samples.<br /><br />Overall, while miRNA research and advancements in TB diagnostics using novel methods offer promising directions, both fields require further investigation to enhance understanding and clinical application.

Keywords

microRNA

sarcoidosis

Xpert-Ultra

tuberculosis

diagnostics

biomarkers

lung diseases

pleural biopsy

miRNA expression

Crouser et al.