Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 20, 2020
Date Accepted: May 24, 2021
Next-generation digital biomarkers for tuberculosis and antibiotic stewardship – A perspective on novel molecular digital biomarkers in sweat, saliva and exhaled breath
ABSTRACT
The internet of healthcare things enables a remote connection between healthcare professionals and patients wearing smart biosensors. Wearable smart devices are potentially affordable, sensitive, specific, user-friendly, rapid and robust, lab-independent, and deliverable to end-user for point-of-care testing. The data sets derived from these devices are known as digital biomarkers. They represent a novel patient-centred approach to collecting longitudinal, context-derived health insights. Adding automated, analytical smartphone applications will enable their use in high-, middle-, and low-income countries. So far, digital biomarkers have been focussed primarily on accelerometer data and heart rate due to well-established sensors originating from the consumer market. Novel emerging smart biosensors will detect biomarkers (or compounds) lab-independently and non-invasively in sweat, saliva, and exhaled breath. These molecular digital biomarkers are a promising novel approach to reduce the burden from two major infectious diseases with urgent unmet needs: tuberculosis and infections with multidrug resistant pathogens. Active tuberculosis (aTbc) is one of the deadliest diseases from an infectious agent. However, a simple and reliable test for its detection is still missing. Furthermore, inappropriate antimicrobial use leads to the development of antimicrobial resistances, which is associated with a high mortality and healthcare costs. From this perspective, we discuss the innovative approach of a non-invasive and lab-independent collection of novel biomarkers to detect aTbc, which at the same time may additionally serve as a scalable therapeutic drug monitoring approach for antibiotics. These molecular digital biomarkers are the next-generation digital biomarkers and have the potential to shape the future of infectious diseases.
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