Yuxia Yu, Shan Gao, Aohui Peng, Xiaoli Zhang, Xinyu Jiang, Zihong Zhang, Liang Li, Yang Liu, Xuejing Wang, Yaojie Shen
Lipoarabinomannan (LAM), recognized as a characteristic antigen within the cell wall of Mycobacterium tuberculosis (MTB), can be detected in the urine of patients suffering from active tuberculosis, which provides an important biomarker for non-invasive diagnosis of tuberculosis. This paper systematically reviews the structure, immunomodulatory function and application value of LAM in the diagnosis of tuberculosis, focusing on the progress and performance comparison of various detection methods from traditional ELISA to emerging quantum dot microsphere technology. Studies have indicated that LAM test has high sensitivity and specificity in HIV-positive patients, especially in CD4 low patients, but the diagnostic efficiency in HIV-negative people still needs to be improved. Nanotechnology such as quantum dots has significantly improved the detection sensitivity (up to fg/mL) through signal amplification and multimodal output, and has shown good potential for point-of-care application. In the future, the development of LAM detection technology should focus on platform integration and intelligence, joint detection of multiple markers, population stratification optimization and standardization system construction. Together, these efforts will make it an important diagnostic tool in the global TB system.