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PRESS RELEASE
15 December 2011 | FOR IMMEDIATE RELEASE
NUS partners FIND to discover novel biomarkers for Tuberculosis
detection
• NUS research team develops new methodology for detecting TB using novel TB
biomarkers
• NUS will collaborate with FIND to translate this technology into a TB diagnostic test
used at point-of-care
Singapore, 15 December 2011– A research team from the National University of Singapore
(NUS) Singapore Lipidomics Incubator (SLING) is collaborating with the Foundation for
Innovative New Diagnostics (FIND) to identify novel target molecules to be employed as
biomarkers for the detection of active tuberculosis (TB). The aim is to translate these targets
into a diagnostic test that is affordable, easy to use and produces rapid results, and that can
be used by community health workers in poor countries.
Scientists have attempted to develop a simple and accurate antigen test to detect TB for
many years, with little success. The World Health Organization (WHO) has yet to endorse
any such test, since it has not deemed that any of the existing examples are of sufficient
accuracy for clinical use. The major reason for this failure is the lack of suitable TB-specific
biomarkers for diagnostic product development. So far, only a very limited number of
antigens have been investigated for this purpose.
“A sensitive, pathogen-specific, point-of-care test for TB case detection would represent a
breakthrough in TB diagnostics for disease endemic settings, but we have so far been
hampered by a lack of appropriate biomarkers,” said Dr Gerd Michel, Senior Technology
Officer at FIND, who is FIND’s project leader. “Through our partnership with NUS, we aim to
address this fundamental gap by developing high performance reagents, which we will be
able to then convert into a laboratory–free rapid test for TB.”
The technology supported by this partnership is based on research conducted by Associate
Professor Markus Wenk, Principal Investigator at NUS SLING, and his team. This revealed
that certain mycolic acids - molecules found on the cell wall of Mycobacterium tuberculosis
(the bacterium causing TB) - are specific TB disease markers. The study analysed sputum
samples from close to 200 individuals with pulmonary TB, some of whom were also infected
with HIV. These samples were obtained from patients and endemic controls in South Korea,
Vietnam, Uganda and South Africa, i.e. countries with a significant burden of TB.
The NUS research team used high resolution mass spectrometry to determine the precise
bacterial remnant in sputum. Based on this analysis, they were able to separate non-TB
patients from those with active TB infection, with diagnostic results better than the most

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widely used TB diagnostic test - sputum smear microscopy (see Annex A for more
information on TB and current diagnostics).
The high resolution mass spectrometry methodology is complementary to existing TB
diagnostics, and is also fast, providing results within a day. The team also revealed in a
preclinical study that their methodology could distinguish between active TB cases and
cases that had been cured from TB. This research is one of the early accomplishments of
the new NUS SLING, which was established in end 2010. The research data from this study
are due to be published in a leading scientific journal, EMBO Molecular Medicine1
. The study
was funded by the National Research Foundation of Singapore and the Novartis Institute of
Tropical Diseases.
“This study is an excellent example of translational research. First, basic biomedical
investigation is integrated with current medical practice to assess the potential clinical utility
of a new biomarker. We then use the results to convert a technology platform developed at
NUS into a commercial diagnostic product, thus translating basic science into medical
practice. In this case, now that we have successfully identified mycolic acids as a marker for
TB infection, we plan to work with the NUS Department of Microbiology to develop
antibodies specific to mycolic acid for detection by immunoassay,” said Assoc Prof Markus
Wenk, who is also from the NUS Department of Biochemistry and Department of Biological
Sciences.
While NUS will focus on the technology development of the diagnostic test, FIND will provide
their extensive expertise in diagnostic product development. If successfully developed, this
test would enter evaluation and demonstration studies, and then be submitted for
endorsement by the WHO, before being rolled out in TB-endemic countries. The NUS
Industry Liaison Office has filed a patent application for the technology, and also facilitated
the research and license agreements.
“Given the worldwide rise of multidrug-resistant TB, I strongly welcome any new test that is
able to accurately diagnose TB. I believe it would be equally interesting to see if this
molecular marker can accurately reflect clearance of the bacteria from the lungs, in order to
monitor treatment response in patients,” said Dr Timothy Barkham, Director, The Molecular
Biology Laboratory, Tan Tock Seng Hospital.
-end-
Media enquiries may be directed to:
Chan Yiu Lin
Greener Grass Communications (For NUS Enterprise)
Mobile: (65) 9-765 5897
Email: yiulin@greenergrass.com.sg
Beatrice Gordis
Communications Officer FIND
Email : Beatrice.gordis@finddiagnostics.org
Tel : (44) 22 710 9310
1
DOI: 10.1002/emmm.201100185 – Abstract can be found at
http://onlinelibrary.wiley.com/doi/10.1002/emmm.201100185/abstract

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About the National University of Singapore (NUS)
A leading global university centred in Asia, the National University of Singapore (NUS) is
Singapore’s flagship university which offers a global approach to education and research,
with a focus on Asian perspectives and expertise.
NUS has 16 faculties and schools across three campuses. Its transformative education
includes a broad-based curriculum underscored by multi-disciplinary courses and cross-
faculty enrichment. Over 36,000 students from 100 countries enrich the community with their
diverse social and cultural perspectives.
NUS has three Research Centres of Excellence (RCE) and 21 university-level research
institutes and centres. It is also a partner for Singapore’s 5th RCE. NUS shares a close
affiliation with 16 national-level research institutes and centres. Research activities are
strategic and robust, and NUS is well-known for its research strengths in engineering, life
sciences and biomedicine, social sciences and natural sciences. It also strives to create a
supportive and innovative environment to promote creative enterprise within its community.
For more information, please visit www.nus.edu.sg.
About NUS Enterprise
NUS Enterprise was established as a University-level cluster to provide an enterprise
dimension to NUS teaching and research involving the University’s students, staff and
alumni. The functions of the Enterprise Cluster complement the academic cluster of the
University to nurture talents with an entrepreneurial and global mindset. NUS Enterprise
promotes the spirit of innovation and enterprise through Experiential Education, Industry
Engagement & Partnerships and Entrepreneurship Support. The NUS Industry Liaison Office
is a division of NUS Enterprise. www.nus.edu.sg/enterprise
About FIND
The Foundation for Innovative New Diagnostics is dedicated to developing affordable, easy-
to-use and cutting edge diagnostic tests that save lives in the poorest areas of the world.
From the initial idea and discovery stage to putting new tests into practice, the organization
works with multiple and diverse groups, from academia, industry, donors, partners in the
field, Ministries of Health and the World Health Organization. With five new diagnostic tools
for TB already in use, FIND also has established programmes in malaria and sleeping
sickness, and has begun working on other neglected diseases, such as leishmaniasis.
Launched in 2003, the not-for-profit Foundation is ISO certified and financed by both the
private and public sectors, including the Bill & Melinda Gates Foundation, Government of the
Netherlands, the European Union, UNITAID, UK Department for International Development,
National Institutes of Health (USA), UBS Optimus Foundation and others.
About National Research Foundation
The National Research Foundation (NRF), set up on 1 January 2006, is a department within
the Prime Minister's Office. The NRF sets the national direction for research and
development (R&D) by developing policies, plans and strategies for research, innovation and
enterprise. It also funds strategic initiatives and builds up R&D capabilities and capacities by
nurturing local talents and attracting foreign ones. For more information, please visit
www.nrf.gov.sg.

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Annex A - About Tuberculosis and existing diagnostic methods
Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. The disease
remains a major global health threat, with over nine million new cases, and close to two
million deaths, annually. In Singapore alone, some 1,500 new cases2
are detected each
year, with foreigners accounting for over a third of these cases. The worldwide epidemic is
further fuelled by co-infections with HIV, as well as the rapid emergence of drug–resistant
strains of the TB bacteria.
Diagnosis of TB is primarily done by sputum smear microscopy, where a patient’s sputum
sample is examined under a microscope for the presence of stained bacteria. This
conventional method is over a hundred years old, and has the disadvantages of being
labour-intensive and having a poor sensitivity of less than 60%3
. Furthermore, this method is
extremely insensitive for extrapulmonary TB, TB in children and in patients with TB-HIV co-
infection. Other TB diagnostic methods, which are more sensitive, can be expensive and it
may take several days to weeks for the results to be delivered, thereby delaying initiation of
treatment and increasing the risk of transmission.
Rapid, accurate and affordable diagnostic tests for TB are therefore urgently needed to fight
the disease on a global basis.
2
Ministry of Health, Singapore
3
Journal of Infectious Diseases, Volume 196, Issue Supplement 1