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The value of the monocyte-to-lymphocyte ratio and osteopontin (SPP1) in tuberculosis treatment response monitoring
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  • Published: 01 April 2026

The value of the monocyte-to-lymphocyte ratio and osteopontin (SPP1) in tuberculosis treatment response monitoring

  • Bongani Motaung1 na1,
  • Anne-Rika Holtzhausen1 na1,
  • Kim Stanley2,
  • Ilana van Rensburg2,
  • Candice I. Snyders2 &
  • …
  • Andre G. Loxton1 

Scientific Reports , Article number:  (2026) Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Cytokines
  • Tuberculosis

Abstract

There is an urgent need to rapidly diagnose tuberculosis (TB) disease and effectively monitor anti-TB treatment responses. Host-directed therapy (HDT) is a promising platform to mitigate challenges in TB diagnosis and anti-TB treatment response monitoring. Identifying changes in systemic proteins and immune cell distributions during the disease is an integral aspect of developing targeted therapies. Here, samples were collected from healthy individuals (CTRL) [n = 32 plasma, n = 9 bronchoalveolar lavage (BAL)] and newly diagnosed TB patients (TB treatment group) [n = 82 plasma, n = 28 BAL] to analyze full blood count, secreted levels of full-length osteopontin (OPN), and inflammatory markers. Peripheral blood and BAL samples were collected at a single time-point from CTRL, while in TB participants, they were collected at TB diagnosis (TBDx), week 1 (TBW1), month 2 (TBM2), and month 6 (TBM6). We observed a significantly increased monocyte-to-lymphocyte ratio (MLR) and plasma OPN in TB group at TBDx compared to the CTRL group. Inflammatory markers including IL-6, VEGF-A, and sFasL showed significant increase at TBDx when compared to CTRL, but these significantly declined by TBM6. Plasma OPN significantly declined at TBW1 and TBM2 when compared to TBDx but significantly increased at TBM6. BAL OPN showed no significant differences between CTRL and TB patients at TBDx, whereas a significant increase was observed in TB group between TBDx and TBM6. Given the study limitations, these findings should be considered preliminary and exploratory. Our results add to literature and identify MLR and plasma OPN as potential targets for early TB diagnosis and treatment monitoring.

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Data availability

Data are contained within the article.

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Acknowledgements

The authors thank the participants and members of the Immunology Research Group for providing the samples.

Funding

AGL and BM is funded by the Centre for Tuberculosis Research (CTR) of the South African Medical Research Council (SAMRC). AGL is supported by the National Research Foundation (NRF) [CSUR Grant number 60502163639] and by the Trails of Excellence in Southern Africa (TESA) III of the European Development and Clinical Trails Partnership (EDCTP) [Grant number CSA2020NoE-3104].

Author information

Author notes

  1. These authors contributed equally to this work: Bongani Motaung and Anne-Rika Holtzhausen.

Authors and Affiliations

  1. DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research; South African Medical Research Council Centre for Tuberculosis Research; Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape, South Africa

    Bongani Motaung, Anne-Rika Holtzhausen & Andre G. Loxton

  2. DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research; South African Medical Research Council Centre for Tuberculosis Research; Division of Immunology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

    Kim Stanley, Ilana van Rensburg & Candice I. Snyders

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  1. Bongani Motaung
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Contributions

Conceptualization, A.G.L.; methodology, B.M., A.H., C.I.S., and I.R.; formal analysis, K.S.; writing—original draft preparation, B.M. and A.H.; writing—review and editing, K.S., I.R., C.I.S; supervision, A.G.L.; funding acquisition, A.G.L. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Andre G. Loxton.

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Motaung, B., Holtzhausen, AR., Stanley, K. et al. The value of the monocyte-to-lymphocyte ratio and osteopontin (SPP1) in tuberculosis treatment response monitoring. Sci Rep (2026). https://doi.org/10.1038/s41598-026-46176-8

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  • Received: 11 April 2025

  • Accepted: 24 March 2026

  • Published: 01 April 2026

  • DOI: https://doi.org/10.1038/s41598-026-46176-8

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Keywords

  • OPN
  • Cytokines
  • MLR
  • Tuberculosis
  • Biomarker
  • Treatment response
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