In the era of personalised medicine, the most valuable information is not always in an MRI, blood test or biopsy. Often, it lies deep within our cells, even before the disease manifests itself clinically.
Thanks to advanced technologies such as multi-parametric flow cytometry and molecular analysis of exosomes, it is now possible to obtain a functional and molecular X-ray of the body that was previously completely invisible. And that information can make the difference between an effective treatment …or one that comes too late.
Flow cytometry: real-time phenotyping of the immune system
Flow cytometry allows simultaneous analysis of multiple parameters in millions of individual cells in a matter of minutes. It uses fluorochrome-labelled monoclonal antibodies that bind to specific proteins on the cell surface or inside the cell, allowing the identification of cell subpopulations, functional states, and processes such as activation, apoptosis, proliferation or oxidative stress.
Why is it so powerful?
- It allows characterisation of minority cellular subtypes with high accuracy.
- Detects phenotypic changes before they translate into clinical symptoms.
- It is highly quantitative and reproducible, ideal for longitudinal studies and clinical trials.
Clinical and pre-clinical applications
- Immunosurveillance in cancer: monitoring of the balance between effector and regulatory T cells, presence of MDSC (myeloid-derived suppressor cells), or expression of checkpoints such as PD-1 or TIM-3.
- Autoimmune diseases: identification of inflammatory cellular patterns before clinical outbreaks.
- Pharmacodynamics: evaluation of the immune response to immunotherapy or immunomodulatory drugs.
Exosomes: the liquid biopsy of the future is now a reality
Exosomes are extracellular vesicles (30-150 nm) released by virtually all cells, which carry within them RNA, DNA, proteins and lipids representative of their cell of origin. They circulate in body fluids such as blood, saliva, urine or CSF, and are an invaluable source of non-invasive molecular biomarkers.
Key advantages:
- They are obtained by liquid biopsy, without invasive intervention.
- They reflect physiological or pathological status in real time.
- They allow early identification of molecular signals even in the absence of visible structural changes on imaging or biochemistry.
What can they reveal?
- Active tumour mutations, drug resistance or altered signalling pathways.
- MicroRNA profiling associated with neurodegenerative or inflammatory diseases.
- Changes in exosomal membrane proteins such as CD9, CD63 or TSG101, differential markers in infectious, immunological or oncological processes.
From the laboratory to the patient: diagnoses preceding the disease
One of the major advances offered by these technologies is the ability to detect immunological or molecular alterations even at pre-clinical stages. This opens up new possibilities in areas such as
Personalised medicine
- Prediction of response to immunotherapy: profiling the patient’s immune status at the cellular level (expression of checkpoints, degree of activation or cellular exhaustion).
- Selection of patients for CAR-T or anti-PD-1 treatments according to specific immunological phenotypes.
Infectious or auto-immune diseases
- Identification of lymphocyte or monocyte activation partons that anticipate outbreaks of lupus, rheumatoid arthritis or ulcerative colitis.
- Monitoring of immune responses in vaccination or persistent infections.
Neuroscience and ageing
Analysis of neuronal exosomes in the blood that carry proteins such as tau or β-amyloid, useful for early detection of Alzheimer’s disease and other cognitive impairments.
Conclusion
Your cells don’t just respond to or anticipate what’s going on in your body. And thanks to tools such as flow cytometry and exosome analysis, we can now access that information with unprecedented resolution and sensitivity.
At Immunostep, we believe that the real breakthrough is not seeing more… but seeing sooner. And today, biotechnology allows us to do so.