Photo Credit: iStock.com/Farrukh Saeed

A novel assay will allow clinicians to analyze neonatal immune status in real-time using a single drop of blood, according to a recently published study.

Researchers recently unveiled BiophysicaL Immune Profiling for Infants (BLIPI), a microfluidic assay that allows clinicians to analyze neonatal immune status in real-time using a single drop of blood—roughly twenty‑fold less than standard tests. According to a study published in Pediatric Research, the technology aims to close a diagnostic gap in neonatal intensive care units, where repeated phlebotomy can exacerbate anemia and complicate care plans.

“The current absence of a reliable blood-sparing diagnostic tool to measure and trend real-time changes in the levels of inflammation and its effects on the immune cells in the infant prevents the early detection and monitoring of inflammatory conditions in this vulnerable group,” wrote Kerwin Kwek Zeming of the Singapore-MIT Alliance for Research and Technology, and colleagues.

Proof‑of‑Concept Pilot Study Findings

The goal of the study was to demonstrate how BLIPI utilizes microfluidic technology to assess changes in immune cells during infection by measuring their size and flexibility, thereby directly illustrating how the baby’s immune system responds.

The researchers applied BLIPI to 24 blood samples (50 µL per sample) obtained during the first month of life from 19 neonates—eight term and 11 preterm. All term infants were from uncomplicated pregnancies and were primarily singleton births. Most preterm infants were of extremely low gestational age, with a median gestational age of 24 weeks and birthweight of 650 g.

Immune cell size and deformation profiles revealed a clear distinction between term and preterm infants, with 48 of 50 markers showing significant differences.

“A preterm infant with late-onset bacterial sepsis had notable size and deformability differences compared to the rest of the preterm cohort,” the authors noted, suggesting that the assay could function as an early warning system and prompt timely antimicrobial intervention.

According to the authors, BLIPI’s real‑time readouts paralleled conventional laboratory indices. Immune-cell profiles correlated strongly with C-reactive protein levels, white blood cell counts, and immature-to-total neutrophil ratios, with Pearson correlation coefficients of 0.98, 0.97, and 0.94, respectively.

Multiple Benefits

“This pilot study provides proof-of-concept for the use of biophysical measurements of immune cells to correlate with clinical conditions in neonatal care, albeit in a small group of patients,” the authors concluded, adding, “Early detection of severe conditions such as sepsis and necrotizing enterocolitis will allow the clinician to provide appropriate and timely clinical support and adjust treatment strategies to prevent the deterioration and development of poor outcomes. The ability to trend levels of inflammation in the newborn period can allow for the development of potential targeted anti-inflammatory therapies to prevent complications, especially among preterm infants.”