Claudio Parolo, PhD

ABSTRACT

There remains a pressing need for point-of-care antibody detection that is both analytically precise (improving clinical specificity) and easily multiplexed (improving clinical sensitivity). In particular, existing point-of-care methods for the detection of specific, disease-diagnostic antibodies (e.g., lateral flow immunoassay) are qualitative, which reduces clinical specificity (due to the subjective nature of their visual readout), and are difficult to multiplex, reducing their clinical sensitivity (because they fail in patients that don’t seroconvert against the single antigen the device presents). Laboratory-bound techniques (e.g., ELISAs, immunoprecipitation, immunocytochemistry), in contrast, overcome both of these limitations, but are expensive, overhead intensive, and slow, generally requiring a day or more to return an answer to the clinician. Given the above, a technology that combines the best attributes of both point-of-care and laboratory techniques would thus significantly enhance our ability to detect, monitor and treat diseases. Here I propose the development of just such a technology. Specifically, I propose to develop a platform that supports the rapid, low-cost, quantitative measurement of multiple, specific antibodies (diagnostic of infections, autoimmune disease, immunization status) in minutes using just a single finger-prick blood sample (Figure 1). As a test bed for the development of this platform, I will focus on the detection of multiple diagnostic antibodies of HIV and syphilis. Nowadays, the mother-to-child transmission of HIV and syphilis causes approximately 305,000 fetal and neonatal deaths every year and leaves 215,000 infants at increased risk of dying from prematurity, low-birth-weight or congenital disease. An accurate diagnosis of diagnostic-antibodies and antiretroviral therapy could stop all those deaths.