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Laboratory tests are essential for clinicians to reach an accurate diagnosis and informing appropriate treatments. The expansion in the use of immunotherapies has highlighted the gap between the knowledge of molecular pathways and targeted therapies with availability of laboratory tests. The translation of vibrational spectroscopic techniques such as Fourier-transform infrared (FTIR) spectroscopy and Raman spectroscopy into clinical practice offer rapid-, noninvasive and inexpensive methods to obtain information on the molecular composition of biological samples. Advances in instrumentation, data analysis and machine learning techniques are key developments that have permitted the availability of results to clinicians in an appropriate timescale. Immunological disorders are complex, often demonstrating interaction across multiple molecular pathways which results in delayed diagnosis. Vibrational spectroscopy is being applied in many fields and here we present a review of its potential use in clinical immunology. This review addresses the potential use of spectroscopy in clinical immunology. Potential benefits that these novel techniques offer, including enhanced definition of molecular process and its use in disease diagnosis, monitoring and treatment response is discussed. Whilst not covered extensively, an overview of the method principle, quality control processes, and the requirements for multivariate data analysis is included to provide the reader with sufficient understanding of its application in the clinical setting. [ABSTRACT FROM AUTHOR]

The diagnosis and management of allergy is complex; the clinical symptoms associated with allergic reactions span a broad spectrum of severity, from mild hay fever-type symptoms through to life-threatening anaphylaxis. Obtaining an allergy-focused clinical history is therefore vital for identifying possible allergic triggers and directing testing. However, this focus could be changing as scientific and technological advances have paved the way for developments within in vitro testing for allergy. With knowledge of allergens at the molecular level expanding, there are now the facilities to characterize the sensitization profiles of allergy sufferers and determine the specific molecules (or components) against which the allergen-inducing immunoglobulin type E proteins have been produced. This technology is termed component-resolved diagnostics. We know that accurate identification of immunoglobulin type E specificity, the source of the causative allergen, and knowledge of potential allergic cross-reactivities are required for optimal clinical management of allergy patients. These factors can make allergy a diagnostic challenge outside of a specialist centre, and contribute to the difficulties associated with requesting and interpreting allergy tests. The incorporation of component-resolved diagnostics into current practice has provided a platform for patient-tailored risk stratification and improved the application of allergen-specific immunotherapy, revolutionizing specialist management of these patients. This review discusses the roles of each type of testing in allergy management and predictions for future pathways. [ABSTRACT FROM AUTHOR]

Abstract: Modest work has been performed to improve the sensitivity of residual disease detection or investigate the contribution that the immune system makes in controlling metastatic tumor growth, in particular, the frequency and biological actions of peptide-specific CD8+ T lymphocytes in limiting metastatic disease and/or maintaining remission. Fifty-three peripheral blood samples from 32 prostate cancer (PC) patients were investigated for the presence of circulating prostate-specific antigen (PSA)-expressing cells (CPECs) using a highly sensitive and specific assay combining immunomagnetic epithelial cell enrichment with nested RT-PCR of PSA mRNA. Using HLA-A2 tetramer complexes, frequency of CD8+ T cells specific for PSA-derived peptides was determined. Additionally, serum concentrations of PSA and testosterone were measured. CPECs were detected in 26% of peripheral blood samples from PC patients. CD8+ T cells specific for PSA-derived peptides were detected at low frequency in HLA-A2-positive PC patients. The correlation between these PSA-specific CD8+ T cells and residual prostate tumor cells and clinical measures was investigated. Our data suggest that frequency of PSA-specific CD8+ T cells is correlated to CPECs, but not to serum PSA level. [Copyright &y& Elsevier]