The Future of Blood Testing Is the Immunome

• Main Authors: Ramy A. Arnaout, Eline T. Luning Prak, Nicholas Schwab, Florian Rubelt, the Adaptive Immune Receptor Repertoire Community, Rohit Arora, Rachael Bashford-Rogers, Felix Breden, Syed Ahmad Chan Bukhari, Brian Corrie, Lindsay G. Cowell, Sol Efroni, Christopher Gooley, Victor Greiff, Jason Vander Heiden, Yoshinobu Koguchi, Ton Langerak, Theam Soon Lim, Eline Luning Prak, Encarnita Mariotti-Ferrandiz, Susanna Marquez, Pieter Meysman, Enkelejda Miho, Keshav Motwani, Nima Nouri, Milena Pavlović, Geir Kjetil Sandve, Igor Snapkov, Cinque Soto, Ulrik Stervbo, Johannes Trück, Henk-Jan van den Ham, Corey Watson, Cédric R. Weber
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2021-03-01
• Series: Frontiers in Immunology
• Subjects: adaptive immune receptor repertoire (AIRR); diagnostic test; T-cell receptor repertoire; antibody repertoire; analyses; immunome
• Online Access: https://www.frontiersin.org/articles/10.3389/fimmu.2021.626793/full

It is increasingly clear that an extraordinarily diverse range of clinically important conditions—including infections, vaccinations, autoimmune diseases, transplants, transfusion reactions, aging, and cancers—leave telltale signatures in the millions of V(D)J-rearranged antibody and T cell receptor [TR per the Human Genome Organization (HUGO) nomenclature but more commonly known as TCR] genes collectively expressed by a person’s B cells (antibodies) and T cells. We refer to these as the immunome. Because of its diversity and complexity, the immunome provides singular opportunities for advancing personalized medicine by serving as the substrate for a highly multiplexed, near-universal blood test. Here we discuss some of these opportunities, the current state of immunome-based diagnostics, and highlight some of the challenges involved. We conclude with a call to clinicians, researchers, and others to join efforts with the Adaptive Immune Receptor Repertoire Community (AIRR-C) to realize the diagnostic potential of the immunome.