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Cytometry Part A

Wiley

Preprints posted in the last 90 days, ranked by how well they match Cytometry Part A's content profile, based on 33 papers previously published here. The average preprint has a 0.02% match score for this journal, so anything above that is already an above-average fit.

1
Label-Free Identification of Human Eosinophils Using 808 nm Side Scatter

Ralhan, K.; Messaggio, F.; Lambooij, J. M.; Tak, T.

2026-06-09 immunology 10.64898/2026.06.04.730064 medRxiv
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Accurate identification and quantification of eosinophils is critical for the diagnosis and monitoring of eosinophil-associated disorders. While flow cytometry remains a powerful tool for leukocyte characterization, conventional instruments equipped with 405 nm or 488 nm side scatter (SSC) detectors offer limited resolution for eosinophil discrimination overlap in scatter with neutrophils. Using a spectral flow cytometer equipped with six distinct SSC detectors, we report a novel, label-free approach for eosinophil detection leveraging high 808 nm near-infrared SSC (IRSSC) uniquely observed in human eosinophils. This optical signature is independent of antibody labeling, activation fixation, or permeabilization, and shows strong concordance with conventional CD66b/CD16 gating strategies (R = 0.997). Notably, the high 808 nm SSC is absent in murine eosinophils, suggesting a species-specific structural feature such as in human eosinophils. These findings establish IRSSC as a robust, reagent-free biomarker for eosinophil detection, with broad implications for both clinical diagnostics and translational immunology.

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A 50-marker mass cytometry panel to expand analysis of the functional breadth of human immune cells

Polanco, L. C.; Cohen, M. J.; Tracey, L.; Loh, C.; Smith-Mahoney, E. L.; Cappione, A. J.; King, D.; Belkina, A.; Snyder-Cappione, J. E.

2026-06-08 immunology 10.64898/2026.06.03.729939 medRxiv
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Human immune single-cell proteomic functional profiling has historically been performed with a limited number of inflammatory and/or cytotoxic readouts, capturing only a fraction of the complex orchestra of factors that comprise immune responses. Given the rising global crisis of chronic inflammation and the lack of clinically available treatment options, there is an urgent need to gain insight into the cell subsets that exhibit anti-inflammatory functional profiles and elucidate the mechanisms regulating these effector capacities. To address this, we developed a 50-marker CyTOF panel that enables unprecedented functional fingerprinting of human T cells, NK cells, monocytes, and B cells, detecting 24 intracellular targets. Healthy donor PBMCs were stimulated ex vivo and stained with this panel; from T cells, cytokines associated with the hallmark Type 1 (IFN-{gamma}, TNF-), Type 2 (IL-4, IL-5, and IL-13), and Type 17 (IL-17A, IL-17F) functional lineages were detected, as well as the chemokines MIP-1-, MIP1-{beta}, and IL-8 and the cell repair factor amphiregulin; from monocytes, IL-1{beta}, IL-35, and IL-8 were detected. To ascertain if some of the cytokines less commonly included in Intracellular Cytokine Staining (ICS) panels were produced in response to physiological TCR stimulation via viral peptides, we measured the T cell response to a CMV-EBV-Flu (CEF) pool; in addition to TNF-, IFN-{gamma}, and IL-2, we also found that individual T cells produced additional cytokines with IFN-{gamma} and TNF-, such as amphiregulin, MIP-1, IL-13, and IL-4. This mass cytometry panel provides an exceptionally broad and deeply resolved view of the functional diversity of human immune cells, surpassing, to our knowledge, the capabilities of previously reported approaches. Due to minimal signal overlap, CyTOF enables flexible panel customization, allowing markers and metal tags to be readily expanded or modified. Based on its resolution and adaptability, we anticipate that this panel and its derivatives will enable the discovery of novel immunomodulatory mechanisms for therapeutic intervention.

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Extracting deep learning based morphology segmentation footprint for boar sperm cells

Park, J.; Ratka, M.; Biswas, A.; Shofner, I.; Kerns, K.; Sarkar, A.

2026-08-13 bioinformatics 10.64898/2026.08.07.743571 medRxiv
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Reliable delineation of the head and tail of swine spermatozoa supports automated assessment of boar semen quality, from morphometric measurement to the quality control of insemination doses. In practice this relies on fluorescent staining, which adds chemistry, cost, and delay to every acquisition and labels only the nucleus. Recent work coupling imaging flow cytometry with machine learning has advanced rapidly, yet the segmentation stage still depends on a stained channel at inference and resolves the head alone. We present a supervised encoder decoder network that segments boar spermatozoa from brightfield images acquired on an Amnis ImageStream Mark II with no stain at inference. Training labels derive from the Hoechst 33342 nuclear channel (Ch7), recorded in registration with brightfield (Ch1); the dye serves only as an annotation source, and the network sees Ch1 alone. The best semantic segmentation model reaches a Dice coefficient of 0.940 on held-out cells. For comparison we evaluate a classical morphological pipeline, four further semantic segmentation models spanning three decoder families and two ImageNet-pretrained backbones, and two zero-shot pipelines built on the Segment Anything Model 2 (SAM 2), prompted either by a dilated box around the predicted head mask or by head and tail boxes emitted by a Gemma 4 Vision Language Model (VLM). The zero-shot route scores 0.637 against Ch7 but labels the tail, which the fluorescence protocol cannot. Cells scoring worst under the supervised model proved to be mostly registration failures rather than segmentation failures, as Ch7 is displaced relative to Ch1. Manual screening for this drift is infeasible at dataset scale, so we propose a flagging system that marks any Dice below 0.792, two standard deviations below the mean, and pairs it with a zero-shot pipeline in which a VLM l and SAM 2 cross-check the flagged cell before human review.

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Simulation-Trained Deep Learning for Automated Cell-Based HLA Antibody Assay Interpretation in Pre-Transplant Diagnostics

Afting, C.; Semmler, A.-L.; Oulghazi, S.; Ries, J. I.; Lichtenberg, A. E.; Jaeger, J. F.; Merk, C.; Fuerst, D.; Lorenz, H.-M.; Tonn, T.; Seidl, C.; Exner, T.

2026-07-27 transplantation 10.64898/2026.07.23.26358785 medRxiv
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Preformed and de novo antibodies against donor human leukocyte antigen (HLA) antigens remain a major cause of antibody-mediated rejection and graft loss after organ transplantation. Although solid-phase assays and virtual crossmatching have reshaped pre-transplant risk assessment, physical crossmatching, which assesses whether recipient antibodies react with donor cells, remains widely used as the final compatibility assessment before transplantation. These workflows include both complement-dependent cytotoxicity (CDC) and flow cytometry crossmatch (FCXM) assays, but their interpretation remains partly manual, operator-dependent, and, for microscopic CDC readout, semi-quantitative. Here, we present AlloViewer, a web-based software platform for automated and traceable interpretation of image-based and flow-cytometry-based HLA antibody diagnostics. For CDC microscopy, AlloViewer employs a simulation-trained deep learning (UNet) workflow that combines automated lymphocyte segmentation with experiment-specific fluorescence classification and well-level cytotoxicity scoring. To deliberately capture the technical variability encountered in routine diagnostics, we generated simulated CDC-like training images spanning differences in image resolution, acquisition conditions, staining quality, cell density, cell distribution, clustering, and background fluorescence, among others. The resulting simulation-trained model enabled robust lymphocyte detection across heterogeneous imaging conditions and outperformed a conventional rule-based image analysis pipeline under variable acquisition conditions. Automated CDC scoring achieved performance within the range of human inter-annotator variability and approached the practical reproducibility limit defined by human disagreement. To cover all modalities of pre-transplant physical crossmatching, AlloViewer further supports automated FCXM interpretation through cell population identification and population-specific immunoglobulin G (IgG) readouts. The platform integrates these workflows in an assay-specific web interface and provides application programming interface (API) access for programmatic submission of assay data and retrieval of processed results. Together, AlloViewer establishes an integrated computational framework for standardized and traceable interpretation of CDC crossmatch assays, CDC-based HLA antibody identification testing using commercial test-cell panels, and FCXM workflows. More broadly, this work demonstrates how simulation-trained artificial intelligence (AI) can facilitate robust computational analysis across technically heterogeneous laboratory environments, providing a framework for standardizing traditionally operator-dependent diagnostic workflows.

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CyStainer: A transformer-based variational autoencoder for robust marker imputation in high-parameter cytometry

Ivanov, K.; Moussawy, M. A.; Kirk, F.; Samuli, R.; Lohi, O.; Olsen, L.; Modvig, S.; Hautamäki, V.; Heinäniemi, M.

2026-06-30 bioinformatics 10.64898/2026.06.30.735235 medRxiv
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High parameter cytometry is essential for clinical diagnostics through precise immune cell profiling, improved patient stratification, and monitoring, while also enhancing the understanding of cellular responses in disease and therapeutic contexts. The amount of cytometry data is growing fast, and with that, the need to merge different datasets for unified analysis. Here, we present CyStainer, a transformer-based variational autoencoder that demonstrates competitive or superior performance to existing methods on several key tasks related to marker prediction. As a key novelty, we demonstrate that CyStainer can impute markers without having a set of shared backbone markers. We performed several benchmarks using real-world FACS, CyTOF, InfinityFlow and CITE-seq datasets to show that CyStainer is a robust and flexible tool for panel merging, marker imputation, dataset integration and virtual staining of unseen samples.

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EventHorizon: A Foundation Model for Clinical Flow Cytometry

Medina Grespan, M.; Morrison, M.; O'Fallon, B.; Shean, R.; Spies, N. C.; Ng, D.

2026-06-22 bioinformatics 10.64898/2026.06.18.733197 medRxiv
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Flow cytometry is an essential tool for diagnosis of hematologic malignancies, but existing clinical workflows are highly dependent on expert manual interpretation. Existing machine learning approaches typically require extensive labeled data and are sensitive to variability in panel design, instrumentation, and laboratory workflows, limiting their generalizability. We present EventHorizon, a self-supervised foundation model for clinical flow cytometry that produces unified specimen-level representations from heterogeneous multi-panel data. EventHorizon employs a two-stage hierarchical transformer architecture with marker-aware tokenization, enabling seamless integration of cells measured across different antibody panels into a single shared latent space. We pre-train the model using a DINO-inspired self-distillation strategy with a variety of flow cytometry-specific augmentations on a dataset of more than 100,000 clinical specimens across 17 distinct panels. We evaluate the resulting embeddings on three clinically relevant classification tasks spanning common and rare panels, demonstrating that simple k-nearest neighbor probing of frozen EventHorizon embeddings achieves performance comparable to a fully supervised baseline model and a prior panel-specific self-supervised model. To ensure EventHorizon is not simply shortcut learning on features such as the markers/panels run for a given specimen, we perform a graph-theoretic analysis of EventHorizons latent space which argues that specimen embeddings are organized primarily by biological diagnosis. Taken together, these results demonstrate that EventHorizon produces biologically meaningful, panel-agnostic specimen representations from clinical flow cytometry data which, with further development and validation, could provide a potential basis for scalable, reproducible diagnostic support across diverse clinical laboratory settings.

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Vision Language Models Fail to Reliably Detect Acute Myeloid Leukemia in Bone Marrow Smears

Schulze, F.; Loeffler, C.; Radoynova, M.; Winter, S.; Roellig, C.; Sockel, K.; Kroschinsky, F.; Bornhaeuser, M.; Middeke, J. M.; Kather, J. N.; Eckardt, J.-N.; Ghaffari Laleh, N.

2026-08-22 hematology 10.64898/2026.08.19.26359329 medRxiv
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Hematologic diagnostics and especially cytomorphologic assessment are time-intensive and require high levels of expertise. Vision Language Models (VLM) show promise in medical image analysis in radiology and histopathology, while an evaluation on detecting acute myeloid leukemia (AML) is lacking. Our goal was to evaluate three Vision Language Models regarding their diagnostic accuracy and safety in clinical decision support in detecting AML from digitized bone marrow smears (BMS). Whole slide images were obtained from bone marrow smears of 50 AML patients and 50 bone marrow donors. Ten representative fields of view per sample were extracted manually. Three VLMs were used, two of which are considered generalist models (Qwen3.5-397B-A17B-FP8, GLM-4.6V-FP8), while the other one is a medically adapted model (Medgemma-27b-it). All models performed zero-shot analysis using two prompting strategies: First, a context-rich prompt requesting reporting of WHO/FAB diagnostic criteria in a structured manner, and secondly a minimal prompt without specific hematologic context. Overall diagnostic accuracy was poor for all models as they exhibited the overwhelming tendency to classify most samples as leukemic: With context-rich prompts, GLM4.6 identified 90% of leukemic samples while also labeling 92% of bone marrow donors as AML. The medical specialist model MedGemma-27b showed similar failure, misclassifying 86% of healthy donors and correctly detecting AML in only 66% of cases. Qwen3.5 performed best under detailed prompting, achieving a specificity of 0.26 and accuracy of 0.51. Accuracy of all models improved with context-free prompts (accuracies range 0.47-0.79), yet they still lacked the ability to correctly distinguish between leukemia and healthy bone marrow. Qwen3.5 was the only model to maintain meaningful specificity (0.64) and correctly identified 94% of AML, yielding an overall accuracy of 0.79. Morphologic feature-level agreement with human expert reports was poor across all models, indicating poor recognition of cell-level morphologies. This failure is likely driven by the fact that pathology imaging archives are vastly scraped during model training while hematological samples are not as widely available and therefore, hematology is an out-of-bounds use-case for these models, rendering them currently unsuitable for clinical decision support in hematology.

8
Generative cell phenotyping with structured latent populations

Bodart, F.; De Voeght, A.; Baron, F.; Louppe, G.

2026-07-03 bioinformatics 10.64898/2026.06.30.735507 medRxiv
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Flow cytometry produces high-dimensional single-cell protein measurements central to immunophenotyping and clinical monitoring. Yet analysis still relies largely on manual gating, which is labour-intensive, poorly reproducible, and ill-suited to large marker panels. Existing computational approaches address classification or discovery in isolation, treating cell-type identity as a post-hoc annotation rather than as part of the generative model itself. We present MARVIN, a semi-supervised variational autoencoder that encodes the assumption that cells organise into discrete populations with continuous intra-population variability through a Gaussian mixture prior in the latent space. Because each component represents a distinct cell population, classification, discovery, and density estimation emerge as complementary views of the same representation. On public benchmarks, MARVIN matches or exceeds existing methods using as few as 10% labelled cells. Trained exclusively on healthy samples, it identifies leukaemic cells through elevated reconstruction error, providing an unsupervised anomaly detection signal. On paired stimulation data, it maintains stable population assignments while capturing condition-specific shifts in abundance and marker expression at patient-level resolution. MARVIN is open-source and designed for local deployment, adapting to institution-specific panels and instruments

9
CyFj11: FlowJo v11 Workspace Import and Legacy Format Export for R-Based Flow Cytometry Analysis

Jagla, B.; Culina, S.; Le-Guerroue, F.; Karkeni, E.; Hasan, M.

2026-07-31 bioinformatics 10.64898/2026.07.28.741192 medRxiv
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AO_SCPLOWBSTRACTC_SCPLOWHigh-dimensional flow cytometry measures immune cells at single-cell resolution, enabling systematic characterization of cell populations at scale. But harnessing this potential requires seamless interoperability between the interactive gating tools used by biologists and the statistical environments used for detailed downstream analysis. FlowJo, one of the most widely used commercial cytometry analysis software packages, now stores workspaces in a format that existing R tools cannot read, leaving researchers unable to import their gating strategies into R, or to return R-based results to FlowJo for visual review or collaborative sharing, without manual reconstruction. We present CyFj11, an R package that closes this gap, enabling import of FlowJo v11 gating hierarchies into R and export of R-defined gates back to FlowJo (throughout this paper, "import" refers to bringing a FlowJo v11 workspace into R, and "export" to writing an R-derived GatingSet back out to FlowJo). Using a combination of synthetic test scenarios and a real-world immunophenotyping dataset, we show that population counts in FlowJo 10 and 11 matched R-derived values with Pearson correlation coefficients exceeding 0.99. CyFj11 is platform-independent, requires no additional software infrastructure, and is freely available at https://github.com/C3BI-pasteur-fr/CyFj11.

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Intra-slide calibration technology improves immunohistochemical harmonization within and between anatomic pathology laboratories

Fernandes, G. M. d. M.; Wang, W.; Parwani, A.; Ahmadian, S. S.; Alves, M. J.; Philips, J. J.; Otero, J. J.

2026-06-08 bioinformatics 10.64898/2026.06.04.730099 medRxiv
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The reproducibility of immunohistochemistry in tumor tissue analysis across reference labs remains a persistent challenge. We tested the extent to which an intra-slide calibration technology mitigated discprepencies in inter-laboratory assays of p53 immunohistochemical (IHC) reactions in brain biopsies of glioblastoma (GB), IDH-wildtype. Intra-slide calibration technologies apply a 0-100% concentration scale incorporating primary surrogate and secondary antibodies to generate a standardized curve for DAB precipitation. IHC from GB samples was performed independently by pathology departments from two different hospital laboratories and were digitalized at 40x magnification using Aperio Image Scope software. Feature extraction, including intensity and texture parameters was performed using the EBImage package in R, followed by UMAP dimensionality reduction and DBSCAN clustering analysis. Our results show significant differences in intensity and texture clustering patterns between laboratory tissue samples and intra-slide calibration technology ruler caused by the different laboratories. Intra-slide calibration technology coupled with polynomial regression analysis improved ~90% the data harmonization. Our findings demonstrate a key role for computational pathology using intra-slide calibration technology to enable intra-laboratory consistency and inter-laboratory reproducibility. These advances strengthen the reproducibility of diagnostic assessments and support more objective, data-driven decision-making in neuro-oncology.

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CytoGate-Bench: an LLM benchmark for cross-panel cell gating in cytometry

Kim, J.; Lee, B.; Ahn, N.; Ionita, M.; McKeague, M. L.; Lee, M. E.; Jeong, C.-U.; Apostolidis, S. A.; Baxter, A. E.; Shwetank, ; Greenplate, A. R.; Wherry, E. J.; Sohn, K.-A.; Kim, D.

2026-08-26 bioinformatics 10.64898/2026.08.24.746336 medRxiv
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In cytometry, the workhorse single-cell technology of clinical immunology, every study defines its own antibody panel and cell-type vocabulary, so a classifier trained on one cannot annotate the next. Immunologists instead annotate by manual gating, splitting one parent population at a time on a two-marker plot, down an expert-defined hierarchy. We introduce CytoGate-Bench, a benchmark that reformulates this per-step procedure as a zero-shot, panel-agnostic task for large language models. It comprises 23,646 expert-annotated instances re-curated from 11 public flow- and mass-cytometry cohorts spanning eight marker panels. Across six open- and closed-weight backbones, the strongest formulation draws one rectangular gate per candidate and falls within the range of trained, panel-specialized baselines. It degrades less under distribution shift. Walking the hierarchy stepwise outperforms predicting every cell type at once. Ablations trace the signal to the data distribution shape and curated marker priors. However, adding vision or a self-verification loop systematically tightens gates.

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A streamlined spectral cytometry method for FAD and NADH autofluorescence analysis in immunometabolic studies

Stylianakis, E.; Hoevelmeyer, N.

2026-06-08 immunology 10.64898/2026.06.03.729953 medRxiv
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Abstract/SummaryWe present a streamlined protocol that enables the characterization of the metabolic state of immune cell populations through their distinct NADH/FAD autofluorescence fingerprints using a FACSymphony A5 spectral cytometer. We demonstrate the utility of this approach by profiling the metabolic status of diverse splenic B-cell subsets and assessing metabolic changes associated with their activation state.

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Interpretable Peripheral Blood Cell Classification via Vision-Language Concept Bottleneck and Soft Decision Tree

Chen, K.; Hu, T.

2026-07-20 bioinformatics 10.64898/2026.07.14.738462 medRxiv
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MotivationDeep learning classifiers for medical image analysis typically function as black boxes, disclosing neither the image features underlying their predictions nor the reasoning by which individual decisions are reached. Peripheral blood cell classification exemplifies this challenge: experienced laboratory professionals identify cell types through structured morphological criteria--nucleus shape, chromatin texture, nucleus-to-cytoplasm ratio, granularity, and staining properties--yet existing automated systems cannot express their reasoning in these same terms, impeding clinical audit and verification. ResultsWe present a two-stage interpretable pipeline that addresses both levels of opacity. In the first stage, a frozen domain-adapted vision-language model (ConceptCLIP) projects each cell image onto a 70-dimensional vector of morphological concept scores via zero-shot cosine similarity, eliminating the need for per-image concept annotations. In the second stage, a Soft Decision Tree (SDT) classifies cells solely on these concept scores, producing a deterministic, concept-based decision path for each prediction. On BloodMNIST (eight cell types, 3,421 test images), the full pipeline achieves 94.86% test accuracy--approximately 3 percentage points below the black-box ceiling--while providing fully traceable decision logic. Post-training histological annotation confirms that the learned routing logic aligns with established hematological morphology criteria and reveals an emergent separation of immature granulocyte subtypes (promyelocyte versus metamyelocyte) without subtype supervision, demonstrating that concept-based decision trees can recover clinically meaningful distinctions beyond the granularity of the training labels. Availability and implementationThe source code, trained SDT weights, precomputed concept score data, and inference scripts are publicly available at https://github.com/aquamarineaqua/CLIP-CBM-SoftDecisionTree.

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Deep learning-based identification and quantification of rare circulating hybrid cells in orthotopic pancreatic cancer models

Rounds, C. C.; Ravi, D.; Huang, G.; Mengesha, B.; Tran, S.; Garcia, A.; Rueb, N.; Chang, Y. H.; Park, B. S.; Wong, M. H.; Gibbs, S. L.

2026-08-18 cancer biology 10.64898/2026.08.14.744773 medRxiv
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SignificanceRare-cell identification in fluorescence microscopy remains challenging because targets are sparse and background varies between specimens. Combining specimen-specific fluorescence enrichment with image classification may enable efficient and more specific automated detection of rare cells. AimWe developed a two-stage framework to identify and quantify candidate rare circulating hybrid neoplastic cells (CHCs, ECAD+/CD45+) in peripheral blood mononuclear cell (PBMC) preparations from tumor-bearing and tumor-naive mice. ApproachPBMCs from 28 mice were imaged by multichannel fluorescence microscopy. Matched unstained samples established animal-specific ECAD and CD45 background distributions for candidate cell enrichment. Blinded multi-annotator consensus labels were used to train a convolutional neural network (CNN) from DAPI, ECAD, and CD45 image crops. Generalization was evaluated by leave-one-animal-out validation across 10 random initializations. Final classification used a 10-model ensemble, and rare-cell burden was compared between groups using negative-binomial regression with total segmented-cell count as an exposure. ResultsOf the 1,065,512 segmented cells, enrichment retained 10,176 candidates (0.96%), reducing the search space by >99%. Four of five evaluable tumor-bearing animals showed reproducible held-out discrimination, with median quantified area under the receiver operator characteristic curve (AUROCs) of 0.918-0.951; one animal was a reproducible outlier (median AUROC, 0.338). Ensemble deployment identified 157.94 positive-consensus cells per 50,000 segmented cells in tumor-bearing animals versus 49.55 in controls. The estimated rare-cell rate was 3.15-fold higher in tumor-bearing animals (95% CI, 0.91-10.99; two-sided p=0.071; prespecified one-sided p=0.036). ConclusionsSpecimen-specific fluorescence enrichment combined with supervised image classification reduced the cellular search space and enabled automated quantification of a rare CHC (ECAD+/CD45+) phenotypes. Cross-animal validation also identified specimen-specific generalization failure, highlighting the importance of biological-specimen-level validation.

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FlowSpot Enables Decentralized Phenotypic and Functional Cellular Immune Profiling from Dried Blood Spots

Caddell, R.; Adams, S.; Mushatt, D.; Vaccari, M. D.; Fahlberg, M. D.

2026-07-23 immunology 10.64898/2026.07.20.739622 medRxiv
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Expanding access to cellular immune analysis is essential for decentralized clinical care, clinical trials, and population-based research. However, current flow cytometry workflows require rapid processing of fresh blood, proximity to a centralized laboratory, and cold chain logistics. Although dried blood spots (DBS) have transformed decentralized molecular diagnostics, no comparable approach has enabled robust flow cytometric analysis of immune cells. Here, we present FlowSpot, a novel platform that enables recovery of leukocytes from DBS and preserves their immunophenotypic characteristics, allowing downstream flow cytometric analysis following ambient-temperature storage and shipment. FlowSpot recovers intact leukocytes while preserving immune cell subset frequencies with strong concordance to fresh whole blood. We demonstrate its clinical utility by enabling remote CD4 T cell immunophenotyping in people living with HIV, showing high agreement with routine clinical measurements across a broad range of CD4 T cell frequencies. Beyond cellular phenotyping, FlowSpot extends immune monitoring to functional profiling by enabling detection of intracellular cytokine responses, including IFN{gamma}, IL-2, and TNF production by CD4 and CD8 T cells following ex vivo PMA/ionomycin stimulation. By overcoming a longstanding barrier to leukocyte recovery from DBS, FlowSpot extends flow cytometry beyond specialized laboratories, expanding access to cellular immune analysis for clinical care, decentralized clinical trials, and population-scale immunology.

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Integration of clinical and T-cell immune profiling to predict early response to CD3xBCMA bispecific antibody immunotherapy in Multiple Myeloma

Deredec, N.; Aziez, L.; Boussaid, I.; Decroocq, J.; Guedon, A.; Michot, M.; Catelain, C.; Selimoglu-Buet, D.; Arbab, A.; Alanio, C.; Kosmider, O.; Willems, L.; Fontenay, M.; Franchi, P.; Birsen, R.; Chapuis, N.; Bouscary, D.; Vignon, M.; Simoni, Y.

2026-08-21 immunology 10.64898/2026.08.17.743749 medRxiv
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The emergence of bispecific antibodies (BsAbs) targeting T cells (CD3+) and tumor plasma B cells (BCMA+) has provided a new therapeutic option for patients with relapsed/refractory multiple myeloma cancer. However, responses to CD3xBCMA BsAb therapy remain heterogeneous, and treatment is associated with frequent immune-related adverse events. Although baseline immune characteristics have been associated with clinical outcomes, little is known about the early immune dynamics induced by this therapy. Here, we investigated whether longitudinal clinical monitoring and high-dimensional profiling of blood circulating T cells could identify early biomarkers of response or toxicity during treatment. Our results indicate that all treated patients exhibit an early depletion of circulating T cells associated with T-cell activation within the first two weeks. Integration of clinical and immunological parameters using Factorial Analysis of Mixed Data (FAMD) identified immune features associated with treatment outcome. Responders had lower plasma soluble BCMA concentrations, fewer bone lesions, higher circulating lymphocyte counts at baseline. During the first days of treatment, responders exhibited a more pronounced increase in plasma CXCL10 levels, associated with a greater decrease in T lymphocyte counts. Overall, our findings suggest that integrating clinical and immune parameters measured during the first days of treatment may enable early patient stratification and support the development of a predictive score to identify patients with multiple myeloma who are most likely to benefit from CD3xBCMA BsAb therapy. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=94 SRC="FIGDIR/small/743749v1_ufig1.gif" ALT="Figure 1"> View larger version (34K): org.highwire.dtl.DTLVardef@1cb079org.highwire.dtl.DTLVardef@1860106org.highwire.dtl.DTLVardef@ad36d3org.highwire.dtl.DTLVardef@1ea5c1e_HPS_FORMAT_FIGEXP M_FIG C_FIG HighlightsO_LIIntegrated clinical and blood T-cell immune profiling using FAMD enables patient stratification following CD3xBCMA BsAb therapy. C_LIO_LIT-cell immune activation occurs predominantly within the first two weeks of therapy. C_LIO_LIFirst-week clinical and immune parameters identify patients most likely to benefit from therapy. C_LIO_LIHigh CXCL10 levels, a profound early decline in circulating T cells, low sBCMA levels, and fewer bone lesions are candidate predictive markers of treatment response. C_LI

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Developing Buoyant-Analyte-Magnetic (BAM) Assays for Ultrasensitive Yet Rapid Point-of-Care Detection

Wang, C.; Satterfield, E.; Erwin, N.; Correa, J.; Wampler, W.; Dean, D.; Moschella, P.; Anker, J.

2026-06-26 emergency medicine 10.64898/2026.06.15.26355555 medRxiv
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Rapidly detecting infectious diseases such as Covid-19 is essential to control outbreaks and treat patients early. However, no available screening method combines low cost, portability, speed (<20 min, ideally <5 min), and ultrasensitivity (e.g., <1 virus/L): lateral flow assays are fast, portable, and inexpensive but insensitive, whereas ultrasensitive assays require centralized labs with long turnaround times. We recently developed an ultrasensitive immunoassay that captures, separates, and counts saliva biomarker molecules using buoyant microbubbles and magnetic microspheres, but the original assay took 55 minutes and was not readily deployable. Here, we redesigned the assay protocol and reader for emergency medicine and mobile care by streamlining the workflow, collecting saliva with larger swabs, filtering it through a 10 m cap, and using larger microbubbles to accelerate flotation. A paramedic successfully ran the assay on the back of a parked medical van in 3.5 minutes (spit-to-results) while achieving a 1.3 fg/mL analytical detection limit for SARS-CoV-2 nucleocapsid protein (~0.04 virus1/L). The assay remained positive across 9 orders of magnitude. We describe the challenges and opportunities ahead for point-of-care deployment.

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A Circulating TLR2pos CD14neg CD16neg '' Unclassified Subset '' is Decreased in Multiple Myeloma Patients and May Comprise CD163pos Dendritic Cells.

Kristensen, M. W.; Kvorning, S. L.; Jon Moller, H.; Hokland, M.; Vorup-Jensen, T.; Andersen, M. N.

2026-07-25 immunology 10.64898/2026.07.21.739900 medRxiv
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BackgroundStrategies to define human monocytes by flow cytometry vary considerably across studies. Recently, toll-like receptor 2 (TLR2) has been proposed as a marker to identify "all monocytes" in human peripheral blood. However, the TLR2-defined monocytes also contained a previously ignored TLR2posCD14dim/negCD16neg population, which we termed the unclassified subset (UCS). MethodsPeripheral blood mononuclear cells (PBMCs) from healthy donors and patients with multiple myeloma (MM) or monoclonal gammopathy of undetermined significance (MGUS) were analyzed by multiparameter flow cytometry using TLR2pos gating. PBMCs from additional healthy donors were analyzed to characterize the UCS population, including the impact of using either TLR2pos or a negative selection-based gating strategy. ResultsThe TLR2pos CD14dim/neg CD16neg UCS population was present in healthy controls, MGUS, and MM patients. The UCS expressed the monocyte-macrophage scavenger receptor CD163 and was significantly reduced in MM patients compared to healthy donors (P<0.002). Further phenotypic characterization in healthy blood donors revealed that approximately 80% of UCS cells expressed CD163 at levels comparable to classical monocytes, yet phenotypically resembled CD163pos dendritic cells (DCs). Importantly, gating strategies influenced the composition of the UCS: negative selection-based gating captured all DC subsets, whereas TLR2pos gating primarily included CD1cpos DCs that were highly CD163pos. ConclusionsThese findings demonstrate that circulating CD163pos CD1cpos DCs are included in the TLR2pos cell population previously described as exclusively monocytes, highlighting the impact of gating strategy on monocyte subset identification. Further, the lower level of TLR2pos CD14dim/neg CD16neg CD163pos cells in MM patients may represent decreased levels of circulating DCs that may contribute to the immune dysregulation in this disease.

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Semi-automated reconstruction of glomerular architecture from 3D confocal microscopy data

Loyd, Y. M.; Chase, S. E.; Krendel, M.

2026-07-10 cell biology 10.64898/2026.07.03.736410 medRxiv
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Nephrons are the functional units of the kidney; within each nephron, the glomerulus is the initial site of selective filtration that allows removal of waste products while preserving proteins in the bloodstream. Each glomerulus consists of a network of capillaries surrounded by specialized epithelial cells, podocytes, which mediate selective filtration. Abnormalities in glomerular structure impair renal function, resulting in proteinuria and kidney disease. Although several microscopy-based approaches exist to characterize glomerular architecture and structural abnormalities, quantitative analysis is often limited by labor-intensive image segmentation. In this study we present a semi-automated approach for segmentation and analysis of glomerular architecture from three-dimensional confocal microscopy data. Using mTmG transgenic mice that express membrane-associated EGFP in podocytes and membrane-associated tdTomato across all other cell types, we reconstruct podocyte processes and glomerular capillaries from volumetric renal images. This semi-automated approach reduces manual segmentation effort and supports more efficient, standardized analysis of glomerular architecture in three-dimensional confocal microscopy datasets.

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CD3, CD28, TCRαβ expression and IL-2 production in a spontaneous glycosylphosphatidylinositol-deficient Jurkat T cell line

Glass, W. S.; Zuleger, C. L.; Cai, Y.; Newton, M. A.; Albertini, M. R.

2026-07-26 immunology 10.64898/2026.07.22.740193 medRxiv
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Glycosylphosphatidylinositol (GPI) anchors are involved in the organization of membrane microdomains that support T cell receptor (TCR) signaling. However, their role in regulating expression of TCR-related proteins and downstream functional output remains unclear. This study aimed to characterize the effects of GPI-deficiency on TCR, cluster of differentiation 3 (CD3), and CD28 expression as well as interleukin-2 (IL-2) production using a GPI-deficient Jurkat T cell line (S12). Flow cytometry confirmed the complete loss of GPI anchors and GPI-anchored proteins (GPI-APs) in the S12 cell line. Compared to GPI-producing parental Jurkat, S12 had significantly higher expression of CD3 and TCR{beta} while CD28 had similar expression. IL-2 production by S12 was assessed following stimulation with anti-CD3/anti-CD28 beads and following stimulation with phorbol 12-myristate 13-acetate (PMA) and ionomycin. Neither S12 nor parental Jurkat produced detectable IL-2 in response to anti-CD3/anti-CD28 bead-mediated stimulation. Both parental Jurkat and S12 produced IL-2 following PMA/ionomycin-mediated stimulation. No significant difference in IL-2 production was observed between S12 and parental Jurkat following PMA/ionomycin-mediated stimulation. These findings demonstrate that GPI-deficiency influences surface receptor expression but does not significantly impair downstream IL-2 production under PMA/ionomycin stimulation. This finding suggests that GPI anchors and GPI-APs contribute to proximal signaling organization but are not required for cytokine production when downstream pathways are directly activated.