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Journal of Immunological Methods

○ Elsevier BV

Preprints posted in the last 30 days, ranked by how well they match Journal of Immunological Methods's content profile, based on 24 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.

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Development of immunological reagents for the identification of biomarkers of inflammation in the common marmoset

Lambrou, E.; Hallengard, D.; Turbow, B.; Callery, J.; Hodara, V. L.; King, J.; Ross, C. N.; Ahlborg, N.; Makower, B.; Giavedoni, L. D.

2026-09-23 immunology 10.64898/2026.09.17.752376 medRxiv
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Marmosets (MAR, Callithrix jacchus) are nonhuman primates extensively studied in a broad array of preclinical biomedical research areas. However, the limited number of available immunological reagents remains a critical shortcoming of these models. We successfully developed monoclonal antibodies (mAbs) pairs that can be used in immunoassays for the identification and quantification of the biomarkers of inflammation C-reactive protein (CRP), CXCL-10 (IP-10), interleukin (IL)-4, IL-6, and IL-10. Recombinant MAR protein variants were produced in mammalian cells, purified and used for mice immunization. Hybridoma clones were selected first for their capacity to bind the recombinant proteins. All possible pair combinations of these mAbs were then tested for their capacity to identify their targets in MAR-derived samples. These MAR samples consisted of supernatant of PBMCs exposed ex vivo to different stimulants, and plasma samples from animals stimulated in vivo with a low-dose intravenous LPS inoculation. The majority of the mAbs that recognized the recombinant proteins failed to bind to the MAR-derived homologs. However, we found MAR-derived reactive mAbs and selected pairs with optimal sensitivity and signal-to-noise ratio for immunoassays that included Luminex multiplexing assays, ELISA, and ELISpot assays. These immunoreagents and assays will improve the translational value of different MAR biomedical models.

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To TTV or Not to TTV? A Combined Urinary Biomarker Approach in Kidney Transplant Recipients Using Torque Teno Virus, Cell-Free DNA, and BK Polyomavirus Measurements

Alhadid, Y.; Mamroth, M.; Wang, Z.; Castaneda, J.; Chadha, A.; Vlassov, A.; Chikova, A.

2026-10-15 transplantation 10.64898/2026.10.13.26365472 medRxiv
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Background: Noninvasive biomarkers capable of detecting kidney allograft injury and distinguishing rejection from infection remain an important clinical need. Torque teno virus (TTV) reflects host immune status, but its utility in urine has not been well established. We evaluated urinary TTV, total cell-free DNA (cfDNA), cfDNA fragmentation, and BK polyomavirus (BKV) as potential biomarkers of kidney transplant rejection and BK polyomavirus-associated nephropathy (BKPyVAN). Methods: Urine samples from 334 kidney transplant recipients were analyzed in association with kidney biopsies performed within 30 days of sample collection. TTV and cfDNA were measured by multiplex quantitative PCR (qPCR), with a subset analyzed by digital PCR (dPCR), and BKV was quantified by qPCR. Associations with biopsy results were evaluated using group comparisons and nominal logistic regression. Changes associated with outcomes of consecutive biopsies were assessed by matched pairs analysis. Results: Among 544 unique urine samples, the urinary TTV/cfDNA ratio was significantly lower in rejection than in non-rejection samples (P<0.0001). Logistic regression adjusted for demographic factors confirmed an inverse association between the qPCR-derived TTV/cfDNA metric and rejection (adjusted odds ratio per delta Cq, 0.91; 95% CI, 0.88-0.94; P<0.00001). Significant differences were observed for all types of rejection. Association was confirmed by dPCR: higher TTV was associated with lower rejection odds, whereas higher cfDNA was associated with greater rejection odds. A nominal logistic model incorporating dPCR measurements achieved an AUROC of 0.76 (95% CI, 0.69-0.82). Matched pairs analysis showed a significant decrease in TTV/cfDNA when rejection developed and an increase following recovery from rejection, with no significant changes when biopsy status remained unchanged. BKV levels were strongly associated with BKPyVAN. No correlation between TTV and BKV was observed. Nominal logistic regression integrating TTV, cfDNA, and BKV measurements yielded AUROCs of 0.75, 0.97, and 0.73 for rejection, BKPyVAN, and non-rejection, respectively. Conclusions: A reduced urinary TTV/cfDNA ratio is associated with biopsy-defined kidney transplant rejection, and changes in the ratio correlate with transitions in biopsy results. Combined TTV, cfDNA, and BKV measurements showed differential associations with rejection and BKPyVAN, supporting further evaluation as complementary urinary biomarkers.

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SCKAnalyzer: A Web Tool for Single-Cycle Kinetics Analysis and Simulation

Malard, F.; Blanc, J.-M.; Roubin, E.; Schafer, T.; Di Primo, C.

2026-10-09 biophysics 10.64898/2026.10.07.756993 medRxiv
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Surface plasmon resonance (SPR) and biolayer interferometry (BLI) are well-established label-free analytical technologies used to determine biomolecular interaction rates (ka, kd) and equilibrium constants (KD). While assays historically rely on multi-cycle kinetics (MCK), this approach requires intermediate surface regeneration, risking sensor degradation and increasing reagent consumption. Single-cycle kinetics (SCK) avoids regeneration by sequentially injecting increasing analyte concentrations. However, implementing SCK workflows on biosensor platforms like the OctetRR8 BLI instrument (Sartorius) remains a challenge due to the lack of built-in or online data analysis tools. To address this, we introduce SCKAnalyzer, a free, user-friendly web application designed for processing and fitting SCK datasets. SCKAnalyzer accepts column-based text files and native raw BLI data (.frd format) from Sartorius instruments, performing data pre-processing and non-linear fitting to a 1:1 interaction model. Additionally, it offers advanced simulation capabilities that allow variable association and dissociation durations across sequential injection steps, a feature absent in existing platforms such as BiacoreTMSimul8. The performance of SCKAnalyzer was experimentally validated using a 3-step SCK method (SCK3) for DNA/RNA duplex formation on a Biacore T200, as well as 4-step (SCK4) and 5-step (SCK5) methods for DNA/DNA duplex formation on an OctetRR8 BLI instrument. Binding parameters (ka, kd, KD) derived from SCKAnalyzer showed excellent agreement with values from established proprietary softwares such as Biacore T200 Evaluation Software v3.2.1 and BIAevaluation v4.1.1. SCKAnalyzer provides a practical alternative to MCK, reducing probe consumption and extending SCK utility across biosensor platforms. SCKAnalyzer is available at sck.iecb.u-bordeaux.fr (source code: github.com/synthaze/sckanalyzer).

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Spectral Analysis of the T Cell Repertoire Recovery Following Allogeneic Stem Cell Transplantation

Toor, A. A.; Marinos-Velarde, A.; Qayyum, R.

2026-09-29 transplantation 10.64898/2026.09.28.26364185 medRxiv
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The human T cell repertoire is generated through recombination of a multitude of T cell receptor gene segments, yielding a complex array of T cell clones. T cell receptor beta (TRB) V gene segment defined, T cell clonal frequency when organized in correspondence with the respective V gene segment positions on the TRB genomic locus yields a periodic, undulating curve in the spatial domain. Using the genomic distance from the TRB-D1 segment to the TRB-V1-29 segments, spectral analysis was performed utilizing Lomb-Scargle periodogram (modified Fourier analysis) to obtain spectral power curves quantifying the TRB V clonal frequencies from 12 allogeneic stem cell transplant donors (baseline) and recipients (<100 days or b/w 100-365) using a variety of analytic software. Patients either underwent HLA matched related bone marrow or HLA matched unrelated blood stem cell transplantation, using PT-CY for the former and ATG for the latter. Spectral Power curves revealed dominant spectral peaks at wavelengths ranging from 113-335 millicycles/kb in the 12 donors, with consistent frequency domain spectral patterns, supporting similar use of V segments across healthy individuals. PT-CY recipients had power spectra closely corresponding to the respective donors, however the ATG recipients had relatively dispersed spectra, with spectral centroid shifted towards higher frequencies compared to donors and a reciprocal decline in the low frequency indices. Spectral power was concentrated in the <3 kb and 3-12 kb wavelengths in both groups, consistent with the periodicity observed in the relative V gene segment usage across the repertoire. The analyses reported here demonstrate that the healthy SCT donors have a spectral signature occupying short to intermediate wavelegnths in the frequency domain, PT CY recipients recover with donor-like spectra on the average, however ATG recipients tend to shift towards higher frequencies. These findings are consistent with a normal organized distribution of TRB V segment usage in healthy individuals, with PT-CY preserving this organization more consistently than ATG. Spectral (Fourier) analysis of TRB sequencing data provides a repertoire wide summary of T cell clonal distribution.

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Rapid Molecular Assessment of Kidney Allograft Rejection Using the Biopsy Transport Medium

Li, Z.; Kalverboer, N.; van der Helm, D.; Callegaro, G.; van de Water, B.; Meziyerh, S.; Vries, A. P. J. d.; Baelde, H. J.; Kers, J.

2026-10-02 neurology 10.64898/2026.10.01.26364480 medRxiv
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Introduction Timely diagnosis of kidney allograft rejection is critical for post-transplant management, yet treatment decisions may need to be made empirically while awaiting the final pathology report. We previously demonstrated that biopsy transport medium (BTM) contains molecular signals reflective of allograft rejection. Building on these findings, we developed a rapid BTM qPCR workflow using a targeted gene panel for early molecular assessment of rejection. Methods Kidney transplant biopsies assessed at Leiden University Medical Center from April 2023 to November 2024 were eligible. A predefined gene panel was quantified in BTM by qPCR, while matched formalin-fixed paraffin-embedded tissues were profiled using Tempo-Seq. Elastic Net, Random Forest, and support vector machine models were developed to classify rejection and predict continuous histological indices directly from the BTM. Results A total of 134 paired BTM samples and biopsy tissues were analyzed. The best-performing BTM gene-panel models demonstrated good discrimination for rejection, with a median AUC of 0.80, and good calibration (median slope, 0.92; median intercept, 0.08). For continuous histological indices, the best-performing BTM gene-panel models achieved R square values of 0.33 for Activity, 0.31 for TCMR/TI, and 0.27 for AMR/MVI. Corresponding biopsy gene-panel models showed similar patterns across diagnostic outcomes. Conclusions The BTM qPCR workflow captures molecular features of kidney allograft rejection and enables prediction of rejection status along the spectrum of continuous activity indices. By providing same-day molecular information while definitive biopsy interpretation is pending, this rapid approach has the potential to complement conventional histopathological diagnostics and support early clinical decision-making.

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Whole Blood Deep Immunophenotyping and Platelet-Leukocyte Aggregate Quantification by Spectral Flow Cytometry

Ding, H.; Gerbino, K. R.; Gilham, K.; Tong, Y.; Hu, A.; Huang, E. L.; Zabriskie, E.; Ozpolat, T.; Guo, L.; Brakenridge, S. C.

2026-10-07 immunology 10.64898/2026.09.30.755388 medRxiv
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Platelet-leukocyte aggregates (PLAs) are a proposed interface between coagulation and immune regulation, but their distribution across leukocyte subsets beyond monocytes and neutrophils, and their behavior in acute disorders of immune regulation, such as sepsis and severe trauma, remain largely undefined. The study of thromboimmune mechanisms in these acute conditions has relied heavily on murine sepsis models, whose species differences in platelet and leukocyte biology limit translation to human disease. Direct measurement in human whole blood is needed yet reported PLA frequencies vary widely because quantification is highly sensitive to sample handling. Here we present a robust, minimally manipulative 27-color spectral flow cytometry protocol that allows simultaneous deep immunophenotyping and classification of PLAs across >40 leukocyte subpopulations. In healthy donors, PLA frequency ranged from 1.7% on memory CD4 T cells to over 50% on monocyte subsets, with monocytes contributing 25% of all PLAs. We also found novel platelet-binding leukocyte populations, including Th9 and Th22 CD4+ T cells. Optimization identified anticoagulant choice, centrifugation conditions, dilution, and sample processing time as key determinants of reproducible measurement; PLA quantification was validated by imaging flow cytometry. In a small validation cohort of sepsis and trauma patients, the assay recapitulated established immunophenotypic features of critical illness, including neutrophilia and myeloid-derived suppressor cells (MDSC) expansion, and quantified PLAs within each subset. This protocol provides a reference framework for studying thromboinflammation and other dysregulated immune response diseases directly in human blood, and a foundation for further studies, defining the mechanisms and clinical relevance of platelet-leukocyte interactions in disease.

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Rapid Phenotypic Antibiotic Susceptibility Determination Direct From Spiked Urine Samples Shows Strong Correlation with Gold Standard for Urinary Tract Infection

Roegner, M.; Ahmadi, C.; Lyon, S.; McGee, Z.; Chittur, K.; Millirons, P.

2026-09-23 microbiology 10.64898/2026.09.21.753156 medRxiv
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GeneCapture is developing a novel, point-of-care, rapid AST technique that, when fully automated, can accomplish AST within 2 hours directly from a raw sample, representing a significant advancement in diagnostic capabilities. For this study, a panel of uropathogen isolates was collected from clinical specimens positive for urinary tract infection from various laboratories in the southern US. A selection of these isolates were then spiked into fresh clean-catch urine samples to produce mock samples covering a variety of antibiotic responses. Testing was performed on 20 strains of Escherichia coli, the cause of over 80% of UTIs, and 6 strains each of Klebsiella pneumoniae and Proteus mirabilis, the next most common causes. Each strain was tested against the susceptible, intermediate and resistant (S-I-R) breakpoints of up to 5 appropriate antibiotics including Amoxicillin-Clavulanate, Cefpodoxime, Ciprofloxacin, Nitrofurantoin and Trimethoprim-Sulfamethoxazole. The new method uses a phenotypic assessment of bacterial growth, comparing responses from bacteria treated with antibiotics at S-I-R breakpoint concentrations to untreated controls as the metric for determining susceptibility. Exposure to the drugs for only 90 minutes gave a Categorical Agreement of 98% to gold standard culture results across the resulting 247 bacteria/antibiotic pairs. Testing on separate days of nine of these strains in triplicate gave a reproducibility of 97%. The sequential steps of this novel AST - sample processing, growth, labeling, and counting - can readily be performed on an automated cartridge that is currently under development. The presented work, which took place in a laboratory setting, demonstrates the efficacy of the assay.

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Using a 3-step semi-automated image analysis pipeline to quantify differences in VE-cadherin junction morphology in lymphatic endothelial cells in vitro

Larson, S. M.; Feller, A. K.; Whittington, C. F.

2026-10-06 bioengineering 10.64898/2026.10.05.756815 medRxiv
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Lymphatic endothelial cell (LEC) function is strongly tied to transitions between button- and zipper-like junctions that control fluid flow into vessels. Published methods quantifying junction morphology are limited to single cell analysis or use few quantitative metrics to describe junctions across LEC monolayers. Therefore, a novel 3-step image analysis pipeline was developed to identify new metrics that quantify differences in button- and zipper-like junctions in LECs. The pipeline used Cellpose, CellProfiler, and Fiji to analyze VE-cadherin expression across lymphatic vessels within a 3D microfluidic chip and quantify VE-cadherin radial intensity, number of objects, object size, branchpoints, end-points, and junction thickness. Tumor necrosis factor (TNF)- exposure produced but-ton-like junctions, and unexposed cells were zippered. Radial intensity was heightened at the cell membrane in zipper-like junctions while perinuclear intensity increased for but-ton-like junctions. Increased branchpoints, endpoints, objects per cell, and junction thick-ness were associated with junction buttoning, while increased object size was associated with junction zippering. Principle component analysis results reinforced these trends and identified metric combinations that represented each junctional state. Overall, this semi-automated pipeline quantified differences in VE-cadherin junction morphology across LEC monolayers and generated new quantitative metrics to expand the tools available for studying junction morphology in lymphatic vasculature.

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homeRNA Just Dropped! Streamlining Remote Blood Collection and RNA Stabilization for Smaller Sample Volumes with homeRNAdrop

Eakman, M.; Stefanovic, F.; Liang, W.; Robertson, I. H.; Jindal, A.; Adams, K. N.; Berthier, E.; Haack, A. J.; Theberge, A. B.

2026-09-23 bioengineering 10.64898/2026.09.22.753625 medRxiv
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At-home sampling can address obstacles to participation in transcriptomics research. We previously developed the homeRNA and homeRNAmax platforms; these custom-designed tubes containing RNA stabilizer interface with a blood tube compatible with upper-arm blood collection devices, allowing for blood collection and RNA stabilization to occur from a participant's home. In this work we introduce homeRNAdrop, an insert for a commercially available blood tube (BD Microtainer) that divides the tube into two compartments: the top compartment holds 200 L blood and the bottom compartment holds ~590 L liquid stabilizer (RNAlater). By combining blood collection and RNA stabilization into the same tube, homeRNAdrop streamlines sample preparation for participants and allows for more compact sample storage for the lab. In a remote pilot study, n=25 participants from across the United States tested the homeRNAdrop kit. The n=23 samples successfully received by the lab show that samples collected using homeRNAdrop are of sufficient RNA quality (all RINs > 6, a common cutoff for analysis) and yield (mean yield=1.44 g) for downstream gene expression analysis. Almost all participants who successfully collected blood using the Tasso Mini device found the homeRNAdrop device easy to use (n=23/24). Overall, this work adds a simplified, user-friendly platform to the growing suite of tools for remote blood RNA stabilization.

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Redefining Delayed Graft Function: From Binary to Dynamic Using a Trajectory-Based Model to Evaluate Renal Recovery After Kidney Transplantation.

Makki, M. M.; Kumar, K.; Harutyun, D.; Kusakabe, J.; Fernandes, E.; Pinna, A.; Refaai, K.

2026-10-07 transplantation 10.64898/2026.10.04.26362581 medRxiv
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Background Delayed graft function (DGF) is among the most used metrics in transplant medicine, yet its prevailing definition-dialysis requirement within the first seven postoperative days lacks granularity and fails to capture the dynamic nature of graft recovery. It reflects a treatment decision rather than graft biology, varies by centre practice, and offers no temporal information about the pace or pattern of recovery. This study proposes a trajectory-based framework using serial serum creatinine measurements across three biologically defined time windows to capture the dynamic nature of early renal recovery. Methods We retrospectively analysed 205 adult kidney transplant recipients at Cleveland Clinic Weston Hospital in 2025. Donor groups included living donors, donation after brain death (DBD), donation after circulatory death with normothermic regional perfusion (DCD-NRP), and DCD without NRP. Creatinine slopes were estimated for Days 1-7, 7-30, and 30-90 using ordinary least-squares regression. Logistic regression assessed the predictive performance of each trajectory window for DGF, adjusting for Kidney Donor Profile Index, cold ischemia time, BMI, and donor type. Results DCD non-NRP kidneys showed negligible early creatinine decline (slope +0.02) compared to DBD (-0.71) and DCD-NRP (-0.57) grafts during Days 1-7. During Days 7-30, DCD-NRP kidneys showed accelerated recovery and converged toward DBD-level trajectories, whereas DCD non-NRP grafts remained sluggish. Predictive modelling identified the Day 7-30 trajectory had the strongest discrimination for DGF, with AUC 0.83, pseudo-R2 0.25, and the lowest AIC (181.73), outperforming Days 1-7 (AUC 0.75) and 30-90 (AUC 0.79). DGF rates were 0% in living donors, 25.5% in DBD, 20.7% in DCD-NRP, and 58.9% in DCD non-NRP recipients. Conclusions A trajectory-based creatinine model provides more informative prognostic value than the conventional binary DGF definition The Day 7-30 window periods offers the highest discriminatory power, and normothermic regional perfusion appears to favourably shift DCD kidney recovery trajectories in a manner the binary definition fails to detect.

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qPyCR: A qPCR Data Analyzer for Template Quantification and the Detection of Performance Outliers

Moore, S. D.

2026-10-09 bioinformatics 10.64898/2026.10.08.757329 medRxiv
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Motivation: Real-time qPCR data are commonly analyzed to obtain a Cq values, which are used to compare the relative abundance of a targeted template. However, improper background subtraction distorts Cq and changing the assigned threshold can alter experimental conclusions. In addition, a Cq values provide no information on the quality of the qPCR for a given sample. Alternatively, global fitting of qPCR data provides agnostic quantification without the use of Cq or thresholds, and the fitting terms provide a useful metric of reaction performance. Current implementations of global fitting are limited to custom in-house programs. Results: qPyCR is comprehensive analysis tool written in Python that performs background signal subtractions, computes a threshold, and reports Cq values in a traditional manner. The program also performs global fitting and reports template abundances along with reaction quality values. The quality values can be used to assign performance standards, which allow researchers to distinguish aberrant reactions from true changes in template abundance. Availability and Implementation: Code and example data are freely available on GitHub (https://github.com/sdmoore-labs/qPyCR) and on Zenodo (https://doi.org/10.5281/zenodo.21115342).

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A Practical Assay for Assessing Mean Red Blood Cell Age Using the Protein 4.1a/4.1b Ratio

Makhro, A.; Seiler, E.; Bender, N.; Eppenberger, P.; Hobbs-Ray, C.; Baerlocher, G.

2026-10-09 biochemistry 10.64898/2026.10.08.757720 medRxiv
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BACKGROUND: The protein 4.1a/4.1b ratio is an intrinsic molecular marker of mean red blood cell (RBC) age resulting from progressive deamidation of protein 4.1b during RBC circulation. Despite its potential for estimating mean RBC age from a single blood sample, its application has been limited by labor-intensive RBC membrane preparation, and its interindividual variability has not been characterized in a large human population. METHODS: We developed a low-volume method for direct RBC membrane isolation from whole blood using saponin permeabilization and differential centrifugation without prior RBC washing. Membrane proteins were separated by SDS-PAGE, and protein 4.1a/4.1b ratios were determined by densitometric analysis with Gaussian peak fitting. Assay conditions, sample-volume requirements, membrane protein recovery, and analytical reproducibility were evaluated. The method was subsequently applied to 114 anonymized residual samples from routine diagnostic testing selected for complete blood count parameters within the corresponding laboratory reference intervals. RESULTS: The optimized procedure used 50 uL of whole blood, 0.06% saponin, and centrifugation at 9000 g, although protein 4.1a/4.1b remained measurable from starting volumes as low as 5 uL. Mean within-subject CVs were 3.90% for electrophoretic/densitometric determination and 5.39% for membrane protein recovery; whole-procedure CVs in 3 subjects were 1.40% to 3.50%. In the population analysis, the mean protein 4.1a/4.1b ratio was 1.428 (SD 0.146), with an observed range of 1.052 to1.799 and a central 95% interval of 1.151 to 1.695. Ratios did not differ significantly between females and males (P=0.246) or among females aged 18 to 50 years, females aged >50 years, and males (P=0.151). The ratio showed modest positive correlations with chronological age in females (Spearman p=0.26, P=0.047) and males (p=0.33, P=0.015), while substantial interindividual variability remained across the age range. CONCLUSIONS: Direct isolation of RBC membranes from small volumes of whole blood enables reproducible determination of the protein 4.1a/4.1b ratio using a simplified workflow. Application of the assay to a comparatively large human population revealed substantial interindividual variation in this molecular marker of mean RBC age that was not explained by sex or chronological age alone. The method provides a practical approach for investigating biological variation in mean RBC age and its potential contribution to laboratory measurements influenced by RBC survival.

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Diagnostic Accuracy of Fine Needle Aspiration Cytology in Thyroid Diseases: Comparison with Histopathological Findings in Hawassa, Ethiopia

Nisro, A. M.; Geremew, T. T.; Tadele, A. K.; Fenta, B. D.; Engida, G. G.; Lukas, F. Y.; Tesgera, T. G.; Alem, A. T.

2026-10-21 pathology 10.64898/2026.10.16.26365726 medRxiv
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Introduction: Thyroid diseases are major health problems and among the most common endocrine disorders worldwide, including in Ethiopia. They are characterized by alterations in hormone secretion, enlargement of the thyroid gland, or both. Fine needle aspiration cytology is an important initial screening tool, and histopathologic examination is essential for the definitive diagnosis of thyroid disease. This study aimed to compare the diagnostic accuracy of fine needle aspiration cytology with histopathology in identifying thyroid diseases. Methods: A cross-sectional study was conducted at three health facilities in Hawassa City, Ethiopia, involving 304 patients who underwent both thyroid fine needle aspiration cytology and histopathologic examination of the same site between 30th October 2024 and 29th October 2025. FNAC results were classified using the Bethesda system, with histopathology as the gold standard. Data were entered into Kobo Toolbox, exported to SPSS version 27, and analyzed using cross-tabulation and chi-square ({chi}{superscript 2}) tests to determine diagnostic accuracy. Result: 304 patient records were included in the study. The fine needle aspiration cytology was determinate/diagnostic in 81.6% of cases. The study revealed the sensitivity and specificity of fine needle aspiration cytology to be 88.2% (CI 77.6-95.1%) and 94.4% (CI 90.6-97.1%), respectively. The false negative and false positive rates in this study were 2.4% and 4.4%, respectively. The positive predictive value was 80.3% (CI 68.7-89.3%), and the negative predictive value was 96.8% (CI 93.8-98.7%). The accuracy of fine needle aspiration cytology in differentiating benign from malignant thyroid lesions was 93.1%. Conclusion: FNAC demonstrated strong agreement with histopathology and remains a reliable, cost-effective first-line diagnostic tool for thyroid disease, particularly in resource-limited settings. Strengthening sample handling, ultrasound guidance, and adherence to Bethesda criteria may further improve diagnostic precision

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Quantitative Fetal Hemoglobin Measurement: GazelleTM Point-of-Care Electrophoresis versus Standard HPLC Methodology

Williams, T. N.; Connon, R.; Muhindo, R.; Amorut, D.; Ongodia, P.; Okalebo, C.; Abeso, J.; Alaroker, F.; Asio, S.; Odiit, A.; Kiyaga, C.; Uyoga, S.; Mochamah, G.; Nyutu, G.; Mogaka, C.; Muyinda, A.; Abongo, G.; Maitland, K.; Gibb, D.; Walker, A. S.; George, E. C.; Ware, R.; Olupot Olupot, P.

2026-10-05 hematology 10.64898/2026.09.30.26364074 medRxiv
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Quantitative measurement of fetal hemoglobin (HbF) using high-performance liquid chromatography (HPLC) is standard but expensive and widely unavailable in low-income settings. The newer Gazelle method, which employs single-use alkaline electrophoresis cartridges, provides a portable and relatively inexpensive potential alternative. In the current study, we tested 3055 venous blood samples collected from 1780 children with sickle cell anemia who were enrolled into the H-PRIME trial by both Gazelle and the Bio-Rad D-10 HPLC instrument, before and during hydroxyurea treatment. Data reinterpretation was required to quantify accurately high HbF values derived using the D-10. Mean (standard deviation) baseline HbF values by HPLC and Gazelle (N=2042) were 11.4% (SD 5.9%) versus 16.3% (SD 7.5%), respectively, while mean on-treatment HbF values (N=1013) were 18.9% (SD 9.0%) versus 25.4% (SD 11.5%), respectively. While overall agreement was good (Lins concordance 0.76, 95% CI 0.75-0.78), HbF values derived using Gazelle were modestly higher than HPLC values (Bland-Altman agreement mean +5.4%, 95%CI -2.4% to +13.2%), with the difference between measures increasing at higher HbF percentages. With strong concordance and more easily interpretable HbF values, Gazelle represents an attractive and inexpensive alternative to HPLC for HbF quantification in the low-income settings where most patients with sickle cell anemia live.

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Gene dosage effect and reduced core fucosylation in B lymphocytes of FUT8 heterozygous mice

Ma, Y.; Wang, J.; Liu, J.; Zhu, S.; Wang, N.; Li, Z.; Zhou, D.

2026-10-02 immunology 10.64898/2026.09.28.750819 medRxiv
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Core fucosylation (alpha1,6-fucosylation) of N-glycans, catalyzed solely by fucosyltransferase 8 (FUT8), plays important roles in development, immunity, and antibody effector functions. Here we report the generation of Fut8 floxed mice using a CRISPR/Cas9-based Extreme Genome Editing (EGE) system, in which loxP sites flank exon 8 of the Fut8 gene and a LoxP-STOP-LoxP-RFP cassette was knocked in downstream of the promoter, rendering the targeted allele functionally null before Cre-mediated recombination. Crossing floxed mice with CMV-Cre transgenic mice yielded complete knockout mice carrying the Cre-recombined allele. A PCR-based genotyping method was established that unambiguously distinguishes the wild-type, heterozygous, and homozygous genotypes (+/+, delta/+, and delta/delta). Intercrossing of heterozygous mice revealed that homozygous knockout mice die during the early postnatal period, consistent with previous reports, whereas heterozygous mice are viable. Flow cytometric analysis of AAL binding to splenic B cells and AAL lectin blotting both demonstrated markedly reduced core fucosylation in heterozygous mice (60.0 +/- 6.8% and approximately 48% of wild-type levels, respectively). These results show that disruption of a single Fut8 allele substantially reduces core fucosylation, and the mouse model described here provides a practical tool for functional studies of core fucosylation.

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The Natural Course of Peri graft Fluid Collections After Kidney Transplantation: A Serial Imaging Cohort Study.

Makki, M. M.; Davtyan, H.; Kumar, K.; Kusakabe, J.; Fernandes, E.; Antonio, P.; Refaai, K.

2026-10-20 transplantation 10.64898/2026.10.15.26364900 medRxiv
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Background. Fluid collections are common after kidney transplantation, but their prevalence at scheduled imaging and their management are inconsistent from canter to canter. We describe the cross sectional prevalence and management of perigraft collections, including an exploratory deepdrain subgroup. Methods. In this retrospective single center cohort, 146 consecutive adult kidney transplant recipients (Cleveland Clinic Weston Hospital, July 2024 to June 2025) were imaged on postoperative day 0/1 and at approximately 1 and 3 months. Routine deep drainage was avoided (n=124), 22 clinically selected recipients with perioperative anticoagulation received a deep drain. The primary outcome was cross sectional prevalence of a perigraft collection at each visit. Secondary outcomes were management among patients with a collection. Drain group comparisons were exploratory. Results. Collections were present in 29 of 146 recipients at postoperative day 0/1 (19.9%; 95% CI, 14.2 to 27.1), 71 of 146 at 1 month (48.6%; 95% CI, 40.7 to 56.7), and 34 of 146 at 3 months (23.3%; 95% CI, 17.2 to 30.8). Prevalence in the no drain group was 21.0%, 50.0%, and 23.4%, respectively; corresponding prevalence in the deep drain group was 13.6%, 40.9%, and 22.7%. Between group prevalence comparisons were not statistically significant at any time point. BMI was higher in the deep-drain group than in the no-drain group (30.04 vs 27.1 kg/m2; P=0.01). Among patients with a 1-month collection, management did not differ significantly between groups (any invasive management, 11.1% vs 16.1%; P=1.00). Among patients with a 3month collection, invasive management was more common in the deep drain group than in the no drain group (80.0% vs 13.8%; P=0.007). This comparison included only five deep-drain recipients and was confounded by clinical selection, perioperative anticoagulation, and BMI imbalance. Conclusions. Perigraft collection prevalence was highest at 1 month and lower at 3 months in this predominantly no drain cohort. Most collections were managed conservatively, and invasive treatment was uncommon in the no-drain group. The deep drain subgroup provides clinically relevant information about high risk recipients selected for drainage but cannot support causal conclusions regarding drain benefit or harm. Patient level linkage is required to distinguish persistence, resolution, and new collection formation.

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Thyroid Dysfunction in Male Patients at Asia Med Laboratory, Herat, Afghanistan July 2021-Jan 2022

Tamkin, N.; Habibi, M.; Leming, M.

2026-09-24 pathology 10.64898/2026.09.19.752850 medRxiv
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Objective: Hyperthyroidism and hypothyroidism related to iodine deficiency are major public health concerns in Afghanistan. This study aimed to assess the frequency of thyroid dysfunction among male patients referred for thyroid testing and its association with age, and to examine monthly trends in thyroid dysfunction at Asia Med Laboratory in Herat, Afghanistan, from July 2021 to January 2022. Methods: A retrospective analysis was conducted on 250 male patients aged 0-69 years. We measured Serum TSH, total T4, and total T3 levels, and thyroid status was classified using age specific reference ranges. In addition, the frequency of thyroid dysfunction was analyzed across age groups with monthly trends of thyroid state. Results: Overall, the euthyroid state consisted of 69.2% of participants, 24.8% with overt hypothyroidism, 3.2% with overt hyperthyroidism, and 2.8% with subclinical hyperthyroidism. Thyroid status differed significantly by age (p = 0.0135), with hypothyroidism increasing in older age groups and reaching its highest proportion among men aged 60-69 years (55.6%). Euthyroidism predominated in patients aged 10-39 years, while hyperthyroidism across age groups remained relatively infrequent. After September 2021, a threefold increase was observed in the total number of male patients referred for thyroid testing. During this period, the proportion of hyperthyroidism increased slightly, whereas hypothyroidism cases declined. Conclusion: In conclusion, hypothyroidism was more frequent with older age. The rise in absolute case numbers after September 2021 likely reflects increased patient referrals, underscoring the need for ongoing monitoring of thyroid function. The study may assist in the early management of thyroid disorders and in reducing their complications.

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A Research-Integrated Curriculum on CAR-T Cell Therapy

Khan, Y. H.; Rice, L.; Srougi, M. C.

2026-09-28 cancer biology 10.64898/2026.09.23.753877 medRxiv
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Chimeric antigen receptor (CAR) T cells are patient-derived T cells engineered to recognize specific antigens on malignant cells, representing a major breakthrough in personalized cancer immunotherapy. While CAR-T cell therapy is an established treatment for relapsed or refractory hematologic malignancies, understanding the rationale and methodology behind its development is essential for training the next generation of oncology researchers. Here, we describe a novel, hands-on small-enrollment laboratory course designed to teach upper-level undergraduate and graduate students about immunotherapies and CAR-T cell technology by paralleling a typical bench-scale development process. Students isolated T cells from porcine peripheral blood mononuclear cells (PBMCs) via immunomagnetic selection, followed by flow cytometry to assess purity, viability, and yield. Students then used pre-engineered B7H3 CAR-T cells to perform co-culture assays with U87 glioblastoma cells to evaluate tumor cell killing efficacy. Cytotoxicity was qualitatively evaluated using immunofluorescence microscopy, while IFN-gamma release was quantified using Enzyme-linked Immunosorbent Assay (ELISA). Student performance was evaluated through electronic laboratory notebooks, discussion questions, a capstone project, and student-generated data. Our results demonstrate students high academic performance across assignments and the successful execution of complex laboratory workflows. Collectively, these findings establish the feasibility and implementation of a research-integrated curriculum providing foundational exposure to immuno-oncology research tools and CAR-T cell production techniques.

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A Device That Combines Light Attenuation And Scattering For The Measurements Of Optically Dense Algal Cultures In Cell Culture Flasks.

Perez-Loera, J. A.; Zavala, M.; Zavafer, A.

2026-09-28 bioengineering 10.64898/2026.09.25.754582 medRxiv
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Studying algae requires specialized equipment to characterize culture growth and physiological performance and non-invasive monitoring of these cultures typically relies on optical density (OD) measurements. Currently, OD is often measured using standard spectrometers that suffer from detector saturation at high cell densities, which requires time consuming sample dilutions and lacks compatibility with flat-walled cell culture flasks like Roux bottles. Here we describe a 3D-printable device to measure optically dense algal cultures directly within these cultivation vessels. This instrument combines light attenuation and scattering, resulting in a dual-sensor system that utilizes near-infrared light (950 nm) to precisely quantify biomass without interference from changing photosynthetic pigments. Cultures that reach high cell densities can be assumed to be accurately quantified in situ using the scattered signal, preserving the integrity of the culture and eliminating the need for subsampling. This method is adaptable to the most common geometries of Roux bottles (T-25, T-75, and T-175) and could be used to monitor small-scale batch cultures without contamination risks. A cyanobacteria algal species (Limnospira platensis) and three flask sizes were analysed on light attenuation linearity and scattering detection limits at different cell concentration, demonstrating that the light attenuation module can reliably measure biomass up to an OD of 3.1 (equivalent to >1.5 g/L) without requiring dilution.

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Macrophages from Holstein and Normande cows respond differently to Escherichia coli and Streptococcus uberis

Ferter, M.; Gitton, C.; Bamu, D. F.; Gaborit, M.; Germon, P.

2026-10-06 pathology 10.64898/2026.09.29.755538 medRxiv
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Macrophages, alongside mammary epithelial cells, are major contributors to the innate immune response triggered by bacterial invasion of the mammary gland. To investigate breed-specific immune mechanisms, we stimulated monocyte-derived macrophages from Holstein and Normande cattle with Escherichia coli and Streptococcus uberis, two major mastitis pathogens. We monitored bacterial survival using [methode] and profiled gene expression via RNA-seq. E. coli exhibited significantly higher survival 6 hours post-infection compared to S. uberis (p < 0.05). Moreover, E. coli induced a robust transcriptional response, with 4403 differentially expressed genes (FDR < 0.05, |log2FC| > 1), versus only 813 for S. uberis. Qualitative differences were also observed: genes such as CCL2 and CSF1 were uniquely induced by S. uberis. Additionally, macrophages from Holstein and Normande cattle showed distinct expression profiles: 185, 45, and 174 genes were differentially expressed at steady state or after E. coli or S. uberis stimulation, respectively. These genes were enriched in immune-related pathways. Overall, our results demonstrate a stronger response to E. coli, although S. uberis specifically induces a subset of genes. The observed breed-specific differences may reflect underlying immune mechanisms that could influence disease susceptibility, warranting further functional validation.