Cellular diagnostics: A challenge for laboratory medicine

Abstract

Summary: Investigating cells for genetic features, malignant transformation, surface characteristics, metabolic functions and signalling will be future key elements for diagnosis of diseases. Integrating this new area into Laboratory Medicine will add new competence and responsibility to Clinical Biochemistry and Laboratory Medicine. Cellular genetics will be a main area for the diagnostic laboratory to investigate risk and prognosis for diseases having also impact on a more individualised medication. With the introduction of flow cytometry a more objective way of cell identification by immunophenotyping was added to classical microscopy allowing accurate classification of leukaemias. In addition the functional status and the origin of blood cells or cells in other body fluids (liquor, ascites) can now easily be detected. Cell mediated immunity plays an important role in infectious diseases and in transplantation medicine. The CD4/CD8 ratio of T-lymphocytes is already a routine test for differentiation between viral infection and rejection crises and for monitoring of these conditions. In cellular coagulation platelet function tests will add value to the established plasma tests. The dosage of drugs is now monitored by measuring the blood levels of drugs or their metabolites. In addition investigating the direct effect of drugs on targeted cell functions might be a more specific way.