AUTHOR=Arnaout Ramy A. , Prak Eline T. Luning , Schwab Nicholas , Rubelt Florian , the Adaptive Immune Receptor Repertoire Community , Arnaout Ramy A. , Arora Rohit , Bashford-Rogers Rachael , Breden Felix , Bukhari Syed Ahmad Chan , Corrie Brian , Cowell Lindsay G. , Efroni Sol , Gooley Christopher , Greiff Victor , Heiden Jason Vander , Koguchi Yoshinobu , Langerak Ton , Lim Theam Soon , Prak Eline Luning , Mariotti-Ferrandiz Encarnita , Marquez Susanna , Meysman Pieter , Miho Enkelejda , Motwani Keshav , Nouri Nima , Pavlović Milena , Rubelt Florian , Sandve Geir Kjetil , Schwab Nicholas , Snapkov Igor , Soto Cinque , Stervbo Ulrik , Trück Johannes , van den Ham Henk-Jan , Watson Corey , Weber Cédric R. TITLE=The Future of Blood Testing Is the Immunome JOURNAL=Frontiers in Immunology VOLUME=12 YEAR=2021 URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.626793 DOI=10.3389/fimmu.2021.626793 ISSN=1664-3224 ABSTRACT=

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.