Why current quantitative serology is not quantitative and how systems immunology could provide solutions

Area of Science:

• Immunology
• Medical Diagnostics
• Serology

Background:

• Medical serology aims to detect antibodies against various antigens.
• Standardization efforts led to the term "quantitative serology" due to arbitrary units.
• Current serological tests lack universal standardization for results.

Purpose of the Study:

• To critically evaluate the use of the term "quantitative serology" for current diagnostic methods.
• To propose a more accurate terminology for existing serological assays.
• To explore the potential of a systems immunology approach in advancing serological measurements.

Main Methods:

• Literature review and critical analysis of current serological testing practices.
• Discussion of the limitations of arbitrary units in antibody determination.
• Exploration of the theoretical framework for a systems immunology-driven quantitative serology.

Main Results:

• Current serological tests, despite using arbitrary units, are not truly quantitative.
• Each test and antibody isotype employs unique reference ranges, precluding direct quantitative comparison.
• The term "semiquantitative" accurately reflects the nature of current serological assays.

Conclusions:

• The term "quantitative serology" is a misnomer for existing antibody detection methods.
• "Semiquantitative serology" is a more appropriate description for current assays.
• Developing truly quantitative serology could be facilitated by and, in turn, advance a systems immunology perspective.