Proximity Ligation Assay: From a Foundational Principle to a Versatile Platform for Molecular and Translational...

The precise analysis of protein interactions in their native cellular context and the sensitive quantification of protein abundance in biological fluids are both fundamental to understanding health and disease. Traditional methods for cellular imaging and biochemical quantification often face limitations in specificity, sensitivity, or the preservation of spatial information. The proximity ligation assay (PLA) is a versatile technological platform developed to overcome these challenges by converting protein recognition events into amplifiable DNA signals, thereby achieving exceptional sensitivity. This foundational principle has given rise to two major formats: in situ PLA (isPLA) and solution-phase PLA. In basic research, isPLA provides high-resolution visualization of protein-protein interactions (PPIs), post-translational modifications (PTMs), and subcellular architecture directly within fixed cells and tissues. In translational and clinical applications, solution-phase PLA enables the highly sensitive quantification of low-abundance biomarkers in liquid samples, which is critical for diagnostics and prognostics in fields such as oncology, neuroscience, and infectious diseases. This review discusses the foundational principles, development, and diverse applications of PLA platforms. We also highlight significant technological advancements, including the development of high-throughput formats, integration with advanced readouts, and the use of alternative affinity reagents. These innovations continue to transform PLA from a targeted validation method into a powerful and multifaceted platform for both fundamental systems biology and clinical diagnostics.