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Updated: Feb 7, 2026

Prediction of Red Blood Cell Antibody Significance Using the Monocyte-Macrophage Assay
Published on: February 7, 2025
Paper-based fluorescent assay for blood typing and antibody titer determination using long-term ambient-stored
Yuxuan Li1,2, Yulong Zhang1, Shengqiang Liang3
1Academy of Military Medical Sciences, Beijing, China.
None:
Methods for accurate, rapid blood typing and antibody titration at the point of care are constrained by cold-chain dependent red blood cell (RBC) reagents, time-consuming serial dilutions, and subjective visual interpretation. To overcome these limitations, here we develop a method based on bioengineered red-blood cells. We engineer hemoglobin-depleted RBC membranes that preserve ABO surface antigens, label them with fluorescent nanoparticles, and lyophilize them, demonstrating at least 2 years of stability at room-temperature. We capture hemagglutination on a dual-layer paper pad and quantify it by fluorescence in approximately 8 minutes, eliminating the need for serial dilution. We conduct a registered clinical trial (ChiCTR2300078864) and benchmark performance against the gel microcolumn assay. In a clinical cohort (n = 641), ABO typing achieves 100% concordance. In antibody-titration samples, quantitative titers agree with the gel microcolumn assay (coincidence 80.75%, κ = 0.8623). In summary, we develop a cold-chain-independent, handheld paper-based assay that enables simultaneous ABO grouping and quantitative antibody titration with clinical-grade performance, supporting scalable manufacturing, cross-site standardization, and transfusion decision-making in emergency and resource-limited settings.
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