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Harnessing T Cells To Detect Disease

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Adaptive Biotechnologies recently received FDA Emergency Use Authorization (EUA) for T-Detect™ COVID, a test that detects the unique T-cell signature specific to SARS-CoV-2. T-Detect COVID is the first clinical test launched from Adaptive’s TCR-Antigen Map collaboration with Microsoft, highlighting the potential of using T cells in the blood to detect multiple diseases.

To learn more about T-Detect, its development and how it compares to antibody testing, Technology Networks spoke to Dr Sudeb Dalai, senior medical director at Adaptive Biotechnologies. In this interview, Sudeb also discusses the role that T-cell analysis may play in the diagnosis and treatment of diseases in the future.  

AM: Can you tell us about the TCR-Antigen Map and the role it played in the development of T-Detect?

In 2018, we partnered with Microsoft to build a map of the immune system called the TCR-Antigen Map. This approach uses immunosequencing, proprietary computational modeling, and machine learning to map T-cell receptor sequences to disease-associated antigens for infectious diseases, autoimmune disorders and cancer.

So, when the pandemic hit, we were able to 
expand our work with Microsoft to search for the unique immune signature of SARS-CoV-2 and eventually develop a diagnostic for COVID-19.

AM: Can you tell us more about the T-Detect COVID test and how it could be used during the pandemic to help understand immunity? 

T-Detect COVID is the first in a new class of tests to receive FDA EUA for recent or prior COVID-19 infection. T-Detect takes an entirely new approach to determining past infection by looking at an individual’s T-cell immune response to SARS-CoV-2, the virus that causes COVID-19. The test works by looking at the T-cell response to a broad portion of the virus. Antibody tests look at the immune response to only specific parts of the virus, like the spike protein.

T-Detect COVID correctly confirmed recent or prior COVID-19 infections 97.1% of the time from date of RT-PCR diagnosis with 100% specificity. Because of the way that the technology works, we are able to tease out vaccine response from a primary infection – but this is not part of the current T-Detect COVID result.  

AM: How does T-cell testing compare to antibody testing? What has so far limited greater development and adoption of T-cell tests, compared to antibody tests?

Every disease has its own unique T-cell signature, and T cells arise earlier than antibodies and persist in the blood for longer. T-Detect COVID outperformed leading antibody tests in real-world studies. In a study, 5+ months after an initial PCR diagnosis, T-Detect COVID detected 95% of SARS-CoV-2-positive patients, while antibody tests had a range of 52-71% in detection of SARS-CoV-2-positive patients.

What you’re seeing is the result of the incredibly hard work of our team and the Microsoft team to make this happen from confirming the T-cell signature for COVID to putting the process and infrastructure in place to support this first in class test. Now that it is in place, we can build on this for future indications. 

AM: How important do you think T-cell analysis will become for diagnosing and treating diseases in the future?

T-cell analysis will become even more important in the future. We’ve proven with T-Detect COVID that it is possible to read how T cells detect disease in the blood, and this is just the beginning of a pipeline of tests for many other disease indications

As we continue in this endeavor with Microsoft, we are rapidly learning more that will enable us to use T cells to diagnose thousands of other diseases.

Understanding the adaptive immune system is not only an important step in diagnosing many different diseases but also may ultimately help to develop novel, immune-based treatments.

AM: Can you explain the concept of “Immune Medicine” and the advantages this approach has? 

The adaptive immune system is a force inside your body so powerful it’s able to detect disease and fight it, often before you even realize that you’re sick. We are harnessing this vast system of biology to unleash its power as a natural diagnostic and therapeutic tool to propel a paradigm shift in medicine. We call this Immune Medicine.

We believe the adaptive immune system is nature’s most finely tuned diagnostic and therapeutic for most diseases. Our proprietary immune medicine platform reads and translates the massive genetics of the adaptive immune system into data with scale, precision and speed. We apply AI, machine learning and cloud computing to this to help us turn data into tools for research and diagnostic tests and treatments for patients. This makes up our three business areas: life science research, clinical diagnostics and drug discovery.

We have been able to demonstrate the real power of technology in the life sciences by taking a vast system of biology and translating it into data, fueling a clinical diagnostics and therapeutics engine that could transform the way we diagnose and treat disease. 

Sudeb Dalai was speaking to Anna MacDonald, Science Writer for Technology Networks.