First-of-its-kind device profiles newborns’ immune function

Researchers from the Singapore-MIT Alliance for Research and Technology (SMART), MIT’s research enterprise in Singapore, along with colleagues from KK Women’s and Children’s Hospital (KKH), have developed a first-of-its-kind device to profile the immune function of newborns.   Using a single drop of blood, the BiophysicaL Immune Profiling for Infants (BLIPI) system provides real-time insights into newborns’ immune responses, enabling the early detection of severe inflammatory conditions and allowing for timely interventions. This critical innovation addresses the urgent and unmet need for rapid and minimally invasive diagnostic tools to protect vulnerable newborns, especially those born prematurely. Critical unmet need in newborn care Premature infants are particularly vulnerable to life-threatening conditions such as sepsis and necrotizing enterocolitis (NEC). Newborn sepsis — a bloodstream infection occurring in the first weeks of life — is a major global health challenge, causing up to 1 million infant deaths worldwide annually. NEC, a serious intestinal disease that causes severe inflammation, is one of the leading causes of death in premature babies — up to 50 percent of low-birth -eight neonates who get NEC do not survive. Infants can show vague symptoms, making diagnosis of these conditions challenging. However, both conditions can worsen rapidly and require immediate medical intervention for the best chance of recovery. Current diagnostic methods to detect and prevent these serious conditions in newborns rely on large blood samples — up to 1 milliliter, a significant quantity of blood for a newborn — and lengthy laboratory processes. This is not ideal for newborns whose total blood volume may be as little as 50 ml among very premature infants less than 28 weeks old, which limits repeated or high-volume sampling and can potentially lead to anemia and other complications. At the same time, conventional tests — such as blood cultures or inflammatory panels — may take hours to days to return actionable results, limiting prompt targeted clinical interventions. The novel BLIPI device addresses these challenges by requiring only 0.05 ml of blood and delivering results within 15 minutes. Revolutionizing newborn care In a study, “Whole blood biophysical immune profiling of newborn infants correlates with immune responses,” published in Pediatric Research, the researchers demonstrated how BLIPI leverages microfluidic technology to measure how immune cells change when fighting infection by assessing their size and flexibility. Unlike conventional tests that only look for the presence of germs, BLIPI directly shows how a baby’s immune system is responding. The cell changes that BLIPI detects align with standard tests doctors rely on, including C-reactive protein levels, white blood cell counts, and immature-to-total neutrophil ratios. This testing format can quickly reveal whether a baby’s immune system is fighting an infection. In the study, BLIPI was used to screen 19 infants at multiple time points — eight full-term and 11 preterm — and showed clear differences in how immune cells looked and behaved between the babies. Notably, when one premature baby developed a serious blood infection, the device was able to detect significant immune cell changes. This shows its potential in detecting infections early. The work was led by researchers from the Critical Analytics for Manufacturing Personalized-Medicine (CAMP) and Antimicrobial Resistance (AMR) interdisciplinary research groups within SMART. Just one drop of blood BLIPI is a portable device that can give results at the ward or the neonatal intensive care units, removing the need for transporting blood samples to the laboratory and making it easily implementable in resource-limited or rural health-care settings. Significantly, BLIPI needs just one drop of blood, and 1/20 the blood volume than what existing methods require. These swift results can help clinicians make timely, lifesaving decisions in critical situations such as sepsis or NEC, where early treatment is vital. “Our goal was to create a diagnostic tool that works within the unique constraints of neonatal care — minimal blood volume, rapid turnaround, and high sensitivity. BLIPI represents a major step forward by providing clinicians with fast, actionable immune health data using a noninvasive method, where it can make a real difference for newborns in critical care,” says Kerwin Kwek, research scientist at SMART CAMP and SMART AMR, and co-lead author of the study. “BLIPI exemplifies our vision to bridge the gap between scientific innovation and clinical need. By leveraging microfluidic technologies to extract real-time immune insights from whole blood, we are not only accelerating diagnostics but also redefining how we monitor immune health in fragile populations. Our work reflects a new paradigm in point-of-care diagnostics: rapid, precise, and patient-centric,” says MIT Professor Jongyoon Han, co-lead principal investigator at SMART CAMP, principal investigator at SMART AMR, and corresponding author of the paper. “KKH cares for about two-thirds of all babies born weighing less than 1,500 grams in Singapore. These premature babies often struggle to fight infections with their immature immune systems. With BLIPI, a single prick to the baby’s finger or heel can give us rapid insights into the infant’s immune response within minutes. This allows us to tailor treatments more precisely and respond faster to give these fragile babies the best chance at a healthy start not just in their early days, but throughout their lives,” says Assistant Professor Yeo Kee Thai, senior consultant at the Department of Neonatology at KKH, and senior author of the study. Future research will focus on larger clinical trials to validate BLIPI’s diagnostic accuracy across diverse neonatal populations with different age groups and medical conditions. The researchers also plan to refine the device’s design for widespread adoption in hospitals globally, bringing a much-needed diagnostic solution for vulnerable infants at their cot side. Beyond hospitals, pharmaceutical companies and researchers may also leverage BLIPI in clinical trials to assess immune responses to neonatal therapies in real-time — a potential game-changer for research and development in pediatric medicine. The research conducted at SMART is supported by the National Research Foundation Singapore under its Campus for Research Excellence and Technological Enterprise program. This collaboration exemplifies how Singapore brings together institutions as part of interdisciplinary, multi-institution efforts to advance technology for global impact. The work from KKH was partially supported by the Nurturing Clinician Scientist Scheme under the SingHealth Duke-NUS Academic Clinical Programme.