Shear flow deformability cytometry: A microfluidic method advancing towards clinical use - A review

Abstract

Background: Shear flow deformability cytometry is an emerging microfluidic technique that has undergone significant advances in the last few years and offers considerable potential for clinical diagnostics and disease monitoring. By simultaneously measuring mechanical and morphological parameters of single cells, it offers a comprehensive extension of traditional cell analysis, delivering unique insight into cell deformability, which is gaining recognition as a novel biomarker for health and disease. Due to its operating principle, the method is particularly suitable for the clinical analysis of blood samples.

Results: This review focuses on the recent developments in shear flow deformability cytometry, which is a widely adopted variant of deformability cytometry. It has a strong potential for applications in clinical practice due to its robust and simple operation, demonstrated applications with whole blood samples, as well as its high throughput, which can reach approximately 1000 cells per second. We begin by discussing some basic factors that influence the mechanical properties of cells and give an overview of deformability cytometry and its operational principles for samples from blood, cultured cells and tissues. Next, we review recent clinically relevant applications in analysis of blood and cancer cells. Finally, we address key challenges to clinical adoption, such as regulatory approval, scalable manufacturing, and workflow integration, emphasizing the need for further validation studies to facilitate clinical implementation.

Significance: This article uniquely emphasizes the clinical relevance of microfluidic shear flow deformability cytometry, by giving an overview of mechanical and morphological biomarkers studied in clinically significant samples. In addition, it addresses critical barriers to clinical translation. By identifying these obstacles, this article aims to demonstrate the potential of deformability cytometry to bridge the gap between the research and the routine medical practice.

Keywords: Blood analysis; Cell mechanics; Clinical method; Deformability cytometry; Disease; Mechanical biomarkers; Microfluidics; Single-cell.