SOLUTION

Thrombosis, a localized clotting of the blood leading to the obstruction of the arterial or the venous circulation, is a pan-vascular issue that crosses the borders of all medical specialties. It is a critical clinical concern for a wide range of physician audiences and is one of the deadliest serial killers in our societies: 1 in 4 deaths worldwide is caused by a thromboembolic disorder, and millions of patients suffer, or are at risk of suffering from such disorders, potentially lethal or disabling.

Thrombosis may occur in any vascular territory and organ. Most prominent consequences are when it occurs in the brain (causing the majority of stroke), in the heart (mostly in the coronary arteries, with myocardial infarction being the most severe complication), or in deep veins and pulmonary arteries (causing pulmonary embolism).

Thrombosis may be associated with factors (such as smoking) and other conditions such as pregnancy, cancer – of which thrombosis is the second cause of mortality – or with some surgical or medical therapies.

Conventional coagulation tests, which are mostly performed to investigate abnormal bleeding or to monitor anticoagulant pharmacological activity, do not inform on actual in vivo coagulation status and are insufficient to detect and assess the procoagulant states that will initiate and precipitate thromboembolic events.

Nor do they inform on the specific prothrombotic mechanisms, including potential intertwining with other biological systems (e.g. inflammation), underlying those thromboembolic events, whose knowledge may help in personalizing patient management.

These tests are either limited to the investigation of certain biochemical stages of the “coagulation cascade”, which do not reflect the reality of coagulation in vivo, or they are cellular tests (e.g. platelet aggregation), or global, which do not take into account the complexity of the prothrombotic mechanisms.

As a result, diagnostic delays – with high risks of death or disability – or the use of more invasive treatments – with risks of complications – or more costly (e.g. angiograms, undue hospitalizations).

To address hemostasis and thrombosis complexity in a clinically useful way, Emosis relies on flow cytometry, a powerful technique that revolutionized clinical hematology (e.g. phenotyping of leukemia) and immunology (e.g. HIV).

In flow cytometry, single cells are passed through one or more laser beams, where the light scatter (indicating cell size and granularity) and signal intensity from different fluorescently labeled markers bound to the cell can be measured.

Conventional assays, whether related to coagulation or platelet function, are bulk assays measuring average values over heterogeneous sets of molecules or populations of cells.
In contrast, flow cytometry enables a granular assessment of platelet activation through the measurement of 10 to 20 variables per single cells (e.g. platelets), over tens of thousands of cells (platelets) within second.

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