We present a high-throughput screening Raman spectroscopy (HTS-RS) platform for a rapid and label-free macromolecular fingerprinting of tens of thousands eukaryotic cells. The newly proposed label-free HTS-RS platform combines automated imaging microscopy with Raman spectroscopy to enable a rapid label-free screening of cells and can be applied to a large number of biomedical and clinical applications. The potential of the new approach is illustrated by two applications. (1) HTS-RS-based differential white blood cell count. A classification model was trained using Raman spectra of 52 218 lymphocytes, 48 220 neutrophils, and 7 294 monocytes from four volunteers. The model was applied to determine a WBC differential for two volunteers and three patients, producing comparable results between HTS-RS and machine counting. (2) HTS-RS-based identification of circulating tumor cells (CTCs) in 1:1, 1:9, and 1:99 mixtures of Panc1 cells and leukocytes yielded ratios of 55:45, 10:90, and 3:97, respectively. Because the newly developed HTS-RS platform can be transferred to many existing Raman devices in all laboratories, the proposed implementation will lead to a significant expansion of Raman spectroscopy as a standard tool in biomedical cell research and clinical diagnostics.

Existing approaches for early-stage bladder tumor diagnosis largely depend on invasive and time-consuming procedures, resulting in hospitalization, bleeding, bladder perforation, infection and other health risks for the patient. The reduction of current risk factors, while maintaining or even improving the diagnostic precision, is an underlying factor in clinical instrumentation research. For example, for clinic surveillance of patients with a history of noninvasive bladder tumors real-time tumor diagnosis can enable immediate laser-based removal of tumors using flexible cystoscopes in the outpatient clinic. Therefore, novel diagnostic modalities are required that can provide real-time in vivo tumor diagnosis. Raman spectroscopy provides biochemical information of tissue samples ex vivo and in vivo and without the need for complicated sample preparation and staining procedures. For the past decade there has been a rise in applications to diagnose and characterize early cancer in different organs, such as in head and neck, colon and stomach, but also different pathologies, for example, inflammation and atherosclerotic plaques. Bladder pathology has also been studied but only with little attention to aspects that can influence the diagnosis, such as tissue heterogeneity, data preprocessing and model development. The present study presents a clinical investigative study on bladder biopsies to characterize the tumor grading ex vivo, using a compact fiber probe-based imaging Raman system, as a crucial step towards in vivo Raman endoscopy. Furthermore, this study presents an evaluation of the tissue heterogeneity of highly fluorescent bladder tissues, and

Neutrophils are important cells of the innate immune system and the major leukocyte subpopulation in blood. They are responsible for recognizing and neutralizing invading pathogens, such as bacteria or fungi. For this, neutrophils are well equipped with pathogen recognizing receptors, cytokines, effector molecules, and granules filled with reactive oxygen species (ROS)-producing enzymes. Depending on the pathogen type, different reactions are triggered, which result in specific activation states of the neutrophils. Here, we aim to establish a label-free method to indirectly detect infections and to identify the cause of infection by spectroscopic characterization of the neutrophils. For this, isolated neutrophils from human peripheral blood were stimulated in an in vitro infection model with heat-inactivated Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli) bacterial pathogens as well as with heat-inactivated and viable fungi (Candida albicans). Label-free and nondestructive Raman spectroscopy was used to characterize neutrophils on a single cell level. Phagocytized fungi could be visualized in a few high-resolution false color images of individual neutrophils using label-free Raman spectroscopic imaging. Using a high-throughput screening Raman spectroscope (HTS-RS), Raman spectra of more than 2000 individual neutrophils from three different donors were collected in each treatment group, yielding a data set of almost 20 000 neutrophil spectra. Random forest classification models were trained to differentiate infected and noninfected cells with high accuracy (90%). Among the neutrophils challenged with pathogens, even the cause of infection, bacterial or fungal, was predicted correctly with 92% accuracy. Therefore, Raman spectroscopy enables reliable neutrophil phenotyping and infection diagnosis in a label-free manner. In contrast to the microbiological diagnostic standard, where the pathogen is isolated in time-consuming cultivation, this Raman-based method could potentially be blood-culture independent, thus saving precious time in bloodstream infection diagnostics.

Raman spectroscopy has been widely used in clinical and molecular biological studies, providing high chemical specificity without the necessity of labels and with little-to-no sample preparation. However, currently performed Raman-based studies of eukaryotic cells are still very laborious and time-consuming, resulting in a low number of sampled cells and questionable statistical validations. Furthermore, the approach requires a trained specialist to perform and analyze the experiments, rendering the method less attractive for most laboratories. In this work, we present a new high-content analysis Raman spectroscopy (HCA-RS) platform that overcomes the current challenges of conventional Raman spectroscopy implementations. HCA-RS allows sampling of a large number of cells under different physiological conditions without any user interaction. The performance of the approach is successfully demonstrated by the development of a Raman-based cell viability assay, i.e., the effect of doxorubicin concentration on monocytic THP-1 cells. A statistical model, principal component analysis combined with support vector machine (PCA-SVM), was found to successfully predict the percentage of viable cells in a mixed population and is in good agreement to results obtained by a standard cell viability assay. This study demonstrates the potential of Raman spectroscopy as a standard high-throughput tool for clinical and biological applications.