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The CELL clinic, a new-generation clinical platform to support "cell-based interceptive medicine" for the ultra-early detection and treatment of diseases

The modus operandi of the CELL clinic, which currently stands at an early stage of development, is to recruit apparently healthy subjects and regularly submit them to normal blood draw for isolation of peripheral blood mononuclear cells (PBMC) that are then profiled by combining cell sorting with a panel of recombinant antibodies (FABs) and ultra-high sensitivity mass spectrometry. Proteome profiling serves to monitor modulations of protein complexes in specific blood cells, where changes are easily detected and useful for prediction of different diseases. Because these proteome changes reflect the initial stage of a disease, their detection permits to initiate treatment early. Drugs that have been discovered and validated at the clinic or via our collaborators are used to reprogram the proteome as an early treatment of the disease, before symptoms and tissue damage have occurred. This ultra-early approach to disease detection is consequently oriented towards prevention.

The cell is the fundamental unit of life. The human body is formed of about 37,2 trillion cells that come from the fusion and successive division and differentiation of two progenitor cells that develop multiple gene expression programs for specifying the identity of growing tissues and organs. Evidence has emerged that the cause of many diseases is the result of gene expression disturbances in certain cells that progressively lead to dysfunctional tissues. Detecting cell disturbances at the origin of diseases, before symptoms and tissue damage are present, is key to the development of therapies that can intercept disease progression. This is the objective of a novel medical paradigm named cell-based interceptive medicine that is being implemented in Québec/Canada by the Institut de Recherches Cliniques de Montréal (IRCM)-leaded 37TrillionCells initiative ( 37trillioncells.com ).

In cell-based interceptive medicine, early detection and interception of diseased cells is achieved through application of single-cell multiomic technologies and the data is exploited to develop novel therapeutic and curative avenues. The CELL clinic is aimed at early detection of disease by conducting a longitudinal analysis of apparently healthy subjects and at the development of therapies to rewire gene expression programs of diseased cells. Gene expression rewiring has the ability to interfere with disease progression and restore normal functions. The CELL clinic is intended to regroup a number of academic and industrial scientists specialized in basic research and clinical intervention and applying leading-edge technologies to reprogram gene expression networks, restore normal cell function, and implement treatments to cure patients. A key operational element of the CELL clinic is the development and use of powerful artificial intelligence (AI) algorithms and software to assist predictive diagnosis with unprecedented efficiency and precision. Strategies such as small-molecule screening, immunotherapy, gene editing, and other emerging technologies will be deployed at the single-cell level to rewire gene expression networks. This unique endeavor will contribute to position participating institutions at the forefront of research on disease mechanisms. It will also contribute to reinforce their role as key players for the design and implementation of novel medicines to prevent and treat various diseases.