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A beginner’s guide to Nightingale’s technology

Nightingale's technology is widely used in research and industrial R&D. We're also taking steps towards offering our blood analysis service to healthcare providers. This beginner's guide explains the fundamentals of our technology.

Why the world needs a better blood test

Most of us expect to be given a blood test at some stage in our lives, usually as part of a routine health check-up, but surprisingly few people are aware that blood tests have changed very little since first being introduced. Clinics typically use blood tests that measure a fraction of the molecules present in your blood. This might sound reasonable enough – for example, for many people, just finding out if your blood glucose levels are higher or lower than normal might give you an indication that you’re developing diabetes. However, over time researchers have realized that the information gained from routine blood tests is simply not enough. In fact, it’s estimated that around half of all people that suffer a cardiovascular incident (e.g. a heart attack) have “normal” cholesterol levels when tested by their doctors. 

To improve the diagnostics used for chronic conditions like diabetes and cardiovascular diseases, clinicians need to have accurate and detailed biological information. The current 4-5 molecules detected by routine blood cholesterol tests (i.e. blood biomarkers - molecules in the body that indicate disease) often fail to spot diseases before they progress, resulting in serious complications for patients. The consequences can be extremely damaging, for example there’s recently been a large increase in the number of amputations resulting from type 2 diabetes. 

The lack of information from blood tests contributes to a wider issue – our unsustainable global healthcare system. Currently the number of people diagnosed with type 2 diabetes and cardiovascular disease is increasing, placing a financial and social heavy burden on governments. 

Nightingale aims to help researchers and clinicians to tackle chronic diseases through our innovative blood analysis service. Our technology incorporates specially developed analysis software and experimental methods to accurately generate health measurements from blood, laying down the foundations for disease prediction. The data produced from our service can also be used to help guide clinicians in deciding who should receive different drug treatments for diabetes and CVD, and to detect minute changes in a patient’s blood that may signal the risk of developing other diseases (e.g. non-alcoholic fatty liver disease). 

Blood testing 2.0 

To help overcome the problems clinicians face in diagnosing patients, Nightingale provides a technique that measures a far wider range of biomarkers than the number currently used.

Our blood test uses an analytical technique called nuclear magnetic resonance (NMR) spectroscopy. NMR instruments detect the different molecules present in a blood sample, with readings providing information on the overall composition and concentration of the molecules. NMR instruments exploit the magnetic properties of atoms to measure radiowave resonance, magnetic field fluctuations caused by the behavior of different molecules. Resonance from all the different molecules in the blood sample is then converted and combined into a spectrum that Nightingale’s software (using advanced statistical methods) can convert into a measurement. This meaningful measurement can tell us the concentration levels of different molecules present in a blood sample.

We use NMR spectroscopy to measure the concentration of biomarkers, biological molecules present in blood (e.g. glucose, lipids and amino acids). Blood biomarkers can accurately reflect the health state of individuals. In routine clinical practice, typically only a handful of blood biomarkers are captured to diagnose heart disease and diabetes. Our platform provides over 220 biomarkers from a single blood sample. By using NMR instruments to screen patients for 220 blood biomarkers simultaneously, Nightingale can produce a metabolic profile that provides a “bird’s eye view” of a person’s health. 

Here’s how it works: 

1. A customer (e.g. researcher) sends blood (serum or plasma) samples to one of our labs.

2. We run their samples through our automated NMR-based analysis process and Nightingale’s proprietary software analyses the NMR spectra of the biomarkers.

3. The processed data of each sample is sent back to the customer. 

4. The customer now has data on the concentrations over 220 biomarkers present in the blood samples tested.

By using our in-house bioinformatics software and our integrated quality control system, Nightingale converts NMR results (spectra) into measurements of metabolites in absolute concentration units (e.g. mmol/L) that can be easily interpreted by our customers. This makes our blood analysis particularly useful as the results we provide researchers with can easily be combined with other results they may have received from different analytical methods. Our technology is also much faster than similar methods as our NMR-based analysis process is high-throughput (automated and fast), making it possible to analyze large numbers of blood samples. In fact, Nightingale's technology has already been used to help carry out one of the largest metabolic profiling studies to date, analyzing blood of over 50, 000 samples for the University of Cambridge.  

Comprehensive metabolic profiling = better disease prediction

By analyzing the blood of large population studies, we can uncover undiscovered connections between diseases and human metabolism. As researchers analyze the metabolic profiles of people of different age, gender, environment and genetic background, it will be possible to develop a new type healthcare system that predicts and prevents disease onset. Nightingale’s service can enhance disease risk prediction by providing a more comprehensive blood analysis that uses a wide range of blood biomarkers. In the long-term, we plan to integrate our tools for clinicians so that they can develop preventative healthcare for chronic diseases (such as diabetes and cardiovascular disease). We believe that by doing this, we can help create a future healthcare system that is focused on keeping people healthy.

Find out more about our technology here.

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