Heel prick for anemia may soon be unnecessary, thanks to blood test from this researcher

With newborn babies, you want to do as little blood sampling as possible. Yet sometimes it is necessary, for example when anemia is suspected. That is why Nienke Bosschaart, an adjunct professor at the University of Twente (UT), is developing a method to study blood directly in the veins. “Not painful ánd not harmful.”

Everyone hopes that a newborn baby makes it through the first days and weeks healthy. Unfortunately, some babies develop conditions such as anemia. So it is crucial to monitor these babies' blood properly.

This is now done with a heel prick, but it can be painful. In addition, there is a risk of infection, and that is a danger for fragile, premature babies. In the case of anemia, blood sampling is altogether undesirable.

A medical breakthrough in non-invasive measurement

Bosschaart has been working on an alternative to the heel prick for 15 years. Her non-invasive, optical method is painless and risk-free. She spends much of her time on her research at the UT campus in Enschede, where she supervises PhD and postdoctoral students.

Her work began in late 2007 at the AMC, where funding was available to develop an alternative method for measuring bilirubin within a PhD project. That's a substance released during the breakdown of red blood cells that causes jaundice. “The original idea came from my promoters Maurice Aalders and Ton van Leeuwen. They proposed a new method, low-coherence spectroscopy: an optical technique to analyze tissues. It uses low coherence light to obtain information about the structure and composition of human skin or other biological tissues.” The advantage of this technique is that it is non-invasive and can take measurements without damaging the skin. “In addition, the determination is very localized. You can see blood values from a specific blood vessel. That was not possible until then.”

The shift to hemoglobin

However, the team encountered a bump: “Bilirubin proved difficult to measure accurately,” the researcher explains. Bosschaart didn't leave it at that, and decided to switch to measuring hemoglobin (Hb) levels: the substance that gives blood its red color and is essential for transporting oxygen in the body. “This is because when there is a problem with the blood cells, it also affects the hemoglobin values. And we can measure those values more easily.”

From the laboratory to testing on patients

The technique has now been successfully tested on 27 healthy adult subjects. “That was a big milestone for us,” Bosschaart said. Currently, the device is still a collection of mirrors and lenses on an optical table in the lab. The next step is to make the system smaller and more convenient for use in patients. Bosschaart is looking forward to the upcoming period. “We hope to collaborate soon with a clinical partner so we can develop the technology further,” he said.

Several important issues still need to be investigated before the test can enter the market, such as the influence of blood vessel depth on measurements. In addition, research data show that there is a difference between men and women. Also, fluctuations in hemoglobin between healthy subjects and a clinical group need further study. Indeed, in a clinical group, hemoglobin values may vary more widely due to underlying conditions, which can affect the measurements. “If our technique works well, we will soon be measuring lower Hb levels in people with anemia,” she predicts.

Regular care and emergencies

Several areas of application are conceivable, the researcher says. The technique can be used in newborns or adults to measure anemia or to interpret fatigue symptoms in adults. The technique can also help monitor Hb levels during surgeries when there is a lot of blood loss.

More baby projects

Bosschaart is working on more than one baby-related project. “During the birth of my own children, I was fascinated by how ingeniously the female body can adapt to raising a child - both inside, and outside the body. But breastfeeding is a process that is far from effortless.” With a European grant, she is currently leading a team of researchers in Twente. In doing so, she studies the composition of breast milk and the physiological processes in the breast. The technologies for her projects overlap: optical spectroscopy is proving itself on multiple fronts.

Bosschaart has plenty of work ahead of her. “Well, I have a full agenda,” says the researcher (laughs). But one thing is certain: “I get enormous energy from working with mothers and their babies. It is not only a lot of fun, but also very necessary. After all, there is still an awful lot to discover in this field.”

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