Summary
A Nature Comment proposes combining immune-cell, protein, receptor, tissue and imaging data to build a practical picture of immune health. The authors say the priority is to identify a small set of measurements that improves clinical decisions.
A Nature Comment published on 27 October 2026 sets out a research roadmap for measuring immune health more comprehensively. Its authors argue that combining information about immune cells, molecules, tissues and responses to challenges could eventually help clinicians tailor prevention, monitoring and treatment. They emphasize that the goal is not to measure everything, but to find a manageable set of tests that can meaningfully improve care.
Why routine tests give only part of the picture
The immune system is a changing network: cells circulate through the body or reside in tissues, while organs support their development and function. Signalling molecules such as cytokines and chemokines help these components communicate. People of the same chronological age can have different immune states, shaped by genetics and factors including infections, diet, smoking and air pollution. The authors note that variation in immune “biological age”—the rate at which the immune system has aged—has been linked to neurodegeneration, cancer and mortality risk.
Routine clinical tests measure only pieces of this system. A white blood cell count measures the level of circulating immune cells, while C-reactive protein can indicate inflammation. Neither, on its own, describes the resilience of the immune system as a whole or whether it can mount an effective response to a particular challenge.
The proposed “immunome” would bring together measurements from several sources: circulating proteins and antibodies; detailed profiles of individual cells; sequencing of immune-cell receptors, which helps reveal the diversity of cells able to recognize threats; and imaging of immune-related organs such as the thymus, spleen and bone marrow. Spatial tissue profiling could show where immune cells are located relative to other cells. Measuring immune activity before and after a challenge, such as vaccination, could capture the strength, timing and persistence of a response.
From broad profiles to useful clinical tests
The authors propose building longitudinal datasets that measure multiple parts of the immune system alongside health and disease indicators in the same people over time. Following people through vaccination could help researchers test whether a routine vaccine response provides a practical read-out of immune competence. Such studies could also help explain why people respond differently to the same infection or vaccine.
These datasets need to reflect the diversity of human immunity. The Comment points to differences in malaria-vaccine efficacy between populations and notes that many existing immune-profiling datasets come from high-income countries. Shared protocols across regions would make results more comparable. Artificial-intelligence models could help identify patterns across many measurements, but the authors say those patterns must be tested in independent populations and over time: otherwise, a model might learn differences between laboratories, technologies or populations rather than clinically meaningful immune signals.
Potential uses include identifying people with unusually rapid immune ageing, tailoring disease monitoring, and helping select patients for cancer treatments that depend on the immune system. These are proposed applications, not established routine uses. The authors call for research to determine whether immune measurements actually improve treatment decisions and disease outcomes.
The practical test of the immunome approach will be whether a small, accessible set of measurements can guide care. Measuring every aspect of immunity is unlikely to be feasible for every patient, so the authors prioritize tests that are manageable in clinical settings and models that are evaluated across hospitals and populations before routine use.