{"paper_id":"a3930d73-fb40-4b87-9afa-a6018d1d9c5a","body_text":"ARPHA Conference Abstracts 9: e182179\ndoi: 10.3897/aca.9.e182179 \nConference Abstract \nApplicability of the Ella system for automatic\nElisa to detect biomarkers in endometriosis\nEliana Mihaylova , Radoslava Vazharova , Ralitza Lechоva-Dimitrova , Ivanka Dimova , \nDragomira Nikolova\n‡ Sofia University St. Kliment Ohridski, Department of Biology, Medical Genetics and Microbiology, Sofia, Bulgaria\n§ Medical Center Femina, Sofia, Bulgaria\n| Department of Medical genetics, Medical Faculty, Medical University, Sofia, Bulgaria\nCorresponding author: Eliana Mihaylova (eliandimova@gmail.com), \nDragomira Nikolova (dnikolova@medfac.mu-sofia.bg)\nReceived: 11 Dec 2025 | Published: 07 Jan 2026\nCitation: Mihaylova E, Vazharova R, Lechоva-Dimitrova R, Dimova I, Nikolova D (2026) Applicability of the Ella\nsystem for automatic Elisa to detect biomarkers in endometriosis. ARPHA Conference Abstracts 9: e182179. \nhttps://doi.org/10.3897/aca.9.e182179\nAbstract\nAim. Endometriosis  is  a  chronic  gynecological  disorder  characterized  by  ectopic\nendometrial tissue, inflammation, and angiogenesis. Non-invasive biomarkers in serum\nand  urine  could  improve  diagnosis and  disease  monitoring. This study evaluates the\napplicability  of the  Ella  automated  ELISA  system  for  quantifying  key  endometriosis-\nassociated biomarkers.\nMethods. The Ella platform (ProteinSimple/Bio-Techne) allows automated, multiplexed\nquantification  of  cytokines,  chemokines,  and  growth  factors  from  minimal  sample\nvolumes. Plasma and urine were considered as matrices for biomarker detection. System\nperformance,  including  sensitivity,  reproducibility,  and  multiplexing  capability,  was\nassessed  based  on  previously reported  biomarker levels in  women  with  and  without\nendometriosis.\nResults. Previous  studies  reported  elevated  levels  of IGFBP-1  ( UniProt Consortium\n2025b, National Center for Biotechnology Information 2025c ), CD5L Hong 2025  ,ANXA1\n(Fang  2024), MCP-1  ( National  Center for Biotechnology Information  2025b ), VEGF-A\n(Didžiokaitė 2025 ), TNF-α ( National Center for Biotechnology Information 2025a ), and\n‡ ‡ § |\n|\n© Mihaylova E et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC\nBY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source\nare credited.\n\nIL-6  in  serum  ( UniProt  Consortium  2025a ),  reflecting  systemic  inflammation  and\nangiogenic activity. Urine samples showed increased IL-6 ( UniProt Consortium 2025a ),\nIL-8 (UniProt Consortium. 2025a ), VEGF (Didžiokaitė 2025 ), IL-6-ST (National Center for\nBiotechnology Information. 2025 ), Alpha-Enolase  ( UniProt Consortium. 2025b ), VDBP\n(Fernando 2020 ), and CA125 ( Felder 2014 ), indicating both local and systemic disease-\nrelated changes. For better visual representation, the proteins described above and their\nfunctions are listed in Table 1. These findings support the feasibility of using automated\nELISA platforms like Ella to detect disease-relevant biomarkers in both biofluids.\nConclusions. The  Ella  automated  ELISA  system  provides  a  reliable  and  efficient\napproach for measuring serum and urinary biomarkers associated with endometriosis. Its\nmultiplexing  capacity  and  low  sample  requirements  enable  non-invasive  biomarker\nstudies, supporting early diagnosis, monitoring of disease progression, and evaluation of\ntherapeutic interventions.\nGene Full name Protein Function\nIGFBP1 Insulin like growth\nfactor binding\nprotein 1\nIGFBP-1 Regulates the bioavailability and acitvity of insulin-like growth\nfactors; important in cell migration and metabolism\nCD5L CD5 molecule like CD5L Key regulator of lipid synthesis; regulates mechanisms in\ninflammatory responses\nANXA1 Annexin A1 ANXA1 Ubiquitous protein;Inhibits phospholipase A2 and has anti-\ninflammatory activity\nCCL-2 C-C motif\nchemokine ligand 2\nMCP-1 Regulates leukocyte recruitment; Chemotactic activity for\nmonocytes and basophils\nTNF Tumor necrosis\nfactor\nTNF-αInvolved in the regulation of a wide spectrum of biological\nprocesses including cell proliferation, differentiation, apoptosis, lipid\nmetabolism, and coagulation\nVEGF-\nA\nVascular endothelial\ngrowth factor A\nVEGF-A Key mediator of angiogenesis and inflammation; Implicated in\nreproductive and immune processes\nIL-6 Interleukin 6 IL-6 Potent inducer of the acute phase response; Induces the\nproduction of VEGF\nCXCL8 C-X-C motif\nchemokine ligand 8\nIL-8 Mediates inflammatory response by attracting neutrophils,\nbasophils, and T-cells to clear pathogens and protect the host from\ninfection\nIL6ST Interleukin 6\ncytokine family\nsignal transducer\nIL-6ST Part of the cytokine-receptor complex; Suggested role in regulating\nmyocyte apoptosis\nTable 1. \nApplicability of the Ella system for automatic Elisa to detect biomarkers in endometriosis.\n2 Mihaylova E et al\n\nGene Full name Protein Function\nENO1 Enolase 1 Alpha-\nenolase\nGlycolytic enzyme; Involved in various processes such as growth\ncontrol, hypoxia tolerance and allergic responses\nGC GC vitamin D\nbinding protein\nVitamin D-\nbinding\nprotein\nImmunoregulation, glucose metabolism, and regulation of blood\npressure; involved in maintaining an environment of tolerance to\npaternal and fetal tissue and the augmentation of pro-inflammatory\nstates\nMUC16 Mucin 16, cell\nsurface associated\nCA 125 Immune attack resistance; Plays role in metastasis; Contributes to\novarian tumor growth\nKeywords\nautomated Elisa (Ella), endometriosis, biomarkers\nPresenting author\nDragomira Nikolova\nPresented at\nInternational Conference on Natural Sciences and Biotechnology – Kliment’s Days 2025\nAcknowledgements\nThis  study  is  a  part of the  project D-156/4.6.25  financed  by  the  Council  of Medical\nScience, Medical University - Sofia, Bulgaria.\nFunding program\nProject D-156/4.6.25\nConflicts of interest\nThe authors have declared that no competing interests exist.\nApplicability of the Ella system for automatic Elisa to detect biomarkers ... 3\n\nReferences\n• Didžiokaitė G, et al. (2025) Serum VEGF Potential as a Biomarker for Diagnosis of\nFemale Unexplained Infertility: Does Atopy Matter? International Journal of Molecular\nSciences https://doi.org/10.3390/ijms26199499\n• Fang L, et al. (2024) Annexin A1 binds PDZ and LIM domain 7 to inhibit adipogenesis and\nprevent obesity. Signal Transduction and T argeted Therapy https://doi.org/10.1038/\ns41392-024-01930-0\n• Felder M, et al. (2014) MUC16 (CA125): tumor biomarker to cancer therapy, a work in\nprogress. Molecular Cancer https://doi.org/10.1186/1476-4598-13-129\n• Fernando M, et al. (2020) Vitamin D-Binding Protein in Pregnancy and Reproductive\nHealth. Nutrients https://doi.org/10.3390/nu12051489\n• Hong H, et al. (2025) Characterizing Kupffer Cell Production of CD5 Antigen-Like and Its\nFunction on Regulating Migration of NaturalKiller T Cells. The American Journal Of\nPathology https://doi.org/10.1016/j.ajpath.2025.06.003\n• National Center for Biotechnology Information (2025a) TNF tumor necrosis factor [Homo\nsapiens (human)] – Gene ID: 7124. https://www.ncbi.nlm.nih.gov/gene/7124\n• National Center for Biotechnology Information (2025b) CCL2 C-C motif chemokine ligand\n2 [Homo sapiens (human)] – Gene ID: 6347. https://www.ncbi.nlm.nih.gov/gene/6347\n• National Center for Biotechnology Information (2025c) IGFBP1 insulin like growth factor\nbinding protein 1 [Homo sapiens (human)] – Gene ID: 3484. https://www.ncbi.nlm.nih.gov/\ngene/3484. Accessed on: 2025-10-21.\n• National Center for Biotechnology Information. (2025) IL6ST interleukin 6 cytokine family\nsignal transducer [Homo sapiens (human)]. https://www.ncbi.nlm.nih.gov/gene/3572\n• UniProt Consortium (2025a) P05231 – IL6 – Interleukin-6 – Homo sapiens (Human). \nhttps://www.uniprot.org/uniprotkb/P05231/entry\n• UniProt Consortium (2025b) P08833 – IGFBP1 – Insulin-like growth factor-binding\nprotein 1 – Homo sapiens (Human). https://www.uniprot.org/uniprotkb/P08833/entry.\nAccessed on: 2025-10-21.\n• UniProt Consortium. (2025a) P10145 – CXCL8 – Interleukin-8 – Homo sapiens (Human). \nhttps://www.uniprot.org/uniprotkb/P10145/entry\n• UniProt Consortium. (2025b) P06733 – ENO1 – Alpha-enolase – Homo sapiens (Human).\nhttps://www.uniprot.org/uniprotkb/P06733/entry\n4 Mihaylova E et al","source_license":"CC0","license_restricted":false}