History of the inventions
Albuminomics did not appear at once. It grew from a decade of work on how metals bind to albumin, at INSERM UMR1248 / CHU Limoges, led by Dr Souleiman El Balkhi and colleagues. Each step built on the last.
1 — Exchangeable copper and REC (the foundation)
The lineage begins with copper–albumin binding. Albumin carries a fraction of plasma copper loosely, at its N-terminal site. Measuring this labile pool — exchangeable copper (CuEXC) — and expressing it as a fraction of total copper gives relative exchangeable copper (REC).
REC proved to be a highly specific and sensitive biomarker for Wilson disease, a disorder of copper metabolism. It is now recommended for Wilson-disease diagnosis in the 2025 EASL-ERN Clinical Practice Guidelines — a full journey from bench to clinical guideline, validated in a large multicentre cohort.
Why it matters for albuminomics: REC established the group’s core expertise — reading disease from how metals bind to albumin by ICP-MS — and the analytical workflow (ultrafiltration + ICP-MS) that the SEB test would later reuse.
2 — The SEB test (function)
The next question was: if albumin is damaged in liver disease, does it lose its ability to bind, more broadly than copper? The Serum Enhanced Binding (SEB) test answered yes. Serum is spiked with a panel of ligands (copper, gold, cadmium, cobalt, L-thyroxine, dansylsarcosine), each probing a distinct binding site; the unbound fraction is measured by ICP-MS. A high free fraction means the site is disrupted by PTMs.
The SEB test detected liver injury earlier than standard enzymes (ALT/AST) in animal models and discriminated cirrhotic patients from controls in a human cohort ([[el-balkhi-2024-seb|El Balkhi et al., Sci Rep 2024]]).
Protected by 104458 A1 (granted EP 3 884 280 B1).
3 — Top-down isoform profiling (structure)
Function tells you that albumin is damaged; structure tells you how. Using top-down mass spectrometry, the group resolved intact albumin into its full isoform spectrum and showed that the profile stages chronic liver disease across its whole range — outperforming FIB-4 and reproducible across instruments from different manufacturers ([[el-balkhi-2025|ALBOM study, Sci Rep 2026]]).
Protected by 074685 A1 (isoform etiology profiling).
4 — Absolute quantification (rigour)
Top-down profiling was held back by two problems: insufficient mass accuracy on routine instruments, and no absolute quantification without costly isotope labels. The group solved both by using equine myoglobin as a multifunction internal standard — recalibrating each spectrum in real time and yielding absolute isoform concentrations (Lakis et al.). This is what turns the isoform profile from a research readout into a reproducible, deployable measurement.
Protected by 099157 A1 (absolute quantification by internal calibration).
Where it stands
- ALBOM (el-balkhi-2025) — published multi-class staging, cross-platform validated.
- MALAHBAR (NCT06318949) — an ongoing multicentric study (560+ patients, 8 French university hospitals) to externally validate the profile and the SEB test, reading out in 2027.
The through-line
One idea runs through all four steps: albumin is not a passive marker but a functional, chemically-recording molecule, and reading its modified forms — structurally and functionally — reveals disease. That is albuminomics.
See also
What is albuminomics? · Patent portfolio · SEB test · Human serum albumin