Applicability of the Ella system for automatic Elisa to detect biomarkers in endometriosis

Aim. Endometriosis is a chronic gynecological disorder characterized by ectopic endometrial tissue, inflammation, and angiogenesis. Non-invasive biomarkers in serum and urine could improve diagnosis and disease monitoring. This study evaluates the applicability of the Ella automated ELISA system for quantifying key endometriosis-associated biomarkers. Methods. The Ella platform (ProteinSimple/Bio-Techne) allows automated, multiplexed quantification of cytokines, chemokines, and growth factors from minimal sample volumes. Plasma and urine were considered as matrices for biomarker detection. System performance, including sensitivity, reproducibility, and multiplexing capability, was assessed based on previously reported biomarker levels in women with and without endometriosis. Results . Previous studies reported elevated levels of IGFBP-1 (UniProt Consortium 2025b, National Center for Biotechnology Information 2025c), CD5L Hong 2025 ,ANXA1 (Fang 2024), MCP-1 (National Center for Biotechnology Information 2025b), VEGF-A (Didžiokaitė 2025), TNF-α (National Center for Biotechnology Information 2025a), and IL-6 in serum (UniProt Consortium 2025a), reflecting systemic inflammation and angiogenic activity. Urine samples showed increased IL-6 (UniProt Consortium 2025a), IL-8 (UniProt Consortium. 2025a), VEGF (Didžiokaitė 2025), IL-6-ST (National Center for Biotechnology Information. 2025), Alpha-Enolase (UniProt Consortium. 2025b), VDBP (Fernando 2020), and CA125 (Felder 2014), indicating both local and systemic disease-related changes. For better visual representation, the proteins described above and their functions are listed in Table 1. These findings support the feasibility of using automated ELISA platforms like Ella to detect disease-relevant biomarkers in both biofluids. Conclusions. The Ella automated ELISA system provides a reliable and efficient approach for measuring serum and urinary biomarkers associated with endometriosis. Its multiplexing capacity and low sample requirements enable non-invasive biomarker studies, supporting early diagnosis, monitoring of disease progression, and evaluation of therapeutic interventions.