24 chasa: Dr. Svetla Gecheva: Immunology is the driving force behind modern medicine, advancing science and changing the lives of our patients

Dr. Svetla Gecheva, leading clinical immunologist at Heart and Brain in Pleven and Burgas

• April 29 marks World Immunology Day, celebrating one of the most dynamically developing modern sciences. Immunology Day was first celebrated in Europe in 2005. Since 2007, this event has also been celebrated by the global immunology community.
• Immunologists around the world come together to present the achievements in clinical immunology to the public, its importance for the development of medicine and biology in the diagnosis and treatment of a number of diseases involving immune mechanisms – infections, immune deficiencies, tumors, autoimmune diseases, allergies, transplant and reproductive disorders.

– Dr. Gecheva, what is the motto of this year’s World Day and what messages does it convey?

– In 2025, World Immunology Day will be celebrated under the motto: “Brain and Immunity: Immunological Insights into Neurological Disorders.” The theme carries a very important message – we cannot view the brain and the immune system as completely separate worlds. Neuroimmunology studies this interaction in various aspects, for example, how infections, autoimmune diseases, and inflammatory processes can affect brain function and lead to symptoms such as fatigue, depression, or cognitive impairment. We are seeing how more and more neurological conditions—such as multiple sclerosis, autoimmune encephalitis, depression, and even autism—are beginning to be better understood through the lens of immunological mechanisms.

In recent years, the role of immunology in the diagnosis, prognosis, and treatment of socially significant diseases such as Alzheimer’s and other forms of dementia has grown significantly. New research shows that the immune system and inflammatory processes in the brain play a key role in the development and progression of these diseases. The role of microglia in neuroinflammation has been assessed and new biomarkers have been introduced. Specific anti-inflammatory therapies against microglial activity are being developed, as well as therapies with antibodies against beta-amyloid and tau proteins. Some of these have already been approved in the US (e.g., Lecanemab and Aducanumab).

– Why is immunology considered the most dynamic science in recent years?

– Immunology has established itself as one of the most dynamic medical sciences because it is fundamental to understanding and treating some of the major health challenges we face today. In my practice as a clinical immunologist at Heart and Brain, I see how advances in immunology are literally changing everyday medical practice. Discoveries about the role of the immune system are not limited to infections or autoimmune diseases—it is also proving to be key in oncology, neurology, metabolic diseases, and even psychiatry.

In recent years, we have witnessed real breakthroughs: the creation of innovative vaccines in record time, the development of immunotherapies that give cancer patients a new chance, new biomarkers for diagnosis, and personalized approaches to treatment. The immune system is no longer seen as just a “shield against infection,” but as a complex, intelligent network that participates in almost every physiological process. This dynamic is the result not only of scientific progress, but also of technological advances—modern bioinformatics, genomics, and proteomics allow us to peer into the depths of the immune response in ways that seemed unimaginable until recently. In this sense, I can categorically state that immunology is the driving force behind modern medicine. It is not just developing rapidly—it is advancing science and changing the lives of our patients in real time.

How does the multidisciplinary approach you apply in your work at Heart and Brain in Pleven and Burgas benefit patients?

The immunology laboratory works closely with almost all clinical medical specialties, providing timely and reliable immunological diagnosis, modern immunotherapeutic approaches, preventive care, and expert advice on immune-mediated disorders. The laboratory offers testing for a wide range of autoantibodies associated with rheumatological, gastroenterological, and hematological diseases, as well as conditions associated with an increased risk of thrombosis. In collaboration with other highly specialized diagnostic laboratories—genetic, clinical, and pathological—we ensure a high standard of diagnosis, supporting the modern and personalized treatment of our patients. In the spirit of the motto: “Brain and Immunity,” I will be more specific about research related to diseases of the nervous system. Immunological tests in cerebrospinal fluid (CSF) are extremely important in neurology, especially in the diagnosis of inflammatory, autoimmune, infectious, and oncological diseases of the central nervous system. We have recently added a new biomarker to the working algorithm for cerebrospinal fluid testing: free light chains κ and λ. Measuring their concentration provides valuable information about the presence of an inflammatory process in the nervous system, which, as we have said, is extremely important for a number of diseases. The data from this new biomarker is a valuable tool in the diagnosis and prognosis of multiple sclerosis, contributing to earlier detection and more precise management of the disease, which is essential for improving the quality of life of patients.

The laboratory also tests a panel of onco-neurological antibodies used primarily to diagnose paraneoplastic neurological syndromes. These are neurological conditions that arise as an immune response to a tumor, but this response mistakenly attacks the nervous system. In the presence of onconeural antibodies without an established tumor, the most common suspected conditions are: lung cancer, breast cancer, testicular or ovarian tumors, lymphomas, and others.

Another additional biomarker related to neurology is currently being introduced – neurofilaments. These are structural proteins of axons that are released into the interstitial space and then pass into the cerebrospinal fluid and blood when neurons are damaged. It has been found that levels of NfL (especially neurofilament light chain – NfL) are elevated in multiple sclerosis, neurodegenerative diseases, and acute neurological events.

The full news article can be found here.