Immunoproteomics for wastewater-based health surveillance: A review.

Wastewater-based epidemiology (WBE) offers a unique window into the health and habits of communities through the analysis of pollutants and biomarkers in sewage. Traditionally focused on small molecules, such as pharmaceuticals and illegal drugs, recent advances in environmental proteomics have expanded WBE to include large biomolecules such as proteins. Notably, novel sampling methods using polymeric probes and high-resolution mass spectrometry have facilitated the detection of human and animal proteins, both soluble and in particulate material, linking them to specific populations and industrial activities. An immunological dimension to this approach is fundamental to include the recognition of host immunoglobulins, immune-response proteins, and pathogen antigens in wastewater, potentially serving as indicators of community immune status, infection prevalence, and vaccination coverage. This review consolidates the latest advancements in environmental proteomics as applied to WBE, emphasizing an immunological perspective as a comprehensive tool for assessing population health and environmental conditions to bridge environmental monitoring, public health, and clinical diagnostics.