News
First diagnostic antibody tests now available for Zika virus
In 1947, the first documented discovery of the Zika virus occurred. 80% of infected people do not know they have contracted the virus as the symptomology is generally mild. There is a heightened level of investigation to determine if a causal link exists between the Zika virus infections and the fetal malformations and cases of Guillain-Barré syndrome.
EUROIMMUN AG, a manufacturing company in Germany, has developed the first complete test package for the serological detection of the Zika virus (ELISA and indirect immunofluorescence tests to determine IgM and IgG antibodies). The test can detect current and past infection of the virus, and can be used for rapid screening in outbreak scenarios. The tests will be implemented shortly in studies at Fiocruz which is an institute associated with the Brazilian Health Ministry.
Related Article: In Fight Against Zika Virus, Officials Consider Genetically Modified Mosquitoes
Related Article and Video: Commercial test for Zika virus could be available within weeks
Ebola, Zika and more: Designing one test to catch them all
Quote: “We’re always a step behind the next disease that emerges from the jungle or the hinterland…With a universal diagnostic such as this, we’ll be prepared for the next infectious threat – no matter what it is”, states Dr. Charles Chiu, an associate professor of Laboratory Medicine and director of the UCSF-Abbott Viral Diagnostics and Discovery Center.
Traditionally, clinicians and scientists have created virus tests using a one to one ratio, a “one bug, one test” formula. On a small scale, such as the hospital setting for a typical patient, these uniform tests may be beneficial as they limit the patient to unnecessary diagnostics. However, during large scale outbreaks, these tests cannot adopt or be created fast enough to deal with new viral threats. Manufactured by Oxford Nanopore Technologies, a new technique called “nanopore sequencing” uses a genetic sequencer and laptop software via the usb port to operate. This potentially field friendly device, provides analysis for multiple known pathogens within minutes of a single sample being loaded, including viruses, bacteria, fungi, and parasites known or unknown. Investigators will be travelling to South America, West Africa and the Caribbean to implement and test the technology in the field.
Quality
Making a Case for Automated Data Review
As technology has evolved, there is an associated increase in automated technical quality control (QC) processes. The authors argue that the time and energy that has been provided to developing QC solutions for mass spectrometry has been difficult to do as the instrument, work flow and data is much more complex. The manual labour and decision time associated with the QC time is extensive. Read this important discussion article that reviews the cost/benefit analysis of automated QCs, building a custom solution as a viable option and how to justify incurred costs . The authors also provide an example of a communication tool called SBAR (Situation-Background- Assessment-Recommendation) that can support your local facility needs.
Leadership
Working With Nurses to Make Laboratory Systems Safer
According to Dr. James Hernandez, Associate Professor of Laboratory Medicine and Pathology, and Medical Director and Chair of the Division of Laboratory Medicine at Mayo Clinic in Scottsdale and Phoenix, Arizona, “Laboratorians should consider working more closely with nursing colleagues to make our systems safer. Because laboratorians are adept at seeing the big picture, analyzing data, and seeing patterns and process flows, we complement our nursing colleagues, who see problems at the bedside. By strengthening the hand-offs between nursing and laboratorians, we understand and humanize each other. We begin to understand each other’s special challenges.” Find out what the 5 main concerns are that laboratory staff have about nursing and the 5 concerns nursing has about the lab. What can we do to help decrease the tension?
Examples:
- Nurses don’t understand the technical or workflow challenges in the laboratory. For example, a nurse may not appreciate the multiplicative effect of an error, such as mislabeling.
- Changes in policies and procedures without proper notification.
- Inability to coordinate multiple tests for the same patient.
Hematology
New treatment option for the acute phase of the rare disease TTP
Thrombotic Thrombocytopenic Purpura (TTP) is a rare hereditary or acquired disorder caused by an enzyme deficiency and is defined by a mechanical hemolytic anemia, severe thrombocytopenia, and visceral ischemia due to systemic platelet-rich microthrombi. "If patients can survive this acute phase [of the disorder], which has to be treated by plasma exchange, then the autoimmune disease can be easily treated by immunosuppression. Even to the point that it disappears completely," explains Paul Knöbl. Unfortunately though, approximately 10 – 20% of patients do not survive past this point. Researchers from the Medical University of Vienna have developed a treatment strategy to prevent the clotting of blood in vessels. In a study published in the England Journal of Medicine, it was found that a newly developed antibody (caplacizumab) prevents over activity of the von Willebrand protein which can stop life-threatening clotting faster. Ultimately, this may result in better and easier treatment of patients in the acute phase that could improve survival rates.
Related Commentary: Von Willebrand Factor — A New Target for TTP Treatment?
Cell Marker Found for Leukemia-Initiating Capacity in Chronic Myelogenous Leukemia
Patients with chronic myelogenous leukemia (CML) receive lifelong treatment using tyrosine kinase inhibitor drugs which reduce the leukemia-initiating cells but may not eliminate all. Only a small proportion of patients are able to stay in remission once treatment is discontinued. Researchers from the University of Alabama at Birmingham have published an article in the Journal of Clinical Investigation, which provided evidence to support that leukemia-initiating stem cells in the bone marrow can be differentiated by Mpl gene expression. The study used flow cytometry to select bone marrow long-term hematopoietic stem cells (LTHSC) with either high or low Mpl expression from CML-model BCR-ABL mice. Significant differences were seen between the leukemic and non-leukemic LTHSC for the genes Mpl, c-Myc, CD47, Pten, Sirt1, Ptch1 and Tie2. Those with high levels of Mpl expression are more likely to initiate the disease-causing profusion of white blood cells. The low MpL gene expression group did not continue to proliferate the disease. The researchers concluded, “These results identify MPL expression as a marker as well as a key regulator of leukemogenic potential and drug sensitivity of CML LTHSC… Our findings support further investigation of approaches to antagonize MPL signaling as a potential therapeutic strategy to eliminate leukemia-initiating LTHSC.”
Microbiology
Beard microbiology: Grubby hipsters may be on to something
Did you know that a pogonophobe is someone who has a fear of beards?
Last year, Microbiologist John Golobic, of Quest Diagnostics, swabbed men’s beards in a study and concluded that some of the bacteria “are the kind of things that you find in feces.” Headlines from such articles made their rounds last year and caused some to be “bacterial fear mongers”. To investigate the truth behind the fear, Dr. Adam Roberts, a microbiologist at the University College London, had the beards of 20 men swabbed and sent for testing. When the samples were inoculated on petri dishes with a bacteria “indicator strain”, it was noted that the indicator bacteria (Escherichia coli) was killed by the microbe with which they were co-inoculated. The bacteria was identified as Staphylococcus epidermidis, and was able to work against drug resistant E. coli. In addition to this, Dr. Adams found some beard bacteria to contain anti-adhesion molecules that prevent bacterial binding to surfaces. Maybe the bacterial world of breads isn’t so bad!
Related Article: Bearded men have poop on their faces
Research
K2-EDTA and K3-EDTA Greiner tubes for HbA1c measurement
A study published in Laboratory Medicine by researchers at the Medical School University Hospital Sestre Milosrdnice in Croatia, examined whether K2-ethylenediaminetetraacetic acid (EDTA) and K3-EDTA Greiner tubes could be used interchangeably for glycosylated hemoglobin, type A1C (HbA1c) measurement via the Abbott Laboratories ARCHITECT chemiluminescent microparticle HbA1c assay on the ARCHITECTi2000SR immunoanalyzer. Blood was drawn into plastic Greiner Cavuette tubes for 45 patients, of which tubes were lined with either K2-EDTA or K3-EDTA anticoagulant. The study found that there was no significant difference between the tubes for HbA1c concentration. This supports the notion for the first time, although not an uncommon practice in the lab, that Greiner tubes with either lining can be used interchangeably within the Abbott Laboratories ARCHITECT assay. The authors note that to minimize risk associated with the interchangeable tubes, the lab must ensure the potassium EDTA salts have comparable results.
New Gene Discovery Could Lead To Earlier Lyme Test And Diagnosis
There is a dramatic increase in the number of Lyme disease cases, with the CDC estimating 300,000 cases per year which is 10 times the number of reported cases due to diagnosing difficulties. Published in mBio, a research study examined the blood samples of 29 patients who had contracted Lyme disease, examining their samples pre and post traditional treatment of antibiotics. Using the “next-generation sequencing” technique called RNA-seq, it was identified that distinctive patterns could be found in these patients up to 6 months later. At this follow-up marker, only half of the patients had fully recovered. However, there were no marked differences in the transcriptome. Also, 31-60% of the patterns had commonalities to other immune-mediated diseases. Dr. John Aucott, assistant professor of medicine at the Johns Hopkins University School of Medicine and a senior investigator on the study, concluded, “To our knowledge, this study is the first to document changes in gene expression occurring even after a bacterial infection has been treated with appropriate antibiotics.”
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