News
Red alert: Why is scarlet fever spreading across Britain?
The increase in scarlet fever has exponentially grown in England and Wales to a staggering 17,586 cases in 2015, up from 2,000 cases annually. No fatalities have been reported due to the outbreak and there are no signs that it is resistant to antibiotics. Dr Theresa Lamagni, Public Health England (PHE)’s head of streptococcal infection surveillance has said, “The scarlet fever that would have been around in the Victorian era is a completely different beast to what we see now… It was a very severe infection that led to a lot of childhood deaths, but over the course of the last century its virulence diminished hugely.” The cause of the current spread is still considered unknown. There is no single dominant strain identified. However, PHE analysis has shown a four year cycle of increased contraction, albeit the current cycle is beyond the normal standard. “That was a bit of a surprise for us,” says Lamagni. “It doesn’t seem that the bugs themselves are giving us any clues as to what is happening.” Therefore, why scarlet fever is spreading remains a mystery at this time.
Related Article: Scarlet fever warning as cases hit an almost 50-year high
Status of gene human patents unresolved in Canada
According The Canadian Press, “One of the most contentious issues in genetics is whether researchers should be allowed to patent human genes found to cause disease and to commercialize diagnostic tests based on those mutated snippets of DNA.” In Canada there is no law to prohibit patents being created for portions of human genome (known as whole-exome sequencing) or associated diagnostic tests, unlike the US or Australia. In an out-of-court settlement, the Children’s Hospital of Eastern Ontario (CHEO) announced an agreement with US-based Transgenomic Inc. (patents holder of long QT syndrome genes and diagnostic test), setting precedence in Canada that commercial businesses should not make money off of the public sector. Although the decision was not made in a court of law and therefore, not binding in court, it still provides a new standard to work towards.
Press Release: Ground-breaking settlement changes landscape for genetic medicine in Canada
Study challenges accuracy in Theranos blood tests
Theranos is in the news again! A new comparative study has been released that raises questions and concern about the safety of their blood tests. The study recruited 60 healthy adults who volunteered to be tested twice daily by Theranos, Quest Diagnostics and LabCorp.
The research team used 22 diagnostic measures including various types of cholesterol tests and a complete blood count. Although results were similar for the most part, 12.2% of Theranos results were outside normal range values for the population, compared to 7.5% and 8.3% respectively for the other companies. “There is actually pretty widespread variability in these clinical measures, even between the reference labs... But Theranos was more outside of range and outside of range in ways that would impact clinical decision-making” stated Eric Schadt, Director of the Icahn Institute for Genomics and Multiscale Biology.
Theranos' response was to write a letter to the Journal of Clinical Investigation, asking for the publication to be stopped due to “flawed and inaccurate” results.
Related Article: Theranos Devices Often Failed Accuracy Requirements
Quality
Detecting and Handling Hemolysis Using Serum Indices
The majority of detected clinical laboratory errors originate in the preanalytic phase of testing. Hemolysis is one of the most prevalent preanalytic errors, often leading to rejected samples because of interference.
Hemolysis influences the accuracy and reliability of routine chemistry testing by two different mechanisms. The first is through the release of analytes found in high concentrations in erythrocytes; the second is through interference from hemoglobin itself.
Traditionally, hemolysis was detected by visual inspection of serum or plasma. Specimens with a light pink hue indicate slight hemolysis, whereas a deep red colour represent gross hemolysis. This visual assessment of the degree of hemolysis can be highly subjective and unreliable. Fortunately, serum indices on contemporary chemistry analyzers enable automated semi-quantitative assessments of hemolysis, icterus, and lipemia, thereby significantly improving the process for assessing specimen integrity.
Assay manufacturers provide instrument- and test-specific HI (hemolysis index) limits for interference in their instructions for use. Laboratories can use middleware rules to set and customize serum HI thresholds for each analyte. This enables laboratory technologists to readily identify specimens with clinically significant interferences prevent autoverification of results, and intervene as needed.
Clinical Chemistry
Research shows rare form of diabetes may require alternate treatment
Published in the Journal of Biological Chemistry, research from the Washington University School of Medicine provides evidence for new treatment strategies of maturity-onset diabetes of the young (MODY1), a rare genetic form of type 2 affecting 3-5% of diabetics. It was found that the standard oral medications which activate insulin-secreting beta cells to regulate blood sugar results in the destruction of these cells in MODY1, resulting in rapid insulin dependence.
A relationship between two proteins that regulated insulin secretions and enzymes in the stomach, liver, kidney and intestines was identified. One of the proteins is derived by the altered genes in MODY1. "Nature doesn't re-invent the wheel… What these different cells secrete is very different, but the machinery is very similar. As with auto plants, although a BMW is very different from a Volkswagen, the factories where those cars are built are not really that different. It appears the same thing may be true for a number of these cells that secrete key enzymes in the gastrointestinal tract," says Dr. Jason C. Mills.
As research continues to investigate the mechanisms for MODY1, the researchers suggest physicians need to be aware of this rare form of the disease before moving forward with standard treatments.
Hematology
A patient has 'caught' a kiwi fruit allergy from a bone marrow transplant
In a world first, a food allergy was directly transmitted to a patient arising from a bone marrow transplant. The rare allergy associated with kiwi fruit was confirmed by researchers that it originated in the donor’s hematopoietic stem cells.
The study, published in the Journal of the European Academy of Dermatology and Venereology, demonstrates evidence that exceeds previous reported cases where the patient development a new, unrelated, allergy post transplant. In the kiwi allergy patient, specific blood cells were isolated and fluorescent in situ hybridisation (FISH) provided the confirmation evidence. Although the foundational information to explain this allergy transmission between siblings is not fully understood, it supports an investigational direction to determine how allergies are created and potentially cured. Other similar transference has been reported in rare cases such as blood transfusions which cause temporary allergies.
Fun Video: Friends Season 2 Episode 6 – Ross is allergic to kiwi
Microbiology
Uropathogenic bacteria linked to deadly disease in preterm infants
Necrotizing enterocolitis (NEC) is known as the most common and serious intestinal disease affecting babies born prematurely due to the undeveloped organs. The disease occurs when there is damage to the small or large intestinal walls resulting in the backup of waste and bacteria growth.
Research from the University of Massachusetts Medical School obtained 166 infant stool samples which were sequenced. A metagenomic analysis tool was developed to identify the infants with NEC by using uropathogenic E. coli (UPEC) as the E. coli type most sytrongly linked to the disease. UPEC was found in 44% of the infants who developed NEC and succumbed to it, compared to 16% who survived. An association between vaginal delivery and death from NEC in extremely premature infants was also identified. Metagenomic multilocus sequence typing analysis further defined NEC-associated strains as sequence types often associated with urinary tract infections, including ST69, ST73, ST95, ST127, ST131, and ST144.
Research
Findings in humans provide encouraging foundation for upcoming AIDS vaccine clinical trial
An emerging vaccine strategy involves immunizing people with a series of different engineered HIV proteins as immunogens to teach the immune system to produce broadly neutralizing antibodies against HIV. This strategy depends on the ability of the first immunogen to bind and activate special cells, known as broadly neutralizing antibody precursor B cells, which have the potential to develop into broadly neutralizing antibody-producing B cells.
A research team has now found that the right precursor ("germline") cells for one kind of HIV broadly neutralizing antibody are present in most people, and has described the design of an HIV vaccine germline-targeting immunogen capable of binding those B cells. The findings by scientists from The Scripps Research Institute (TSRI), the International AIDS Vaccine Initiative (IAVI) and the La Jolla Institute for Allergy and Immunology were published in Science on March 25.
"We found that almost everybody has these broadly neutralizing antibody precursors, and that a precisely engineered protein can bind to these cells that have potential to develop into HIV broadly neutralizing antibody-producing cells, even in the presence of competition from other immune cells," said the study's lead author, William Schief, TSRI professor and director, Vaccine Design of the IAVI Neutralizing Antibody Center at TSRI, in whose lab the engineered HIV vaccine protein was developed.
Related Article: Laboratory Testing for HIV - How to Adapt to a New Algorithm and New Assays
Studying the science of science
Quote: “Being a scientist is, at the most fundamental level, about being able to study what’s exciting to you,” says Jeremy Yoder, a postdoctoral student and the University of British Columbia. “If you see something like this and you know how to follow up on it, you should do that.”
This article carefully examines how we can study the art and research of science and the people (good and bad) within it. Discussed as metascience, the information in this article pushes us to look beyond the core research being conducted. “I’m not just going to do research as a scientist; I’m also going to do critical research on science,” anthropologist Kathryn Clancy’s states. Many benefits arise from such focus. Ferric Fang, a professor of laboratory medicine and microbiology at the University of Washington, believes that creating a student environment where encouragement to maintain a work-life balance and high ethical standards sets the stage for generations of quality science. Fang also indicates that his metascience research has made him a more rigorous scientist.
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