News
Stem-Cell Scientists Redefine How Blood is Made, Toppling Conventional ‘Textbook’ View From 1960s
Dr. John Dick, Senior Scientist at Princess Margaret Cancer Centre, University Health Network, and Professor at the University of Toronto, and his laboratory research team have disproven conventional viewpoints on the formation of blood and redefined the building block architecture. In an article published in the journal Science, Dr. Dick describes how they are able to "…finally resolve how different kinds of blood cells form quickly from the stem cell – the most potent blood cell in the system – and not further downstream as has been traditionally thought.” In addition, the article describes how the blood development system is not stable once formed but rather, it is a two-tiered system which changes across a human's life span.
Human blood samples were obtained from various stages of life and approximately 3,000 single cells from 33 different cell populations of stem and progenitor cells were analyzed. The authors suggest that the potential clinical utility of the research findings are significant for those with blood related diseases and disorders and may provide therapies in the future.
Relevant Information: See video discussing this research
World's first blood cancer drug trial reveals life-changing results
Being called a ‘breakthrough advance’, researchers from the University of Leicester and Leicester's Hospitals released a public statement announcing the world’s first human clinical trial to treat Chronic Lymphocytic Leukemia and Non-Hodgkin Lymphoma patients refractory or resistant to chemotherapy. Started in 2012, the study has accrued 90 patients from various healthcare centres in the UK and France. The results have been published in the journal Blood. The study was led by Dr Harriet Walter and Professor Martin Dyer from the Ernest and Helen Scott Haematological Research Institute at the University of Leicester and from the Leicester Royal Infirmary.
The clinical trial examined the efficacy of a new inhibitor, ONO/GS-4059 that targets BTK, a protein essential for the survival and proliferation of the tumour cells. Chronic Lymphocytic Leukemia patients demonstrated the best response to treatment and most continue to stay on study after 3 years without notable toxicities. The “success story of this drug” is suggested to allow for the future development of combination studies, which are expected to begin recruitment shortly in Leicester.
Related Article: World-first blood cancer drug trial reveals life-changing results
Scientists have breached the blood-brain barrier for the first time to treat a brain tumour
Sunnybrook Health Science Centre scientists made history by being the first to succeed in non-invasively breaching the blood-brain barrier (BBB) and more effectively providing chemotherapy treatment. The oncology patient discussed is the first of ten that will be admitted to the study and receive this innovative technique.
According to the press release, “The research team infused a chemotherapy drug, then tiny, microscopic bubbles, into the bloodstream of a patient with a malignant brain tumour. The microbubbles are smaller than red blood cells and pass harmlessly through the circulation. The researchers then used state-of-the-art MRI-guided focused low-intensity ultrasound (sound waves) to target blood vessels in the BBB area near the tumour. The waves repeatedly compress and expand the microbubbles, causing them to vibrate and loosen tight junctions of the cells comprising the BBB. Once the barrier was opened, the chemotherapy flowed through and deposited into the targeted regions.”
The study is the result of two decades worth of research and collaboration between Sunnybrook Research Institute and industry partner Insightec. The results are encouraging for more than oncology patients and suggest potential future investigations into other brain disorders and diseases that may benefit from targeted chemical treatment, including Alzheimer’s, Parkinson’s and psychiatric conditions.
Press Release: World first: blood-brain barrier opened non-invasively to deliver chemotherapy
Relevant Information: See video discussing this research
Quality
Case closed: discrepant results at multiple sites
With increased amalgamation of hospitals and laboratory information systems, it is clear that laboratories are facing a restructuring of clinical data that requires alignment and standardization between organizations and medical systems. However, what seems like an insurmountable task, also brings with it greater opportunities to investigate inconsistencies and variations in instruments, reagents and more.
Dina N. Greene, PhD, worked for four years at Kaiser Permanente Northern California as a clinical chemistry consultant for the area’s 21 hospital laboratories and directed hemoglobinopathy and myeloma testing for the system’s regional laboratory. Read about her experience and the puzzling case that she investigated along with Nikola Baumann, PhD, of the Mayo Clinic in Rochester, Minnesota.
Clinical Chemistry
Early Warning Sign for Kidney Disease Identified in Study: Researchers say blood test can predict risk up to five years before damage begins
Press Release Quote: “SuPAR promises to do for kidney disease what cholesterol has done for cardiovascular disease,” said Jochen Reiser, MD, PhD, senior author of the preventive medicine study and the Ralph C. Brown, MD, Professor and chairman of Medicine, Rush University Medical Center.
Published in the New England Journal of Medicine, researchers from Rush University Medical Centre, in conjunction with three other institutions including Harvard, have discovered an early warning sign for potential chronic kidney disease. Current testing methods using estimated glomerular filtration rate (eGFR; based on measuring creatinine in the blood) and proteinuria in urine are not sensitive enough to predict or prevent disease development.
Using single blood tests, suPAR (soluble urokinase-type plasminogen activator receptor) protein levels can be monitored and have shown to reliably predict a person's risk of developing destructive chronic kidney disease up to five years prior.
Press Release: Early Warning Found for Chronic Kidney Disease
Hematology
Surface Marker Allows New Diagnostic Approaches for Sarcoidosis
Although the true factors that cause sarcoidosis are still being investigated, it is known that the disease is caused by a strong immune reaction and a concomitant formation of nodules in the tissue. A study published in the journal Blood, examined the involvement of monocytes in sarcoidosis and discusses a new strategy to examine monocyte subtypes to aid in disease diagnosis.
As written in the article, “The team showed that the cell surface marker 6-sulfo LacNAc (slan) can define slan-positive CD14+CD16++ non-classical monocytes and slan-negative CD14++CD16+ intermediate monocytes. Gene expression profiling confirms that slan-negative intermediate monocytes show highest expression levels of major histocompatibility complex (MHC) class II genes, while a differential ubiquitin signature is a novel feature of the slan approach.”
Microbiology
Scottish university scientist behind successful rapid-detection Ebola test
With more than 25 different Ebola tests being used in West Africa, the need for consistency, cost efficiency and effective administration in testing, all in alignment with regional protocols is a necessity. Researchers have created a rapid-detection point-of-care saliva test that has been piloted with successful results. The equipment is housed in a suitcase sized mobile laboratory (battery and solar power) and has been deployed in Senegal and Guinea.
Published in the European Centre for Disease Prevention and Control journal Eurosurveillance, the study evaluated 928 post-mortem samples of which 120 tested positive for Ebola. The test kit yielded a sensitivity and specificity of 100% in reference to one real-time RT-PCR assay. Also, the equipment was said to perform exceptionally well under field conditions.
The article cites, “The system represents real progress in the quest to take the laboratory into the field. Our molecular test platform can be adapted to other infectious agents so these mobile laboratories are a sustainable solution for diagnosis of infectious disease in the region and elsewhere."
Anatomic Pathology
HPV test may soon replace Pap smear
As instructed by the National Screening Service and the Health Information and Quality Authority in Ireland, a national health technology assessment will occur this year to assess the clinical and cost-effectiveness of using primary human papillomavirus (HPV) DNA testing instead of the Pap smear. If this is accepted, it will be amongst the first screening programs in the world to convert.
Specifically, the group will be examining the applicability of completing the HPV test first and secondarily utilizing cytology to identify women who need further monitoring or colposcopy. This represents an inversing of order in these tests. Clinical Director of CervicalCheck, Dr Grainne Flannelly states, “In practical terms, a woman would go to her GP and have exactly the same test and the laboratories would do the tests in a different order.” Research has shown that a negative HPV test confers greater protection from the development of CIN3 in the following five years.
Molecular Biology
World first treatment using 'designer immune cells'
Press Release Quote: Professor Waseem Qasim states: "We have only used this treatment on one very strong little girl, and we have to be cautious about claiming that this will be a suitable treatment option for all children. But, this is a landmark in the use of new gene engineering technology and the effects for this child have been staggering."
In this podcast, listen to the discussion about a research team from Great Ormond Street Hospital and their ability to be the first to use designer cells to treat leukemia in an infant that was considered incurable.
The research team used "molecular scissors" to edit genes and create the designer immune cells (used modified T-cells from donors, known as UCART19 cells) to find and eradicate the drug resistant leukemia. Having only been previously tested in mice, the success of this human based procedure is suggested to have potential in combating other blood disorders and cancers.
Press Release: World first use of gene-edited immune cells to treat ‘incurable’ leukaemia
Simple, low risk blood test can detect fetal blood group and genetic conditions in unborn babies
Quote: “The end is now in sight for the invasive techniques of amniocentesis and chorionic villus sampling." states Professor Neil Avent from Plymouth University School of Biomedical and Healthcare Sciences.
As opposed to the traditional amniocentesis test, which carries a minor (1%) risk of miscarriage, the research collaboration between Plymouth Hospitals NHS Trust and Plymouth University has resulted in a simple, accurate and non-invasive low risk blood test that can detect fetal blood group, sex, and genetic conditions in unborn babies. The results of this work have been published in the journal Clinical Chemistry and demonstrates positive results using blood from the mother. The blood can be extracted at her first general practitioner or midwife appointment early in pregnancy. The developed test can be targeted to parents at risk of X-linked genetic recessive diseases including hemophilia and Duchenne muscular dystrophy and mothers at risk of hemolytic disease of the newborn.
Press Release: World First Blood Test Reduces Risk and Increases Accuracy in Prenatal Testing
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