BioMedica2022 Online: Monday 28th & Tuesday 29th March 2022
Session 1: 10am - Monday 28th March: Welcome / President’s Address and Keynote Speaker: Dr Catherine Ludden. +Microbiology and Virology
Monday 28th March
10:00: Welcome & President’s Address
Bernadette Jackson, President of the Academy of Clinical Science and Laboratory Medicine
Keynote Speaker: Dr Catherine Ludden, Medical Scientist and Director of Operations, COVID-19 Genomics UK Consortium (COG-UK).
From Medical Science to Variant Hunting
Dr Catherine Ludden is Director of Operations for the COVID-19 Genomics UK Consortium (COG-UK) and Director of COG-Train. She is responsible for overseeing COG-UK operations and the delivery of the COG-Train programme, developing long-term strategic plans, coordinating public health investigations, and engaging with technical experts, collaborators and senior leaders. Catherine also holds the position of Head of Operations for the Pathogen Genomics COVID Programme at Public Health England (PHE) and is responsible for the service delivery of SARS-CoV-2 genomics in the UK and the continuous genomic service improvement. Catherine is a genomic epidemiologist with expertise in pathogen genomics, antibiotic resistance, and clinical microbiology. Prior to joining COG-UK and PHE, Catherine was working with the European Centre for Disease Prevention and Control where she provided scientific and technical expertise for the analysis and interpretation of European whole genome sequencing datasets and supported international outbreak investigations. She is a One Heath expert and was previously awarded a Sir Henry Postdoctoral Wellcome Fellowship at the London School of Hygiene and Tropical Medicine to define reservoirs and transmission of antimicrobial-resistant Escherichia coli using a One Health approach.
Catherine will address the following topics:
2. Genomic epidemiology (case studies)
3. COVID-19 Genomic UK consortium
4. Medical science driving future developments of clinical diagnostics
11:00 – 12:30 Microbiology / Virology
Investigation of D614G SARS-CoV-2 pseudovirus infectivity and binding of Spike protein to the ACE2 receptor.
Laura McCullagh, Senior Technical Officer, NVRL
Graduated with a degree in Biomedical Science with a diploma in Professional Practice from the University of Ulster in 2010 and then moved to Australia to work as a Product Development Technician at Regeneus, Sydney. After moving back to Ireland, worked for the last four years in the National Virus Reference Laboratory (NVRL), UCD, Dublin as a Technical Officer in the Serology section and a Senior Technical Officer in Molecular Virology before recently taking up a Research Assistant post in the University of Ulster, Magee. Obtained a MSc in Biomedical Science specialising in Microbiology in Sept 2021 through the University of Ulster online, which included a research project investigating the correlates of protection in SARS-CoV-2
Understanding the functional characteristics of the antibodies produced against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) will assist in the determination of disease outcome for this virus. In this study, the ability of antibodies to inhibit virus entry into the host cell through the interaction of the receptor binding domain of the viral spike protein and the Angiotensin-Converting Enzyme 2 receptor on the human cell surface was investigated. SARS-CoV-2 IgG levels in 20 SARS-CoV-2 positive patients were measured using an enzyme linked immunosorbent assay and the samples further analysed using a functional binding assay. Inhibition of viral infectivity was also measured using a pseudovirus neutralisation assay against the D614G SARS-CoV-2 virus strain. Significant correlation between the specific IgG levels and the neutralising antibody 50% inhibitory concentration (IC50) titres was observed, (p<0.05). Similarly, the IC50 titres obtained in the neutralisation and binding assays showed significant correlation (p<0.001). Varying levels of IgG and IC50 titres were observed for the SARS-CoV-2 antibody-positive samples with one sample not showing any neutralising capability despite detectable IgG levels. Gender comparisons showed no statistical differences for any of the assays. These results suggest that increased SARS-CoV-2 IgG levels correlate with greater protection against entry of the virus into cells; however, further investigations in larger studies are needed to confirm the correlates of protection.
Revised EUCAST guidelines- the SVUH perspective.
Orla Donoghue, Senior Medical Scientist, St Vincents Healthcare Group
Orla Donoghue is a Senior Medical Scientist in the Microbiology Department of St. Vincent’s University Hospital. She has a particular interest in antimicrobial susceptibility testing and has worked predominantly in this section of the laboratory for the last ten years.
The European Committee on Antimicrobial Susceptibility testing (EUCAST) is responsible for developing and standardising in-vitro antimicrobial susceptibility testing methods used in Europe and determining, reviewing and revising European clinical breakpoints for the surveillance of antimicrobial resistance. In the past number of years EUCAST have introduced significant changes to their breakpoint tables for interpretation of MIC’s and zone diameters. These changes primarily came about as a result of the redefinition of the traditional “Intermediate” category of antimicrobial susceptibility testing to “Susceptible, Increased Exposure”. In 2022 the guidelines have recommended a new method of anaerobic susceptibility testing.
The implementation of these new guidelines presented a challenge for both laboratory staff and the clinical microbiology team. This presentation will outline the approach taken in the Microbiology Department of St. Vincent’s University Hospital to introduce the changes, the challenges faced and issues remaining.
Transfusion and Transplantation Science
Implementation of the Haemobank® – a remote assignment blood fridge in University Maternity Hospital, Limerick (UMHL)
Loretta O’Brien, Acting Senior Medical Scientist,Blood Transfusion Laboratory, University Hospital Limerick
I have been working as a Medical Scientist in the Blood Transfusion Laboratory, University Hospital Limerick, for almost 15 years. I qualified as a Medical Scientist in 2007, with a BSc in Biomedical Science from University College Cork. I continued my education by completing an Msc in Biomedical Science (including specialist study in Haematology with Transfusion Science) in 2012 from the University of Ulster. As part of my experience in the Blood Transfusion Laboratory, I have performed the role of Quality Manager and was in this position for a number of successful INAB inspections. I have experience in the validation, management and troubleshooting of the PDAs, across the UL Hospitals group and have also been in the role of deputy of equipment management. From April to December 2021, I performed the role of Haemovigilance Officer for University Maternity Hospital, Limerick. During this period, in addition to the regular Haemovigilance duties, I trained midwifery and clerical staff to our new remote assignment fridge- the Haemobank. To date, this has been a very successful project, with many benefits to both laboratory and clinical staff. I am currently the laboratory lead on the introduction of the targeted Routine Antenatal Anti-D Prophylaxis (tRAADP) project, with a view to implementation in Q1/Q2 2022.
The Haemobank® remote release blood fridge was introduced in UMHL in July 2021. It allows the remote assignment of blood by the Blood Transfusion Laboratory at UHL (5km away). It can be used for patients who are suitable for electronic issue and allows blood to be available 24/7. Approximately 20 units of blood, of different blood groups, are stored in the Haemobank. Previous practice involved having crossmatched blood on site for high-risk patients but now only patients that are not suitable for electronic issue, are issued crossmatched blood. Training: Haemovigilance developed a procedure and video to facilitate training for midwifery staff. Benefits: Faster delivery: Improved turnaround times for blood availability for patients. Transport time from UHL to UMHL can take 15 to 30 minutes. Turnaround time (from unit assigned to begin transfusion) shown to be as efficient as 4 minutes in recent audit. Improved safety: Computerised control of the release of blood minimises the opportunity for human error and the removal of the incorrect unit for the patient. Decreased crossmatch to transfusion (C/T) ratio: C/T ratio is decreased as blood is only assigned to the patient when the decision is made to transfuse. C/T ratio of 24:1 in June 2021 reduced to 5:1 in December 2021. Savings on time and money: Reduced transport costs as less taxis required. Stock rotation performed as required by the haemovigilance officer. Time saving for maternity and laboratory staff as less movement of blood between the sites. 770 less units issued during first 6mths of Haemobank use. Conclusion: The Haemobank allows faster delivery of blood for maternity patients at point of care. This system supports the Blood Transfusion laboratory in UHL and provides a safe and efficient blood transfusion service for patients.
15:30 – 16:00
Fetal RhD Genotyping in Ireland
Dr Diarmaid Ó Donghaile, Consultant Haematologist, IBTS.
16:00 – 16:30
Alice Lorusso, Senior Medical Scientist, IBTS
16:30 – 17:00
Advanced Practice for Medical Scientists in Solid Organ Transplant
James Kelleher, Senior Medical Scientist, Beaumont Hospital
10:00 – 10:45
The Role of the Haematology/Transfusion Consultant Scientist in the Delivery of Clinical and Laboratory Haematology Services
Dr Sharran Grey OBE DClinSci FRCPath FBBTS FAHCS MSc Cert Mgmt Lancashire Haematology Centre, Blackpool Teaching Hospitals NHS Foundation Trust
Dr Grey joined the consultant team at Lancashire Haematology Centre in December 2019. She performs a Haematology Diagnostic Clinic and provides advice and guidance on obstetric haematology. Her specialist responsibilities are lead consultant for blood transfusion and Laboratory Director/Clinical lead for the Haematology and Blood Transfusion laboratories. She is also specialty clinical chair for the newly forming Lancashire & South Cumbria Pathology Service. She has trained and worked in the North West of England. Her doctoral research was ‘Accelerated Blood Transfusion for Selected Patients’ for which she won an NHS England Chief Scientific Officer’s Award in 2017. She also developed and implemented a CE marked red cell dosage web app. She was appointed as a Working Expert for Transfusion-Associated Circulatory Overload for Serious Hazards of Transfusion in 2015. She has a special interest in pulmonary complications of transfusion and contributes to the advancement of this area at an international level. She is also an associate lecturer at Manchester Metropolitan University. Sharran has a number of publications and is a regular contributor at regional and national transfusion forums. She was honoured with an OBE for services to blood transfusion and patient care in 2021.
The British Society for Haematology (BSH) published a haematology workforce report in 2019 which provided a detailed analysis of staff resource issues in haematology and set the scene for the need for a strategic workforce review. The Royal College of Pathologists (RCPath) produced a report shortly after this with similar findings that recognised that Consultant Scientists are well-placed to fill the gaps that have arisen due to staffing issues within the medically qualified haematology workforce, making recommendations to Trusts to appoint Consultant Scientists to support haematology services and patient care. A report was researched by a group of scientifically and medically qualified haematologists, and published by the National School for Healthcare Science (NSHCS) in Health Education England (HEE). The report aimed to identify ‘service gaps’ that remain unfilled by medically qualified consultant haematologists because of recruitment issues, gaps in specialist expertise issues or workload pressures. The report also made recommendations regarding trainee eligibility and education. The finding and recommendations of the report were based on existing consultant/trainee consultant roles and expert opinion. Given the high-level of expertise and utility of this role, the low nu PVGM-Lite Shortcodember of posts suggest this is a highly under-recognised and underutilised workforce resource ideally placed to address gaps in the medical haematology workforce. A blended medical and scientific consultant workforce provides a flexible solution to staffing and recruitment issues in Haematology and Blood Transfusion, and progressive strategy for the future developlement of the profession.
A review of Digital morphology case: “The monkey illusion”.
Therese Cohalan, Medical Scientist, Haematology Department, Cork University Hospital.
Therese is a Medical Scientist working in the Haematology department in Cork University Hospital. She began her career thirteen years ago in the Haematology and Blood Transfusion department in the Coombe Women & Infants University Hospital after graduating with an honours degree from Cork Institute of Technology/University College Cork in 2007. She completed her honours masters in Biomedical Science from Cork Institute of Technology/University College Cork in 2011, specialising in Haematology and Blood transfusion. Therese received her fellowship from the academy in 2014. In 2014 Therese moved home to Cork and joined the Haematology department in Cork University Hospital. Therese has a keen interest in Blood Morphology.
*change in programme
Evans syndrome: an interesting case in Cork University Hospital (CUH).
Lucianne Keating, Medical Scientist, Cork University Hospital
Lucianne is a medical scientist from Tipperary and is a graduate of the BSc Biomedical Science programme at TU Dublin (2020), graduating with a double major in haematology and immunology. At present, Lucianne is undertaking the MSc Biomedical Science Programme at Ulster University and is due to graduate in 2022. Lucianne is currently working in the Haematology laboratory in Cork University Hospital (CUH). Lucianne is eager to nurture and influence developments in the field of medical science by pursuing further education in the hope of contributing more specialist knowledge and learning to the ever-expanding pool of expertise and research in the field.
Evans Syndrome is a rare and chronic autoimmune disease characterised by ‘warm’ autoimmune haemolytic anaemia and immune thrombocytopenia. The disease predominates in a paediatric population. Clinical presentations can include, jaundice, pallor and mucosal bleeding. Acute manifestations include massive haemolysis and severe bleeding. Remissions and exacerbations occurring throughout a patient’s lifetime. I describe a case of a 42-year-old female who presented to the emergency department in CUH with a history of haemolytic anaemia, splenectomy and thrombocytopenia. There will be focus on the unusual and interesting features of disease in this patient as well as response to treatment. I will primarily focus on the role of the haematology laboratory in its investigation of this case and how it aided in monitoring the patient’s clinical state.
13:00 – 13:30
Rapid Tissue Processing Workflow in Tallaght University Hospital,
Laura Anne Williamson Senior Medical Scientist.
‘Harnessing the epigenetic footprint of cervical samples for breast and ovarian cancer detection and prediction’
15:00 – 15:40
Development of therapeutic mRNA vaccines for cancer
Dr Mark McCarron, Principal Scientific Researcher in Cancer Immunology at Genentech Personalised Cancer Vaccines, California.
Dr McCarron is Principal Scientific Researcher and Project Team leader in Discovery Cancer Immunology at Genentech (San Francisco) where he leads research on individualized neoantigen therapies. Dr McCarron received his degree in Biomedical Science from TU Dublin and his PhD in Immunology from University College Dublin and held postdoctoral positions at the National Institute of Health (INSERM) in Lyon (France) and Albert Einstein College of Medicine in New York (USA). Dr McCarron has greater than 15 years of R&D experience in immuno-oncology, vaccination, inflammation and autoimmune disease.
Cancer-specific mutations can generate neoantigens that are recognized as foreign by the immune system and elicit potent T cell responses against cancer. The identification of neoantigens as drivers of effective anti-tumor immunity has prompted the development of neoantigen-based strategies for the generation of large numbers of tumor-specific T cells. Genentech is currently developing two complementary approaches; therapeutic cancer vaccines (mRNA and DNA) to stimulate and expand the endogenous patient T cell response, and adoptive T cell therapy using TCRs engineered to target patient neoantigens. In my talk, I will share data on the clinical development of our mRNA neoantigen vaccine platform that is currently being evaluated in a phase 2 first-line melanoma clinical trial. I will also share pre-clinical data showing that interleukin 1 receptor antagonist (IL-1ra) is an endogenous, inducible suppressor of systemic inflammation in response to mRNA vaccination, and how differences in the IL-1ra response result in dramatic differences in tolerability between mice and humans to mRNA vaccination.
15:30 – 16:00 Implementation of Siemens RAPIDsystems Point of Care Blood Gas Analysers
Francesca Patton, Chief Medical Scientist, Biochemistry Letterkenny University Hospital
Francesca started her career at LUH as a basic grade medical scientist in 2003, became a senior medical Scientist which involved alot of POCT at LUH for 7 years and is currently the Chief in Biochemistry for nearly 3 years.
Presentation on the implementation of Rapidpoint 500 ABG analysers across the hospital site, from existing 3 Radiometer devices to initial 10 Rapidpoint devices and 3 added to support Covid -19 plans.
16:00 – 16:30 SPE as a pathway to diagnosing alpha-1 antitrypsin deficiency (AATD)
Dr Tomás Carroll, Chief Scientist, Alpha-1 Foundation Ireland; Senior Lecturer, RCSI
Tomás is chief scientist with Alpha-1 Foundation Ireland and senior lecturer at RCSI. A native of Sligo, Tomás graduated from University College Galway in 1995 with a B.Sc. in Biotechnology. He completed a M.Sc. in Biomedical Science (2000) at UCG and then began a PhD in cystic fibrosis at the Royal College of Surgeons in Ireland (RCSI). After finishing doctoral work in 2004, he began working on alpha-1 antitrypsin deficiency (AATD) in a position with Alpha-1 Foundation Ireland at RCSI. The Foundation is dedicated to raising awareness, increasing diagnosis, promoting research, and improving the treatment of AATD (see www.alpha1.ie). He has carried out research in innate immune signalling, ER stress, and AATD, leading to over 40 publications spanning basic, clinical, and translational research. In addition to research, Tomás coordinates the national screening programme for Alpha-1 which has tested over 22,000 Irish people since it began in 2004. The HSE-funded programme provides free testing for AATD and has so far diagnosed over 430 Irish people with severe AATD and over 4,500 Irish people with moderate AATD.
Serum protein electrophoresis is how alpha-1 antitrypsin deficiency (AATD) was first discovered in Sweden almost 60 years ago. AATD can cause lung, liver and skin disease and is one of the most common genetic conditions in Ireland. It is caused by mutations in the SERPINA1 gene which lead to a quantitative and qualitative deficiency of serum AAT protein. AATD is under-diagnosed and many affected do not receive a diagnosis until the onset of severe lung or liver disease. The typical adult presentation is COPD, although many newborns are diagnosed with AATD because of liver dysfunction. Importantly, the lifelong risk of lung disease can be greatly reduced by the complete avoidance of smoking or vaping. For this reason early diagnosis is associated with greatly improved health outcomes. Alpha-1 antitrypsin is the major component of the alpha-1 globulin fraction in blood and individuals with severe AATD (ZZ genotype) display a markedly decreased alpha-1 globulin fraction. Individuals with more common moderate AATD (MZ genotype) also display reduced alpha-1 globulin. Of note, the rare F mutation leads to an unusual split alpha-1 globulin band and can be easily identified by SPE. In summary SPE remains a valuable first step on the path to identifying AATD and often prompts an earlier diagnosis of AATD. Low or split alpha-1 globulin SPE results should be reflexed for further testing. This would help tackle the continuing under-diagnosis of AATD and facilitate improved health outcomes.
16:30 0 17:00 PIMS-TS/ covid complications in children
Dr T. Ronan Leahy MB PhD FRCPI Consultant in Paediatric Immunology and ID, Senior Clinical Lecturer in Paediatric Immunology Chair, Drugs and Therapeutics Committee Children’s Health Ireland (CHI) at Crumlin
Dr T. Ronan Leahy is a Consultant in Paediatric Immunology and Infectious Diseases based in Children’s Health Ireland @ Crumlin, Dublin, appointed in 2013. He is a graduate of the National University of Ireland Galway. Having undertaken basic and higher specialist training in Paediatrics in Ireland, he completed a fellowship in Paediatric Infectious Diseases in the Hospital for Sick Children Toronto and subsequently a fellowship in Paediatric Immunology/BMT in the Great North Children’s Hospital, Newcastle upon Tyne, UK. He is the National Specialty Director for Paediatric Immunology and a member of ESID, ESPID and IAAI. He completed a PhD in clinical medicine on the topic of “Molecular predictors of disease severity in viral bronchiolitis” in Trinity College Dublin. He is a Clinical Professor in Paediatrics in the school of medicine in Trinity College, Dublin.
A brief summary of the current state of knowledge in clinical presentation, diagnosis and management of COVID-19 and its complications in children.