Events during September 2023

A myositis-related autoantibody can now be identified in the majority of patients with myositis. They identify homogeneous patient subgroups and are key tools in developing a personalised approach to disease management. There is substantial clinical interest in exploiting myositis autoantibodies as biomarkers, and consequently, a large number of commercial assays have been developed for their detection. Several different commercial assays have now been developed to detect myositis relevant autoantibodies. Many have been developed with the practicalities of clinical practice in mind, offering rapid, affordable, and often multiplex testing. Despite this progress, the perfect system has yet to be realised.

Commercial testing systems do not detect all known myositis relevant autoantibodies and concerns have been raised about the sensitivity and specificity of some assays, including to their ability detect some autoantibodies strongly associated with malignancy and ILD; important causes of mortality and morbidity.

The advantages and disadvantages of different myositis autoantibody testing systems will be discussed. Evidence for the reliability of different types of assays in comparison to immunoprecipitation, as the reference standard, will be reviewed along with testing strategies that make the most of existing technology.

There are complex regulatory changes taking place across the UK and the EU, which could have a significant impact on laboratory services. This session will cover what you need to know to keep on top of this and know what actions you should be taking for compliance.

Next-generation molecular diagnostics: Leveraging digital technologies to enhance multiplexing in real-time PCR

This presentation will give delegates attending an:

Overview of the pre-analytical processing pathway and potential risks associated with each stage.
Historical/current/prospective optimisation of the pre-analytical pathway.
Understanding of the near-future perspectives for standardisation-will technologies such image analysis and spatial profiling affect the practice of pathology laboratories.

COVID – current issues

Direct immunofluorescence (DIF) techniques provide the gold standard diagnostic tests for a number of autoimmune immunobullous diseases, including pemphigus and pemphigoid and have clinical utility in other autoantibody-mediated disorders. They are typically performed on unfixed, frozen skin, mucosal and renal biopsies. For optimal diagnostic value, material for DIF requires careful preparation and a number of factors contribute to the quality of the assessed tissue sections. In particular, weak specific fluorescence intensity and high non-specific background fluorescence can hinder accurate interpretation.

This presentation will provide a brief overview of best practice for optimising DIF performance, with a focus on skin and mucosal biopsies. Troubleshooting and helpful tips will be provided covering areas including specimen preparation and the importance of using an appropriate transport medium, rinsing considerations prior to block preparation, factors influencing embedding and cryotomy, protocols for optimising fluorescence and appropriate use of conjugates, imaging considerations for digital pathology solutions, storage of material prior to reporting and best practice strategies for maintaining internal and external quality control, with reference to the NEQAS CPT DIF EQA scheme.

Myeloma screening is a high volume investigation pathway, performed by both Biochemsitry and Immunology laboratories. National audit data has shown there to be high variation between laboratories on the implementation of this workflow, leading to potentially inconsistent patient care geographically.

This talk will aim to cover the following areas:

Give brief foundation knowledge on serum electrophoresis/immunodisplacement/immunofixation
Introduce the Myeloma UK Best practice guidelines for Myeloma screening
Discuss Mass spec methods for analysing monoclonal protein
Discuss monitoring of myeloma patients and monitoring of Monoclonal gammopathy of undetermined significance (MGUS) patients.

Food-induced immunotherapy has been practiced with varying success for over 100 years. Over the past 10 - 15 years it has gained a greater recognition in the potential management of children with food allergies. Food-induced immunotherapy can take the form of oral, epicutaneous or sublingual routes and usually results in a short-lived desensitisation rather than the acquisition of tolerance. For this reason, food immunotherapy is not a cure but relies on regular, usually daily, ingestion. Peanut immunotherapy lies mainly within the domain of clinic research however Palforzia (roasted peanut flour), was approved by NICE in February 2022 for the management of peanut allergy in children 4 to 17 years of age. The methodologies and factors associated with successful desensitisation to peanut will be discussed.

Delegates will understand:

The pathophysiological aspects of Vitamin B12.
The role of the laboratory in the diagnosis of Vitamin B12 deficiency.

Join some of our panel members for our lunchtime session where we will be hosting an antibody workshop. Looking at different types of antibodies and how to positively identify or eliminate any suspected clincially significant antibodies, whilst testing your knowledge and skills.

The aim is to make the session fun and interactive, focusing on some top tips for solving those antibody mysteries.