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The presentation provides an overview on the technology and analytical performance of a new true molecular point of care testing system without need for upfront specimen preparation, and the potential benefits resulting from its use at the point of care. The presentation also discusses key aspects to be considered prior to implementation at the point of care

Polio – why has it reappeared?

The idea of generating blood cells in vitro for transfusion is not new but only now we are reaching the point where the concept is reaching clinical trials. In vitro derived blood cells (namely platelets and red cells at this stage) are complementary to blood donor-derived products but with distinct advantages: biological safety, more resilient supply line and potentially less immunogenicity.

We have developed a forward programming approach relying on the overexpression of transcription factors in pluripotent stem cells to produce the platelet mother cells, the megakaryocytes, conferring added efficiency and purity to the culture system. The challenges that remain to be addressed are related to transition to GMP production, optimising platelet release in the culture and quality control of the final product. The power of genome editing has also allowed us to explore the production of platelets with added clinical benefit (immune silent, added thrombotic potential).

Red cell production from primary CD34+ progenitors has been demonstrated in academic laboratories about a decade ago. We are now mid-way through a first in human study to look at the potential of using in vitro derived red cells for transfusion. One of the main benefits would be a potentially longer survival of the manufactured red cells in the circulation than their donor-derived counterpart. This would allow spacing out transfusion intervals for patients on chronic transfusion programme, thereby reducing iron overload.

This presentation is based on a case study used for a portfolio of Higher Specialist Diploma awarded by the IBMS. The presentation will look at how blood cultures taken on admission helped with diagnosis and appropriate treatment of a patient. It will also go in to brief detail on the organism isolated, Streptobacillus moniliformis.

Diphtheria is a potentially fatal disease caused by strains of Corynebacterium diphtheriae, C. ulcerans or C. pseudotubercolosis that express the diphtheria toxin. It can present as a respiratory infection or as non-healing skin wounds. Diphtheria was historically most likely to be caused by C. diphtheriae. It is very rare in England (typically <10 cases per year) due to a successful routine immunisation programme. However, there has been a recent gradual increase in cases over several years, particularly cutaneous infections and those caused by toxigenic C. ulcerans strains (which can be carried by household pets).

In 2022, there was a particulary large increase in diphtheria in England, with 87 cases and 3 deaths. This included 72 toxigenic C. diphtheriae infections in asylum seekers, thought to be aquired during their travel to the UK. Symptoms ranged from severe respiratory diphtheria to cutaneous infections and asymptomatic carriage. Similar increases of C. diphtheriae infections in travelling migrants have been seen in several European countries. Some of these isolates are multidrug resistant, including to macrolides, the default recommendation for treatment, and this will require careful monitoring.

Effective vaccine must deal with extreme HIV-1 variability and do so without guidance from natural immunity. For HIV-1, vaccines may need to induce both bNAbs and protective CD8+ killer T cells, the latter of which clearly impose a selective pressure on the virus and their protective potential should be harnessed by vaccines. However, not all antibodies and CD8+ T cells are protective; they must target vulnerable parts on HIV-1 proteins.

The central paradigm of the HIVconsvX T-cell vaccine strategy is focusing T cells on the functionally conserved regions of the HIV-1 Gag and Pol proteins, which are very similar among global isolates and harbour fewer escape mutations. At the epitope level, the remaining variability within the conserved regions is addressed computationally by using a bi-valent mosaic. Results of the first trials testing the HIVconsvX vaccine candidates confirmed that conserved sub-dominant and, therefore, underused T-cell epitopes taken out of the context of the whole virus or full-length viral proteins can induce robust and broad T-cell responses when delivered by an effective heterologous regimen such as ChAdOx1-MVA.

Progress towards an effective HIV-1 vaccine has been slow and riddled with many setbacks. However, systematic iterative development of vaccine components for both neutralizing antibodies and effective T cells informed by human data is beginning to pay off by bringing the first encouragements endorsing the field’s overall direction of travel.

Trichophyton indotinaea is a newly described species of dermatophyte that has emerged with the last 10 years in India, and some Middle Eastern countries. It causes tinea corporis and tinea cruris mainly (ringworm infection of the torso and groin) and can spread to the arms, legs and face. T. indotineae is also characterised by a reduced susceptibility or outright resistance to one of the commonly used and otherwise highly effective antifungals, terbinafine. While high levels of cases are seen in Indida, countries outside of India and the Middle East are now seeing imported cases and the UK is not alone. Working with colleagues in London we have identified signficant numbers of cases and are now understanding how difficult these infections are to treat, even with antifungals that the organism should be sensitive to. Lesions are only superficial, but are itchy and disfiguring, and often relapse after initial antifungal therapy. We are continuing to learn about the epidemiology, transmission, diagnosis and treatment of this emerging infection.

Despite effective treatments and vaccines viral hepatitis remains a massive burden on global health affecting the poorest counties disproportionately. Effective treatments and diagnostics for hepatitis remain outside the reach of most people in resource-poor regions.

In contrast, UK strategies against viral hepatitis have been relatively successful, in particular the prospect of HCV elimination, which is already showing improved outcomes in liver health.

Effective strategies depend on high quality epidemiological data which is gleaned from a wide variety of sources including diagnostic laboratory reporting, sentinel surveillance programs and prospective screening of high-risk groups.

The key components preventing transmission of blood-borne viruses such as donor screening, surveillance of susceptible groups and vaccination are now further enhanced by retrospective case finding from historical data, opt-out screening in emergency departments and high intensity test-and-treat events in prisons.

Biomedical Scientists can make a valuable contribution towards viral hepatitis management by sharing local-level data, enabling practical testing solutions for marginalised groups and working closely with clinical teams.

Who lives in a papaya under the sea? SpongeBob Alloadsorption Pants! A Transfusion Laboratory Perspective of AIHA

The debate about performance and sustainability of our healthcare services is often reduced to a questions of money and beds are there enough of either? Both are back ups to the more important question - are there enough staff?

The size and complexity of the workforce challenge means there will need to be concerted and sustained action across the system on workforce planning, training, retention, productivity, job roles and creating workplace cultures - that demonstrates staff are valued. For our sector, action is needed both in the short term and the long term to support the workforce and meet the needs of our service and how this will meet the wider healthcare service for patients.

This presentation will look at how leaders at all levels need to work collectively to address our workforce challenge and how we can together take action at a local, regional and national level.