Immunology
Programme sponsor
Transplant Assessment and Relative Opportunity Tool (TAROT) for Renal Transplantation: Improving the chance of transplant for immunologically complex patients
Narcolepsy and its association with HLA type
Narcolepsy and its association with HLA type
Immunology
Abstract
This presentation will introduce basic sleep physiology related to the pathophysiological mechanisms Narcolepsy is a rare but debilitating neurological sleep disorder, with a worldwide prevalence of 25-50 per 100,000 people. Onset is most common during the adolescent years, though a diagnostic delay of around 10 years is common. There is currently no cure, though symptoms can be managed using pharmacotherapy. Biochemistry services provide an important role in confirming a diagnosis of narcolepsy in line with current international guidelines such as the International Classification of Sleep Disorders 3rd edition (ICSD-3).
The aims of this talk are to:
1. Introduce basic sleep physiology related to the pathophysiological mechanisms underpinning narcolepsy.
2. To describe the signs and symptoms of narcolepsy and their impact on patients.
3. To review the diagnosis of narcolepsy including the role of biomarkers such as HLA type and CSF hypocretin.
4. To summarise treatment options for narcolepsy.
Learning outcomes
This presentation will introduce basic sleep physiology related to the pathophysiological mechanisms underpinning narcolepsy.
Delegates attending will be able to:
- To describe the signs and symptoms of narcolepsy
- To review the diagnosis of narcolepsy including the role of biomarkers such as HLA type
- To summarise treatment options for narcolepsy
Speakers
Dr Lizzie Hill
Controlled Human Infection Models: Anti-viral immunity in the respiratory tract
Controlled Human Infection Models: Anti-viral immunity in the respiratory tract
Immunology
Abstract
Controlled human infection models (CHIMs) allow researchers to deliberately infect volunteers with a carefully pre-defined viral inoculum and perform detailed investigations. These can examine both pre-existing immune responses and allow longitudinal sampling of multiple immunological compartments following infection. The unique nature of these CHIMs avoid the multiple confounding factors, which tend to limit conventional observational studies of naturally acquired viral infections in patients.
We have successfully established challenge models of influenza (H1N1 and H3N2), Respiratory Syncytial Virus (RSV) and SARS-CoV2, and used a variety of tools (such as multi-parameter flow cytometry, ELISpot, multiplex cytokine and chemokine arrays and transcriptomics) to characterise populations of low-frequency virus-specific CD4+ and CD8+ T cells in both peripheral blood and cells in the upper and lower airways from challenge participants. We have also been able to extend our infection models into vulnerable populations, such as older adults, and use these techniques to investigate fundamental questions about the kinetics, specificities, and functionality of the cell-mediated response in these clinically relevant populations.
Challenge models allow us to probe the immune response to respiratory viral infections in a uniquely detailed manner. These advantages also make challenge models an attractive approach to testing the efficacy of novel vaccines and vaccine platforms, potentially leading to new vaccines and therapeutics, able to generate robust anti-viral immunity, while avoiding the significant risks and costs associated with traditional Phase II/III vaccine trials.
Learning outcomes
Delegates will understand:
- The role of human challenge studies, using respiratory viruses (e.g. RSV, Influenza & SARS-CoV2), in clinical research and development of vaccines and therapeutics.
- The specific influence of HLA polymorphisms upon anti-viral immunity and how we use this information to explore immune responses in healthy volunteers deliberately infected with viruses.
- The impact of age upon anti-viral immunity, particularly the adaptive immune response to respiratory pathogens
Speakers
Dr Stephanie Ascough
Complement genetic testing
Complement genetic testing
Immunology
Learning Outcomes
This presentation will:
- Provide delegates with an outline of complement genetic testing in a clinical setting.
- Summarise the clinical indications for complement genetic investigations and how these tests combine with complement serology methods.
- Give an overview of the complement genetics panels available in the UK.
- Illustrate the utility of complement genetic testing with clinical scenarios; focusing on immunodeficiency, renal disease, HAE and AMD.
Speakers
Dr Adrian Heaps
Idiopathic Membranous Nephropathy: PLA2 and beyond
Idiopathic Membranous Nephropathy: PLA2 and beyond
Immunology
Learning outcomes
Delegates attending this lecture will understand:
- Understanding of the Pathology of IMN
- Pathology of IMN
- Types / Differentiation of IMN
- IMN Complications
- Diagnosis
- IMN Associated Antibodies
- Utility of Measuring titre
- Assay performance and EQA
Speakers
Chris Scott
Peanut Immunotherapy - theory and practice within the NHS
Peanut Immunotherapy - theory and practice within the NHS
Immunology
Abstract
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.
Learning outcomes
This presentation will understand:
- The rationale for developing safe ways of delivering food immunotherapy within the NHS
- Food immunotherapy and its effects on the immune system
- The various methods of delivering peanut immunotherapy (oral, epicutaneous)
- The use of Palforzia to provide 'bite protection' in peanut allergy
Speakers
Dr Eleanor Minshall
Can a laboratory investigate allergic reactions to COVID vaccines?
Can a laboratory investigate allergic reactions to COVID vaccines?
Immunology
Abstract
Vaccinations to Covid 19 virus have been at the forefront of news headlines. One of the issues highlighted was the risk of adverse reactions, both allergic and non-allergic. This caused an influx of queries to Allergy services regarding patients who had suffered potential allergic reactions and posed the question, 'how can they be investigated'?
The laboratory has limited commercial assays to the components and excipients of vaccines. However, tests can potentially be modified or developed in-house to provide evidence of a potential allergy. They could also be utilised to determine if an alternative vaccination can be used. The testing strategy may need to be adapted on a case by case basis.
There is the potential that this could be used to develop a service for allergic reaction investigation for all vaccine types.
Learning outcomes
Delegates will gain knowledge of:
- The components of vaccines that can be allergenic.
- What laboratory investigations can be performed to determine if an adverse reaction was IgE mediated and how these can be adapted to investigate vaccine responses.
- Whether these investigations be used to determine if alternative vaccines can be given to the individual?
- Apply this information to case presentations to show how the investigations can be adapted depending on the questions that need to be answered for the patient.
- Potential further tests that can be introduced to aid in investigating adverse reactions to vaccines.
Speakers
Kirsty Swallow
Vaccines and immunodeficiency testing
Vaccines and immunodeficiency testing
Immunology
Abstract
A person's immune response to previous antigen exposure is one of the most useful measures of how well their immune system is functioning. Vaccination provides a controlled and standardised exposure to an antigen, with the ability to assess immune responses prior to and after exposure. Different vaccine types can be used to explore different aspects of immune function.
Traditionally, antibody levels have been used to interrogate these responses, and it is possible to explore the quality of the antibody response and also cellular responses. A wide variability in the response to vaccination in healthy individuals can complicate interpretation of vaccine responses in patients with recurrent infections. Protection from infection is multifactorial, and while our ability to assess vaccine responses is improving, this alone is often not enough to assess an individual's immunity.
Learning outcomes
- Describe different vaccines and the immune mechanisms involved in vaccine responses.
- Review of current methods to measure vaccine response.
- Protection or investigation? - how to use vaccination in patients with immunodeficiency.
- Future vaccinology: better vaccines and better response assessments.
Speakers
Dr Aarnoud Huissoon
A practical guide to serum free light chains – technical challenges and clinical utility
A practical guide to serum free light chains – technical challenges and clinical utility
Immunology
Abstract
The analysis of free light chains in clinical laboratories to support the diagnosis and treatment monitoring of Myeloma has evolved over 6 decades. From urine analysis for Bence Jones Protein using gel electrophoresis in the 1950s to the launch of the first commercial assay for serum free light chain measurement in 2001.
This talk will describe the biochemistry of free light chains and the benefits and challenges of the different methodologies available in laboratories today. I will also describe the complexity of clinical interpretation of results, highlighting relevant national guidance, recently developed diagnostic tools for clinicians and testing advice for laboratories.
Learning outcomes
Delegates will understand:
- What are free light chains
- Monoclonal v’s polyclonal free light chains
- Why we measure free light chains by different methods
- The laboratory methods we use for measurement
- The pros and cons of immunoassay and electrophoresis free light chain measurements
- The clinical relevance of results
Speakers
Joanne Morris
Immunology online Specialist Diploma programme
HSD in Immunology – A case study (Multiple Myeloma)
HSD in Immunology – A case study (Multiple Myeloma)
Immunology
Abstract
This presentation will cover a case study completed as part of the IBMS Specialist Diploma in Immunology in 2022. It will be of interest to anyone considering completing the Higher Specialist Diploma in Immunology, or anyone who would like to learn more about the case study element. It will also be of interest to anyone who would like to learn more about the protocols used for reading and reporting methods including immunophenotyping by flow cytometry, serum protein electrophoresis and immunotyping, serum free light chains and Bence Jones protein analysis at Greater Manchester Immunology Service (GMIS).
The case is one of an elderly gentleman with who, like roughly a third of new myeloma cases in the UK, presented through A&E. The presentation will cover pre-analysis, analysis and post-analysis, considering how the tests performed in the Immunology laboratory assist in the differential diagnosis and where they fit in with the other tests ordered, both tests within and outside of the Immunology discipline. The presentation will cover the methods performed at GMIS and some of the reporting protocols, as well as discussing some of the relevant associated guidelines.
Learning outcomes
This case study on Multiple Myeloma will demonstrate how the testing perform in the Immunology laboratory supports the clinical diagnosis, alongside the testing performed in other Biomedical Science specialities. It will provide an oversight of how Immunology testing can impact the patient’s outcome.
The talk will be helpful for other prospective HSD students or those interested in what the HSD in Immunology involves; as well as demonstrating the testing pathway for electrophoresis at the Greater Manchester Immunology Service.
Speakers
