Latent Tuberculosis Infection

SPOT the hidden DANGER of latent TB

 

 

 

 

 

 

Active TB vs Latent TB

Of the global population, approximately 2 billion people is estimated to be infected with Mycobacterium tuberculosis1. There are two types of tuberculosis (TB) conditions: active tuberculosis (TB) disease and latent TB infection (LTBI). If untreated, approximately 5%–10% of persons with LTBI may progress to active TB disease, passing the infection to others2 According to the WHO End TB Strategy, systematically providing TB preventive treatment to those at highest risk of developing active TB will prevent the development of disease and reduce the risk of transmission in the population; this is a critical step to End TB.

Latent tuberculosis infection (LTBI) is a state of persistent immune response to stimulation by M. tuberculosis antigens without evidence of clinically manifested active TB3. The immune system cannot eliminate TB bacteria completely instead it is contained in the granuloma. They may develop disease in the future when the immune system weakens, making the person ill and at risk of spreading the infection.

 

 

 

 

 

The WHO’s annual report4 on the status of global efforts to End TB notes that, at the present trajectory, most WHO regions and individual countries will fall significantly short of the End TB milestones. Hence, global TB prevention efforts along with targeted testing and treatment of latent TB infection builds a strong core TB infrastructure to realizing TB elimination. For an infection that kills 1.3 million a year, there’s routine screening or a gold standard test for LTBI5 – Either a tuberculin skin test (TST) or interferon-gamma release assay (IGRA) is used. A diagnosis of LTBI first requires that active TB disease be excluded by medical evaluation.

IGRAs are whole-blood tests that measure the individual’s immune reactivity to tuberculosis. Leukocytes from most individual who have been infected with M. tuberculosis will release interferon-gamma (IFN-g) when mixed with antigens derived from M. tuberculosis. To conduct the test, fresh blood samples are extracted and mixed with antigens and controls. Two IGRAs approved by the U.S. Food and Drug Administration (FDA) are6:

  • QuantiFERON® – TB Gold In-Tube test (QFT–GIT);
  • SPOT® TB test (T–SPOT.TB)

The antigens, testing methods, and interpretation criteria for IGRAs differ as below:

 

 

 

 

 

 

 

 

 

The incremental cost-effectiveness of IGRAs and TSTs appears to be influenced mainly by their accuracy. Bacille Calmette-Guérin (BCG) vaccination plays a decisive role in reducing the specificity of TST, leading the choice towards adopting IGRA-only strategies for better diagnostic accuracy.As with TSTs, IGRAs should be used as an aid in diagnosing latent infection with M. tuberculosis. A positive test result suggests that M. tuberculosis infection is likely; negative result suggests that infection is unlikely. An indeterminate result or borderline test result (T-Spot only) indicates an uncertain likelihood of M. tuberculosis infection6.

NOT all IGRAs are the same.

The T-SPOT.TB test is the only globally regulated IGRA that is normalised for both cell number and culture conditions in each patient specimen. The cell enumeration technology in the proprietary T-SPOT.TB test removes serum factors that could adversely affect the test result, making it the most sensitive and most specific test for TB infection7, supported by clinical data obtained even in challenging patient populations.

Learn more about the T-SPOT.TB Test here.

 

References:

  1. Houben RM, Dodd PJ. The global burden of latent tuberculosis infection: a re-estimation using mathematical modelling. PLoS Med 2016;13:e1002152.
  2. Sutherland I. Recent studies in the epidemiology of tuberculosis, based on the risk of being infected with tubercle bacilli. Adv Tuberc Res 1976;19:1–63.
  3. Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Geneva: World Health Organization; 2018.
  4. WHO End TB Strategy. World Health Organization. WHO End TB Strategy. Published September 8, 2015. Assessed January 9, 2020.
  5. WHO End TB Strategy. Latent tuberculosis infection Updated and consolidated guidelines for programmatic management. Published 2017, Assessed November 30, 2021 via https://apps.who.int/iris/bitstream/handle/10665/260233/9789241550239-eng.pdf
  6. Centres for Disease Control and Prevention, Interferon-Gamma Release Assays (IGRAs) – Blood Tests for TB Infection Fact Sheets. Published May 4, 2016. Assessed November 30, 2021 via https://www.cdc.gov/tb/publications/factsheets/testing/igra.htm
  7. Oxford Immunotec. T-SPOT.TB Package Insert PI-TB-IVD-UK V3. Abingdon, UK. February 2019
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Abionic Early Sepsis Detection with Pancreatic Stone Protein (PSP)

Early Sepsis Detection with Pancreatic Stone Protein (PSP)

Sepsis

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.

Early recognition of sepsis is essential and is a major determinant of the disease’s outcome, according to The WHO and the Surviving Sepsis Campaign.

However this has proven to be challenging as the confirmation of sepsis diagnosis is based largely on nonspecific clinical signs, laboratory findings and medical scores which are usually obtained after sepsis onset.

Currently, C-reactive protein (CRP) and procalcitonin (PCT) are biomarkers routinely used for patients suspected of sepsis. Pancreatic stone protein or PSP is an emerging biomarker showing promise as it is characterized by higher accuracy in the diagnosis and prognosis of sepsis compared to CRP and PCT.

The Pancreatic Stone Protein (PSP)

• A 16 kDa polypeptide of the C-type lectin family of protein.
• Mostly secreted by the acinar cells of the pancreas but also by the intestine and stomach.
• An early sensor of sepsis and multiple organ dysfunction acting as an “alert signal” to help clinicians provide adequate infection control strategies and organ support to restore homeostasis.

Performance

PSP was proven to be more accurate, with a higher sensitivity, specificity, positive and negative predictive values than CRP, PCT, IL-6 and other cytokines for the diagnosis of sepsis and prognosis of unfavourable outcomes in multiple studies and clinical settings (ED, ICU, surgical, nonsurgical adult and children).

It also performed well in studies involving a variety of critically ill patients including severe burns, polytrauma, post-cardiac surgery and on admission to the ICU.

Unique Characteristic

PSP may start to increase above the normal level before the development of clinical signs and symptoms of sepsis.

It was found to be the only biomarker able to identify sepsis 72 hours before clinical diagnosis, thereby providing a large window of opportunity for timely initiation of accurate clinical management.

PSP Measurement

Can now be done via a Point-of-Care(POC) device, which is uncommon for CRP and PCT in ICU, leading the way for simple, on-demand, around-the-clock, serial biomarker assessments instead of one-off testing upon clinical suspicion of sepsis.

This is key to faster treatment decisions, reducing mortality and lowering sepsis-related healthcare costs.

The IVD CAPSULE PSP on the abioSCOPE® is the first CE-marked in vitro diagnostic test to enable fast, reliable and early sepsis detection at the pointof-care from a single drop of blood in only 5 minutes.

Click the link below for more information:

Products | Abionic

 

References:

Eggimann, Philippe & Que, Yok-Ai & Rebeaud, Fabien. (2019). Measurement of pancreatic stone protein in the identification and management of sepsis. Biomarkers in Medicine. 13. 10.2217/bmm-2018-0194.

Pugin, J., Daix, T., Pagani, JL. et al. Serial measurement of pancreatic stone protein for the early detection of sepsis in intensive care unit patients: a prospective multicentric study. Crit Care 25, 151 (2021). https://doi.org/10.1186/s13054-021-03576-8

World Health Organization (WHO). Sepsis. https://www.who.int/news-room/fact-sheets/detail/sepsis

Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study. Lancet (London, England). 2020;395(10219):200-11.

Klein HJ, Niggemann P, Buehler PK, Lehner F, Schweizer R, Rittirsch D, Fuchs N, Waldner M, Steiger P, Giovanoli P, Reding T, Graf R, Plock JA. Pancreatic Stone Protein Predicts Sepsis in Severely Burned Patients Irrespective of Trauma Severity: A Monocentric Observational Study. Ann Surg. 2021 Dec 1;274(6):e1179-e1186. doi: 10.1097/SLA.0000000000003784. PMID: 31972652.

Keel et al., 2009 and Reding et al., 2018 Pathophysiological mechanisms of PSP function in Sepsis- Abionic slides; Abionic brochure

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Unravelling The Complexity Of Tumor Microenvironment With High-Dimensional IHC Analysis Platform

27th August 2021, 4pm – 5pm SGT

A comprehensive understanding of the tumor microenvironment, including stromal composition, cell-cell and cell-matrix interactions, abnormal physiology, as well as cellular characteristics of heterogenous tumors is the key to elucidating cancer complexities. Understanding the cellular, molecular, and biochemical interactions of tumors within their microenvironment is essential to improving cancer diagnosis and treatment.

With multiplexing IHC (mlHC) technologies and high-content pathological analysis platform, scientists can simultaneously detect multiple markers on a single tissue section and the comprehensive study of cell composition, cellular functional and cell-cell interactions. mlHC provides high-throughput multiplex staining and standardized quantitative analysis for highly reproducible, efficient and cost-effective tissue studies. This technique has immediate potential for translational research and clinical practice, particularly in the era of tumor microenvironment study and cancer immunotherapy.

 

Speaker's Biographies

By Dr Edward, Li
International Strategic Marketing Manager

Review employee support systems and work policies to ensure they are forward thinking

Organizations should constantly improve their talent acquisition and retention framework, review workflows to improve processes, build up financial standing with external stakeholders and adopt automation technology to reduce burden where possible, believes Ng Boon Thiam, Group CEO of Biomed Global.

Ng Boon Thiam is the Group CEO of Biomed Global – one of the most respected channels in the biomedical and life sciences industry in Malaysia and Singapore. Recognizing the need to improve the standards of healthcare in Malaysia, he started Biomarketing Services (now known as Biomed Global) in 1994 together with his business partner, Chen Keng Hoong. Over the years, Biomed Global has performed strongly in Malaysia and Singapore and has expanded regionally to a number of ASEAN countries. Now, the company has grown to be a significant total solution provider for Clinical Diagnostics and Life Science.

In an exclusive interaction with us, Ng Boon Thiam shares with us how Biomed Global is navigating the second wave and how it is bolstering employee support systems and work policies to support the workforce.

The toughest time is looming as companies have to ensure business continuity and productive output while supporting their workers amid the resurgence of the virus. How is Biomed Global ensuring that?

Biomed Global is in the Clinical Diagnostics Industry which is a critical piece of the country’s healthcare infrastructure. As such, the whole team has been working extremely hard to ensure continuous supply lines, installations, commissioning, trainings and subsequent support to keep the operation going. This pandemic has further empowered our team members to live to our mission of raising the quality of healthcare standards and live to our tag line of Enriching Partners, Enriching Lives.

Biomed formed a Business Continuity Plan (BCP) committee right before the country implemented (Movement Control Order) MCO 1.0 to ensure compliance to the necessary SOPs and take extra care of our team’s wellbeing. The company has granted MCO meal allowances under special circumstances, maintained annual increments and additional remuneration to recognize the various team members who had to take on risks to carry out their tasks professionally. The various events such as making an extra effort for a shipment, special delivery for installation, and training and repairs were communicated and highlighted to all team members so that the efforts are well recognized. The overall morale during this pandemic remains high.

How should organizations rethink talent management amid all this uncertainty? What is Biomed Global’s focus here?

First and foremost, organizations need to be filled with talent that is in sync with the company’s Mission and Values. Talent that is agile and adaptable in this new norm, with a skill set in digitalization, a strong mindset to face any eventuality is greatly valued now. Biomed operates on a performance-based talent strategy, as such our focus is on retaining our highest performing talents and developing our talents to be high-achievers.

How should organizations level up their employee support systems and work policies? What has Biomed Global done in this regard?

“Organizations should constantly improve their talent acquisition and retention framework, review workflows to improve processes, build up financial standing with external stakeholders and adopt automation technology to reduce burden where possible.”

Biomed has since recruited experienced and strategic team members in Talent Management, Finance, and Supply Chain to support these initiatives. Biomed also constantly reviews our employee support systems and work policies to ensure they are forward-thinking and in line with the best in the industry, if not better.

How are you planning for the future amid predictions of phase three of the virus?

Biomed plans to ensure all team members are protected against COVID-19 by procuring the vaccine for our own workforce if the right vaccine is available commercially. Biomed is also investing to move the remainder of our internal operations onto a cloud-based environment. We have also invested in mobile devices to ensure working from home is possible. As our business is a critical piece of the healthcare infrastructure, we do not expect phase three to have a drastic effect on our business. However, some of our growth plans will be delayed due to uncertainty.

What is the strategy and focus for the leadership to tackle challenges posed by the continuing waves of the virus? Could you shed light on the contingency plan for 2021 and Biomed’s industry outlook for FY 2021-2022?

Biomed is fortunate to be in an essential industry during the COVID-19 pandemic and involved in COVID-19 supplies. Biomed’s leadership will continue to ensure everyone’s safety, to ensure the team can continue to operate without interruption. Biomed will continue to engage with team members regularly via monthly operation meetings, and quarterly town halls.

On the business front, we plan to continue our growth initiatives as well, identify products that will complement our current product portfolio. On COVID-19, Biomed has a total solution platform on COVID-19 diagnosis and will focus on possible automation. Post-vaccination stage, Biomed will very much be focused on immunity monitoring and R&D-related supplies for COVID-19. Biomed is optimistic and the outlook for FY 21-22 will continue to be strong for the group.

Author
Shweta Modgil

A New Platform Technology for Multiplexed Protein Analysis

13th Nov 2020 (Friday), 3pm – 4pm (SGT)

Free Admission

 

Abstract

AYOXXA is an NUS spin-off Biotech company. It has developed a novel platform technology that builds on the simple idea to immobilize beads coated with different highly specific antibodies onto a solid-surface array. Detection signals are easily read and mapped by fluorescence microscopy. This setup translates to highly sensitive, precise and accurate multiplexed protein quantification from minute sample volumes as low as 3μl. Its growing portfolio of protein detection panels is supporting research scientists to gain new insights in basic and translational research fields like Ophthalmology, Immuno-Oncology and various others.

If you would like to register your attendance, do scan this QR code or sign up via this link -> https://bit.ly/3ndaNpo

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Speaker's Biographies

By Dr. Bernd Willems
Scientist and Business Development Manager

Dr. Bernd Willems works with AYOXXA as Scientist and Business Development Manager. Bernd got his PhD from the Department of Biological Sciences at the National University of Singapore.

He then returned to Germany and started his corporate career with a large hospital consortium where he coordinated the Clinical Research arm. Subsequently, he spent three years with QIAGEN as Global Product Manager. In 2017, he joined AYOXXA to represent the company in Singapore.

High Throughput & Automation on Nucleic Acid Purification

26th November 2020, 4pm SGT
Free Admission

Abstract

For more than 20 years MACHEREY-NAGEL develops & produces a large portfolio of purification technologies and formats to meet your everyday needs. During this time, we gained a lot of experience and created a large knowledge data base to resort to.

Kits for all applications are available for both manual and automated use on common laboratory robotic platforms. Automating nucleic acid purification can reduce errors and save plenty of manual, repetitive work. MN has extensive experience with many well-known automation platforms like Hamilton, epMotions, Tecan & KingFisher platforms.

In this webinar we would like to show you the advantages of silica-based and magnetic bead based extraction kits for certain automated applications and how you can automate your nucleic acid purification workflow.

If you would like to register your attendance, do scan this QR code or sign up via this link -> https://bit.ly/35COnHi

We look forward to having you join us!

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Speaker's Biographies

By Dr. Ansgar Flammersfeld
Technical Support Specialist

Joined MACHEREY-NAGEL at the beginning of 2020 as a technical support specialist for the MN Bioanalysis products and supports customers with main focus on APAC countries.

Studied molecular & applied biotechnology with a special focus on molecular genetics & recombinant protein expression at the RWTH Aachen (Germany), Fraunhofer Center for Molecular Biotechnology (USA) and at Bayer CropScience (Germany).

Attained his PhD at the RWTH, Aachen, focusing on understanding the molecular mechanisms of the human malarial parasite Plasmodium falciparum.

Challenges of cfDNA, DNA, RNA Isolation from FFPE and Other Clinical Samples

19th November 2020, 4pm SGT
Free Admission

Abstract

Reliable clinical sample analysis plays an essential role in human healthcare or disease control & strongly depends on products of high performance & quality. Clinical sample isolation & subsequent processing is demanding on several levels. Probably the most challenging aspect of handling clinical samples is their sheer diversity: blood & various other body fluids, stool samples, & formaldehyde-fixed, paraffin-embedded (FFPE) microscopy slides, all fall under the category of clinical samples.

Furthermore, the nucleic acid of interest can originate from both humans as well as their various parasites including, but not limited to viruses, bacteria, & protozoans. With our expertise in DNA & RNA purification from a wide variety of samples as well as extensive experience in making clinical products, MACHEREY-NAGEL is the partner of choice for your clinical project.

Join Dr. Thomas Winkelmüller in this webinar, where you will learn more about the solutions that MN offers to isolate high quality nucleic acids from clinical samples, ensuring robust results with a high degree of reliability.

If you would like to register your attendance, do scan this QR code or sign up via this link -> https://bit.ly/3ox72Na

We look forward to having you join us!

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Speaker's Biographies

By Dr. Thomas Winkelmüller
International Sales Manager

Joined MACHEREY-NAGEL 2018 as technical support specialist. Since 2020, he is an international sales manager that manages the international sales for the MN Bioanalysis portfolio in parts of Europe and SouthEast Asia.

He studied biology with a focus on plant-microbe interactions and molecular plant biology at the RWTH Aachen (Germany), Uppsala University (Sweden) and at Bayer CropScience. During his PhD at Max Planck Institute for Plant Breeding Research, he focused on the evolution of transcriptome responses during immunity in various plant species.

Medical Solutions

Digital health promises to change the face of healthcare. Reflecting this is growing interest in the digital health space, as evidenced by a substantial $4.7 billion being invested in 2017, as outlined in the brand new report from IDTechEx Research, Digital Health 2018: Trends, Opportunities and Outlook. Digital health also took prominence in the JP Morgan Healthcare Conference in January 2018, illustrating its growing importance – but it is not limited to strictly the healthcare space. CES 2018 also saw digital health having a substantial presence marking a new age of patient-centric healthcare.

The Rise of Digital Health

Digital health is a convoluted and complex field, much of which is made up of technologies and services that enable healthcare outside of traditional clinical settings. It follows a global trend in the healthcare industry of decentralization to alleviate overburdened hospitals and clinics. Coupled with escalating healthcare costs, shrinking profit margins and ageing populations suffering with chronic conditions, digital health offers a solution to these problems for all players in the space including patients, providers and payers.

In fact, it presents such an alluring and lucrative opportunity that companies not previously in the healthcare space are making significant investments and moves to do so. Big tech companies such as Amazon, Apple and Alphabet also used January 2018 to announce their endeavours into the digital health space, impacting the price of stocks in the healthcare market.

Numerous Factors Encouraging the Rise of Digital Health

The time is ripe for digital health due to the combination of a number of factors. These include changing population demographics, such as ageing populations with increasing prevalence of chronic diseases, as well as current and upcoming changes to regulations and reimbursements which mean that the route to market and take-up of digital health services and technologies is more likely in 2018 and beyond.

The Wide Scope of Digital Health

The IDTechEx Research report Digital Health 2018: Trends, Opportunities and Outlook acts as a primer to the digital health space, providing a detailed overview of the ecosystem and offering insights into the key trends, opportunities and outlooks for all aspects of digital health. The time is ripe for digital health due to the combination of a number of factors. These include changing population demographics, such as ageing populations with increasing prevalence of chronic diseases, as well as current and upcoming changes to regulations and reimbursements which mean that the route to market and take-up of digital health services and technologies is more likely in 2018 and beyond. The IDTechEx Research report Digital Health 2018: Trends, Opportunities and Outlook acts as a primer to the digital health space, providing a detailed overview of the ecosystem and offering insights into the key trends, opportunities and outlooks for all aspects of digital health.

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Biomed Global in Action [COVID-19 Series | Part 1]

 

Processing COVID-19 patients’ samples at unprecedented speed and highest throughput possible has been the national top priorities ever since this global pandemics hit Malaysia. Here, our application specialist Mr Afiq is conducting an operational training of KingFisher Automated Extraction Systems at the Makmal Kebangsaan Awam Malaysia.

MKAK has been able to resolve a lot of the backlog samples by using this automation! They can now proceed to run a lot more of Real time PCR tests, the gold standard for COVID-19 diagnostic tests. We can expect an inrease of their daily testing capacity.

Distribution of Thermo Applied Biosystems Product

Beginning March 1, 2018, all orders for Thermo Fisher Scientific reagents and instruments:

    • Applied Biosystem (Taqman, SYBR, Applied Biosystems Real-time PCR, Applied Biosystems PCR Thermal Cyclers, Sanger Sequencing Instruments and Reagents, Contaminant and Impurity QC Testing;
    • Ion Torrent Next Generation Sequencing Instruments and Reagents;
    • Arcturus Laser Capture Microdissection Instruments and Reagents.

Will be processed by Biomed Global as follows.

For more information, please visit here.