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My lab: The immunology laboratory

Medical Laboratory Assistant Muneebah Jasat gives a guided tour of her lab at the Manchester Royal Infirmary.

I am based in the immunology laboratory at Manchester Royal Infirmary, the largest immunology department in the North West. Our laboratory provides a regional service to clinicians and GPs in and around the Greater Manchester area and incorporates autoimmunity, immunochemistry, cellular and manual assay services and contributes to the haematological cancer diagnostic partnership that serves Manchester.

My role as a Medical Laboratory Assistant (MLA) in the immunology department is to ensure that samples are properly booked into our laboratory information system. We also receive work referred from other hospitals via NPEx’s Lab2Lab system. As an MLA I provide support to the biomedical scientists who work in the department. The department allows MLAs the opportunity to run the analysers under the supervision of the biomedical scientist in charge of the section. This is useful in helping develop those who want to become biomedical scientists in the future.

A lot of the work we receive is routine, however, there are some tests that may need to be processed urgently. For example, anti-neutrophil cytoplasmic antibodies, which are used in the diagnosis of autoimmune vasculitis, and anti-glomerular basement membrane antibodies, which are used in the diagnosis of Goodpasture’s syndrome. Both such disorders may present with acute renal and/or respiratory failure that requires treating swiftly to prevent further damage to the patient’s vital organs.

Our department is fully equipped with automated analysers, such as our Bioplex 2200 system, which allows the rapid and simultaneous detection of autoantibodies by multiplex bead array analysis. Another automated analyser is the Optilite, which uses turbidimetry to measure antibodies and complement. For example, it measures serum free light chains, which are used in the diagnosis and monitoring of multiple myeloma.

For me, the major aspect that sets our department apart from other regional laboratories is our close contribution to the Haematological Cancer Diagnostic Partnership by providing flow cytometry support. This work is done by the cellular section, which is equipped with two Beckman Coulter Navios flow cytometers. These are used to determine if a patient has a chronic or acute leukaemia and whether the leukaemic cells are of lymphoid or myeloid origin.

The characteristics of neutrophils are also assessed on the same analyser using the dihydrorhodamine assay. This is useful in identifying patients who suffer from chronic granulomatous disease, whose neutrophils are unable to kill bacteria.

The cellular section is also responsible for diagnosing patients who may have a primary immunodeficiency, which may affect lymphocytes or neutrophils. This is done by assessing the subsets of T and B lymphocytes using an automated flow cytometer called the Aquios.

Our department is known for providing an excellent service to its users. We achieve this by working as a team and overcoming challenges together. It is satisfying to know that behind every sample I prepare is a patient that I am helping in either their treatment or diagnosis.

I’m very proud to work for the immunology department with the knowledge that our efforts serve to improve the health and quality of life of thousands of patients with immunological disorders.  

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