Ashley Clarke - biomedical scientist

The ‘clinical’ focus of my job is centred on the analysis of patient blood samples from Addenbrooke’s, East Anglia and the wider UK. I work with a small team of 7 laboratory staff with a combined 170 years of laboratory experience, analysing patient samples for blood proteins and hormones such as insulin, c-peptide, intact proinsulin, leptin, adiponectin and PARC using a technique called immunoassay. The assays (lab tests) used in our laboratory are a vital part of patient care for diagnosis and monitoring of diseases such as Diabetes, Insulin Autoimmune Syndrome (IAS), Genetic Syndromes of Severe Insulin Resistance (SIR), Gaucher’s disease and conditions associated with obesity.

A really important part of my job is understanding the how these assays work and how substances can interfere with the measurement of a protein. Typically immunoassays use one or two separate antibodies produced from an animal source to bind and detect / measure human proteins such as insulin. Some tests require special patient preparation such as fasting before venepuncture. Failure to fast may give misleading results. Other factors such as certain types of medication, interfering antibodies or even physical damage to the blood can also lead to a false result. Being able to identify these interfering factors and troubleshoot the assay procedures (when required) helps us to ensure the results we report are accurate and reliable.

The majority of the work I do in the laboratory is research, where I use manual 96-well plate immunoassays to analyse serum, plasma, urine and cell culture samples for various research studies. Some of these assays are bought commercially and some are developed and evaluated by our lab. These assays are generally close to clinical quality. One ‘in-house’ assay we use frequently is the GDF-15 assay. The assay was used to show increased serum concentrations of GDF-15 are associated with nausea and vomiting in pregnancy (Hyperemesis Gravidarum).

My role also requires participating in the day-to-day running of the laboratory. I maintain ‘stock-control’ databases, receive ‘goods’ and ensure items are ordered promptly, something important for our continuation of service. I also liaise with researchers and clinicians, answering any and all manner of questions they have and receive and ‘book-in’ samples to our ‘sample receipt’ databases so they are accurate and up to date.

Throughout the COVID-19 pandemic CBAL have continued to provide clinical insulin, c-peptide, leptin, adiponectin, PARC and intact proinsulin analysis for Addenbrooke’s Hospital, East Anglia and the wider UK. This is an essential service that has facilitated ongoing diabetes, SIR and Gaucher’s disease care for patients of NHS care teams.

CBAL has been approached to analyse samples for numerous COVID-19 related research studies since April 2020. In one study for Professor John Bradley’s group (Cambridge University), we analysed plasma factor V concentration, which can be increased in patients with severe COVID-19 where it may act as an immune inhibitor.

In another study for Dr. Louise Goff (Kings College London) and Professor Sir Stephen O’Rahilly we analysed complement C3 and C4 in normal glucose tolerant, impaired glucose tolerant and Type 2 diabetes patients. This aided in understanding COVID-19 outcomes in obesity in black African-Caribbean’s vs Caucasians. The most recent COVID-19 study we analysed samples for was with Paul Lyons (Cambridge University), where we measured high-sensitivity C-reactive protein (CRP); it was confirmed patients with severe COVID are characterised by high CRP and lowering of CRP during post-infection recovery may be related to “long COVID”.

The best thing about being employed at CBAL is the variety of the analytical work we do. In one week we could be analysing thousands of samples as part of an ongoing epidemiological study, and the next we could have lots of smaller but equally interesting projects which require more challenging esoteric assays (lab tests).

CBAL as core facility has the capacity and equipment to provide a wide selection of different tests to meet our researcher’s needs. I really enjoy mastering the analysis of samples using new kits, or developing new methods.

Some career advice: During previous ‘health care science weeks’ people have always asked me “How do I become a Biomedical Scientist?”, and so here it goes…..

To become a Biomedical Scientist (BMS) a degree certified by the Institute of Biomedical Science (IBMS) and an IBMS registration portfolio must be completed. If you already have a non-IBMS accredited science degree top-up modules on IBMS accredited courses can be completed and the IBMS website can tell you how along with which Universities offer IBMS accredited courses. The IBMS registration portfolio is your journey of learning in the laboratory as a trainee BMS, MLA (medical laboratory assistant) or MTO (medical technical officer), to gaining your ‘certificate of competence’, which along with your degree enables you to become a newly HCPC (Health and Care Professions Council) registered BMS.