University of Texas Medical Branch At Galveston, Texas, United States
Abstract: Viral immunity is a critical metric in both clinical and research domains. In the setting of SARS CoV-2 (COVID-19) infection, functional immunity has been only loosely assessed typically through elements of the patient history detailing either previous infection or reception of vaccines. However, administration of vaccines does not take into account immune attenuation or lack of vaccine efficacy in real human patients. Thus, understanding true functional immunity by assaying the neutralizing effect of antibodies offers a genuine picture of immunity to COVID infection. Likewise, research use cases—including vaccine development—require assessment of induced immunity which is often best assessed by authentic measurement of neutralizing antibodies. Although the need for such testing is clear, implementation poses significant risks in that it requires the use of live virus, thus potentially exposing laboratory personnel to risk of viral infection. Likewise, the neutralization protocol involves multiple incubation steps which may necessitate sample manipulation during non-standard work hours. Deploying neutralizing testing as either a clinical or research service thus requires overcoming these risks and logistical challenges.
The University of Texas Medical Branch (UTMB), in collaboration with ABB Robotics and Tecan, developed a first-of-its-kind fully automated work cell allowing for walk-away performance of neutralization testing across a full 26-hour run time. Moreover, this work cell incorporates asynchronous loading of sample batches, interval incubation, and integrates a Tecan Fluent 1080, 2 ABB 6-axis industrial robotic arms, 3 Thermo CX-5 cell imagers, and 2 Liconic incubators, all contained within a Biobubble to allow for robotic manipulation of live BSL-3 material. The entire testing process including sample manipulation, storage, deactivation, data analysis, logging, and—when used clinically—posting of clinical results directly into UTMB’s Electronic Health Record system are orchestrated by internally developed software unique to this project that leverages Microsoft Azure and a cluster of microservice containers to allow for resilience and flexibility of the system.
The work cell began development in June of 2021 and completed development in December of 2022. This involved a collaboration between UTMB, ABB robotics and Tecan and this test has been live in production clinically since January 2023, available to order by our UTMB clinicians. Moreover, this assay supports substitution of the viral agent used, allowing this platform to support not only alternative COVID variants but also entirely different viral agents, thus extending its use across both clinical and research workflows.