5 questions for … Dr. Darryl Palmer-Toy

Darryl Palmer-Toy, MD, PhD, is the doc manager of the Regional Reference Core Laboratories for Kaiser Permanente Southern California. He has been in this position for five years. In this function, Dr. Palmer-Toy oversees the ancillary, clinical chemistry, and immunochemistry departments, which perform most 20 million tests per twelvemonth. A student of proteomics (the study of proteins expressed by the genome) and biomarker discovery, his more recent research interests focus on SARS-CoV-two serologic testing.

How does the Regional Reference Laboratory contribute to enquiry at Kaiser Permanente?

We're the source of examination results for millions of Kaiser Permanente Southern California members. That'southward everything including clinical chemistry, bacteriology, immunology, molecular testing, and tissue-based diagnostics. Much of Kaiser Permanente Southern California'south preventive health efforts are anchored in our test results: cervical and colorectal cancer screening, sexually transmitted infection screening, hemoglobin A1c, lipid panels, urine albumin/creatinine, to name a few. By mining our clinical test results and by partnering with researchers to perform more than customized analyses, nosotros're deeply involved in research.

Tin can you tell u.s.a. well-nigh the COVID-19 serologic study grant y'all recently received from the Garfield Memorial Fund?

There are 2 aims of the study. For the commencement aim, we've identified thousands of patients with positive SARS-CoV-2 serology (blood tests indicating a past infection) beyond 4 Kaiser Permanente regions (Colorado, Northwest, Southern California, and Washington). Almost of those had never had a positive RNA test result (nasal or saliva test indicating a electric current infection) because they were never tested or were not tested at the advisable time to notice an agile infection. Consequently, they may not appear in any of our COVID-19 databases. We are interested in whether those patients are still susceptible to post-acute sequalae (long-term effects) of COVID-xix infection (PASC), or "long-haul COVID."

The other aim is looking at SARS-CoV-2 serology in patients who have been vaccinated. We seek to understand how well commercial serologic assays (blood tests) for SARS-CoV-2 reverberate vaccination status and effective immunity, whether post-vaccination serologic response varies past demographics and prior infection, and whether the serologic response predicts the risk for infection or re-infection.

How do SARS-CoV-2 serologic assays work?

There are 2 types of SARS-CoV-two serologic assays. The first type looks for anti-nucleocapsid protein antibodies, which are the all-time marker of past natural infection. The second type looks for anti-spike protein antibodies, which are thought to better reflect constructive humoral immunity (virus-neutralizing antibodies). Just the anti-spike poly peptide antibodies would be elevated in a patient who hasn't been previously infected but who has been vaccinated. So, the second aim of the written report is looking at levels of SARS-CoV-2 anti-fasten poly peptide antibodies in vaccinated patients over time every bit measured by 6 commercially available assays, along with weekly RNA (self-collected saliva) examination results. We desire to run across how well they reflect vaccination-induced amnesty and its durability over time.

For the second report aim, you are recruiting 2,000 health care workers from Kaiser Permanente Southern California. Why is the focus specifically on employees and physicians?

One reason is that, fortunately, we accept very high rates of vaccination among our employees and physicians. Also, many of them have reached out trying to obtain serologic testing to see whether their vaccine was effective, so we figured they would exist interested in furthering this inquiry. Our plan is to collect claret samples at half dozen to vii months and 12 to 13 months post-vaccination, which may be modified every bit enrollees receive the recently authorized booster dose. We intend to couple the serologic results with weekly RNA test results to discover whatever asymptomatic breakthrough infections. We thought this would be near convenient for our employees and physicians who are already at the facilities and so they can collect and submit their samples. Lastly, we have a very various community of employees and physicians, then nosotros idea this would be a practiced mode to capture the breadth of our Southern California community.

What exercise you enjoy doing in your spare time?

I generally savor hiking with my family unit and dogs. We do a lot of hiking in the Santa Monica mountains, and we're all great enthusiasts for state and national parks. My kids–Bryce and Acadia–were both named for national parks.

Prototype: Dr. Palmer-Toy and son Bryce at the Grand Canyon.