An Vanhaesebrouck was awarded the inaugural BSAVA PetSavers Research Fellowship in 2023 to undertake work on the Development of a novel test to diagnose seronegative myasthenia gravis in dogs at Cambridge University.
What sparked your interest in science and your chosen field of study, and how has that interest evolved over time?
Although the initial laboratory work during the first week of my DPhil seemed rather dull, the pursuit of uncovering the underlying question became incredibly addictive.
What inspired you to pursue this research, and can you share details about the team and their roles?
The idea originated from my time during my DPhil. In the lab, graduate students were working on human cell-based assays to detect various autoantibodies associated with myasthenia gravis, now considered the most sensitive test for this condition in humans. In human medicine, the radioimmunoassay (RIA) test is known to miss 10–20% of generalized cases and 50% of focal cases. Based on retrospective analysis of myasthenia cases from Cambridge, Ghent University and the Royal Veterinary College, we decided to explore whether we can detect autoantibodies using cell-based assays in dogs suspected of having myasthenia gravis or acquired idiopathic megaoesophagus (which could be a focal manifestation of myasthenia gravis) but for which the RIA test was negative.
My host lab shared facilities, lab meetings and talks with the Oxford Autoimmune Neurology lab, which focuses on autoimmune neurological disorders. During this period, while enjoying a cup of coffee, I met Dr Paddy Waters, the current director of the lab. I visited Oxford to discuss the possibility of him supporting the project, and he was enthusiastic about it!
BSAVA PetSavers generously supported my research, enabling me to apply our expertise to a project that aims to benefit dogs with myasthenia gravis and idiopathic acquired megaoesophagus. This project would not have been feasible without the invaluable contributions of my colleagues at the clinic and the various laboratories within the Cambridge Veterinary School, particularly the Mellersh and Bryant lab. Additionally, I would like to express my deepest gratitude to colleagues from the UK, Belgium, and other countries who generously provided samples and support. I am truly grateful for the exceptional opportunity to work on this project and would like to extend my sincere appreciation to BSAVA PetSavers for their trust and support.
What is something about this topic that BSAVA members in general practice might find surprising or may not already know?
Myasthenia gravis might be a more complex disease than we fully appreciate in veterinary medicine. In human medicine, there is also the not-to-be-ignored challenge of so-called seronegative patients. In these patients, autoantibodies against other antigens are found, or special tests are needed to detect low-affinity antibodies that otherwise could be missed.
What are the primary goals of your research, and what methods have you used or plan to use to achieve them?
We propose that a portion of dogs with focal or generalized myasthenia gravis may have low-affinity antibodies against acetylcholine receptors or antibodies against other neuromuscular junction proteins that are not detectable by traditional RIA but could be detected by cell-based assays, as in humans. This phenomenon might also be observed in idiopathic acquired megaoesophagus. The cell-based assay is being collaboratively developed with the Oxford lab.
What insights of the project can you share at this stage?
I am afraid you will have to wait for this until all results are gathered and published! However, we will share our results with you as soon as we are able. We are in fact still accepting suitable samples – see below for how you can get involved.
What potential impact could this research have on general or referral practice, and when might general practitioners begin to see its benefits?
The detection of autoantibodies in dogs with canine myasthenia gravis and acquired idiopathic megaoesophagus that were previously negative on RIA testing, would increase the number accurately diagnosed and promptly treated, resulting in improved outcomes. In humans, the type of autoantibody found determines the treatment approach; for instance, pyridostigmine is contraindicated for certain autoantibodies. This principle may also apply to dogs. Furthermore, if a significant portion of dogs with acquired idiopathic megaoesophagus possesses autoantibodies, the disease could be treated, potentially reducing the mortality rate which is
What have been the biggest challenges and obstacles you’ve faced during the project, and what have been the most significant highlights?
The most significant challenge, yet also a highlight, lies in sample collection. Striking a balance between my enthusiasm for reminding my colleagues to collect samples and my desire not to annoy them is a delicate task. Several colleagues have gone above and beyond my expectations and have been invaluable in the sample collection process. I would like to extend an invitation to any veterinary professional reading this to contribute samples of dogs suspected of having seronegative myasthenia gravis or acquired idiopathic megaoesophagus. Ideally, we need excess serum samples from these patients, preferably stored around the time of the first RIA test.
The highlight of this project was the chance to engage in high-level laboratory-based veterinary research that has the potential to directly influence clinical practice. Additionally, it has allowed me to collaborate with colleagues from various countries, universities, and with different job roles. On a personal note, it has also been incredibly rewarding to connect with colleagues, some of whom I believe have become friends. These connections have not only been immensely beneficial to my project but have also been personally rewarding.
Can you share your personal experience with this research? What has it meant to you, and what have you gained from working on it?
For me, this project presents a unique opportunity. It has had a profound impact on both my professional and personal life. I find immense job satisfaction in trying to understand certain diseases and knowing that my work might directly impact the clinic. I can only express my sincere gratitude to BSAVA PetSavers for trusting me with this project. I genuinely hope that, with the many colleagues involved, we will be able to contribute something valuable to the veterinary community.
How has the support from BSAVA PetSavers contributed to your research, and what impact has it had on your work?
BSAVA PetSavers have been supportive throughout; for instance, they promptly assisted with an advertisement for case recruitment. They are discreetly in the background, providing me with the necessary trust to work on my project independently. However, I feel confident that if I need to discuss anything, they will be more than happy to assist me.
If someone was thinking of applying for a BSAVA PetSavers research grant, what would you advise?
I am not sure if I can offer much valuable advice, but if you believe you might enjoy conducting research and advancing veterinary medicine, I highly recommend applying for a research grant, regardless of whether you are a student, a practicing veterinarian or an academic researcher. Design the project, for which case recruitment is necessary, to be as simple as possible, so it is feasible for you and your collaborators. Choosing your mentor or supervisor wisely is crucial, especially for students or those early in their careers. Surround yourself with good collaborators as well.
Please contact me at av354@cam.ac.uk or myasthenia@vet.cam.ac.uk for further information or with details of potential samples.
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