“I have several scanning electron microscope images to show you. I false colored the image so you can tell the different cells apart. The flattened donut-shaped cells are of course red bloods, and these little cream-colored blobs are platelets. This green cell is a monocyte. All normal,” he said and advanced the screen to a new image. “In this image, over here you can see two more lymphocytes, again normal. But this cell, colored blue, I don’t know what it is. It appears to be a lymphocyte, but it is too big. Lymphocytes are seven to eight micrometers, this cell appears to be twelve or thirteen.”
Julie bent over and rested her palms on the desk, bringing her face closer to the monitor for a better look. “Is it neutrophil?”
“No. It’s not a neutrophil, basophil, or eosinophil. Granulocytes have multi-lobed nuclei; this cell is mononuclear.”
“Maybe it’s a monocyte then?”
Jon advanced to another image with higher magnification. “I don’t believe so. Because if you look closely at the microvilli on the surface of the cell they resemble those of a lymphocyte. Monocyte microvilli are longer, more densely packed, and…” He gestured with his hand in the air in a motion like a car traveling over a hilly stretch of road. “What’s the word in English?”
“Wavy?”
“Yes, wavy,” he said.
“Are you sure about the size?”
“Yes, I’m sure,” Jon said. “Since your are the cancer expert here, I was hoping you could tell me if you think it could be a cancerous lymphocyte?”
“It’s hard to identify cancer cells when viewed in isolation, but the shape of this cell is uniform. From outward appearance, I’d say it looks like a healthy cell.”
“That’s what I thought too,” Jon said, with schoolboy excitement. “So I decided to run more tests, and I found something else.”
Julie nodded.
“There are five major categories of antibodies: IgA, IgG, IgM, IgE, and IgD. The IgG anti-bodies are the most common type, found in all bodily fluids and tissues, and comprise about seventy-five percent of the antibodies in circulation at a given time. IgA antibodies make up about ten percent and are found predominantly in the entry and exit orifices of the body — nose, ears, eyes, etcetera. IgM antibodies are…”
“I’m up to speed on my antibodies, Jon. You can skip to the something else part,” she interrupted.
“Ya, okay. I ran a quantitative immunoglobulin screening, and I found an immunoglobulin that doesn’t fit into any of the existing classes or subclasses. I don’t know what it is or what it does.” He minimized the SEM images and pulled up a data table.
Julie looked at the screening results. “If you had to guess, what do think it is?”
“Maybe it’s new subclass of IgG, but I have no way to test this right now. So, I was thinking about running an IgY test just for the hell of it?” Jon replied.
“IgY? Isn’t that an avian antibody?”
“Yes, bird and reptile. I don’t think this is IgY, but I have the EIA to test for it. It could be a starting point. After that, I was thinking about performing a TCR diversity assessment on the lymphocytes in the blood sample.”
“What’s a TCR diversity assessment?’
“TCR stands for T cell Receptor. Analyzing the receptors on a lymphocyte is one way to identify what kind of lymphocyte it is. T cells and B cells are so morphologically similar that scanning electron microscope images don’t provide a reliable means of distinguishing them. So, I need to analyze them chemically. Maybe the mystery lymphocyte in the SEM image is responsible for generating this new antibody… we could be looking at a breakthrough discovery.”
“Bart, what do you make of all this?” Julie asked.
“It’s definitely an anomaly, but at this point it’s nothing to get too excited about. Where did you say you got this sample from?”
“From a clinical subject in the STAT protein study I’m working on. Why?”
“Oh, just curious.”
This was not the response she had expected from Bart. He was usually excitable and talkative, especially when it came to questions in his specialty. The more she thought about it, the more Bart’s behavior made her nervous. First, she would have expected him to be downright euphoric over the discovery of this strange new lymphocyte. Second, she had expected him to panic about her violating BSL safety protocols given the antibodies found in the sample. The one response she had not expected from him was indifference.
“Jon, can you print copies of the SEM images and the other test results for me?” she asked.
“Not a problem,” Jon said. “Hey, maybe we can get this subject in for some tests. Is this a local subject pool, or are these samples being shipped in from somewhere else?”
Julie hesitated and then replied, “The samples are from our UK office, but I’ll call over there this morning, report what we’ve found, and lobby for this subject to fly here for tests.”
“Great! I’ll go grab the pages off the printer for you.”
“Julie?” Bart put his hand on her shoulder. “I’d like you to turn over the rest of the blood samples you have from this patient to me this morning. With the antibodies we found in the blood, this subject’s blood needs to be controlled with Biosafety Level Three protocols.”
“If I recall, you said this was nothing to get too excited about.”
“I did, and it’s not. But safety is paramount, and with the type of antibodies present in this sample it would be prudent to treat it as an infectious agent.”
Julie paused, trying to formulate her response. “The vial I gave you this morning was all I have left from this week’s delivery, after running all my usual tests. I’ll contact the UK branch this morning, however, and instruct them that biosafety hazard protocols need to be implemented regarding this subject.”
Bart looked if he was about to speak when Jon returned from the printer holding the pages she had requested.
“Here you go, Julie. If you’re not busy, you are welcome to help us. Bart and I have plenty of other tests we can run this morning. This is very, very exciting.”
“I need to discuss this with the folks in my department and call the UK office, but I’ll pop back in later. This could be huge if we’ve discovered a new lymphocyte,” she said. She folded the printed pages in half, tucked them inside her purse, and headed for the door. On her way out, she called back over her shoulder, “Thanks, guys. I really appreciate you jumping on this for me.”
Bart stood in silence and watched her leave with a scowl. Then he turned to his assistant. “I’m going need the rest of that sample, to run some more tests. Oh and Jon, until we know what we’re dealing with here, I think it would be best if you not discuss this with anyone. Okay?”
“Ya, okay,” Jon replied with a raised eyebrow. “You’re the boss.”
Julie walked as swiftly as she could, without running, through the corridors toward the west exit. Something was wrong; her intuition was burning like a five-alarm fire. This was not the first time Bart had seen antibodies like the ones in Will’s blood. He was hiding something from her… and she was certain that something had to do with Will.
Chapter Twenty
Albane twirled an ink pen around her forefinger like a tiny propeller with rhythmic flicks of her right thumb. With her left, she pressed icons on a touch screen tablet computer that she had propped on a small table in the hotel suite in Prague. For the third time, she cued up the recording of the brief with Meredith Morley from the Founder’s Forum. The software even allowed her to insert “chapters” like a DVD movie, for ease of navigation and playback.