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2021 ESID short term fellowship report

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By Himanshi Chaudhary

I was awarded the ESID short term fellowship in 2021. I spent almost 2 months at the Department of Immunology at Erasmus Medical center (EMC), Rotterdam, The Netherlands under the mentorship of Prof Martin van Hagen and Dr. Virgil Dalm. I had already finished my training as a post-doctoral fellow in pediatric clinical immunology and rheumatology before starting the fellowship, so it was the ideal time for me to learn the finer nuances of diagnostics and therapeutics of PIDs at a bigger center.

I had absolutely no problems with contacting people at ESID or at EMC. Everyone was very helpful and kind and helped me with arrangements for my visa, travel, paperwork at EMC and accommodation. Prof. Hagen and Dr. Dalm were very kind and patient with me, despite their hectic schedules. I attended clinics, patient discussions, multidisciplinary clinical meetings and clinical rounds with them. We saw and discussed patients with a host of immune-abnormalities on a one to one basis. I saw some very rare PIDs and autoinflammatory syndromes in their clinics.

 I also spent a considerable amount of time in the immunology lab under the guidance of Dr. Hanna Ijspeert. I observed and learnt a host of immunological techniques like

-          RT-PCR / Sanger Sequencing

-          Establishing cell lines and/or cultures from primary cells derived from patient

-          Culturing cells

-          Participating in gene-editing experiments

-          Performing functional in vitro  assays

-          Studying the potential effects of therapeutic agents in in vitro cultures systems

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Prof. Martin van Hagen  introduced me to the complex bio-informatics involved in analyzing genetic variants at their center and showed me some of the  functional assays that were being done to elucidate the significance of some novel genetic variants. I learnt how functional significance of novel genetic variants is studied and evaluated, in order to gain more insight in genotype-phenotype relation in PID. I also got a chance to attend a seminar on a technology that could characterize tissue composition at the cellular level by sorting cells based on morphology and activation. I had also planned to visit the hematopoetic stem cell transplant facility at UMC, Leiden, but I had to cut short my visit due to COVID-19 related restrictions.

 

In all, it was a great learning experience for me and also  helped me to make a decision for my future  plans. I work at a place in India where immunodeficiency disorders are still unknown to most physicians and there are no specialized centers for diagnosing and managing patients with PIDs.  I intend to start my own center for management of immunological conditions, one that has both diagnostic and treatment facilities for these patients. My experiences at Erasmus MC exposed me to some high level diagnostic facilities. I learnt a lot of laboratory procedures that I can consider duplicating at my center in the future.  We also discussed ideas for future collaborations in terms of developing diagnostic facilities, discussing therapeutic options for difficult patients and later on  research facilities, all towards providing better healthcare  for patients with PIDs. I am really grateful to the ESID for awarding me the ESID short-term fellowship and supporting my visit to Rotterdam.