companion apps

Introduction

Health and disease are what happens between tests – making more tests is a burden but not if this is using a pinprick (or even saliva). The Attomarker small testing volume can make comparatively simple repeat tests to get accurate data and the patient can see ongoing changes. We are developing a series of companion apps to log our test results and collect other health parameters such as steps to lead to a more complete integrated picture. The pandemic led to Biomark App to show to explain your immunity profile but we are also developing the Allergy App and the Liver Game.

Biomark App

The Biomark App allows your result from the test to be carried on the iPhone and integrated into other Apps. The end of the scan in the clinic gives a QR code which is read by the app and results in the image below. The App provides some take-away information for the Antibody Immunity profile measured against the Attomarker mucosal immunity threshold.

Attomarker has developed a COVID19 Antibody Immunity test which is CE marked and is fully quantitative referenced to the NIST standard human antibody. The test measures the antibody immunity profile for antibodies binding to spike, omicron-spike, nucleocapsid and receptor binding domain proteins. 1,2  Antibody Immunity profile (Figure 5) provides the following information:

  • Nucleocapsid (N) indicating past viremia;
  • Spike Protein (S) indicating past infection or vaccination;
  • Spike Protein from the Omicron Variant (SO) indicating vaccine binding to the Omicron variant or infection from Omicron;
  • Receptor Binding Domain (RBD)

 The test also measures the familiar C Reactive Protein. The Test is performed currently from venous blood for accuracy with the results available in 7 minutes, presented as the Biomark (Figure 5) available on the iPhone app. 

The concentration of S antibodies is used to assess the number of ‘Immunity Days’ to the ‘Edge of Immunity’ calculated from an antibody half-life of 60 days and a mucosal protection threshold of 3.4 mg/L, rounded to the nearest month.

The Edge of Immunity depends on your antibody half-life and ranges from 60 – 200 days3. The test can measure your precise half-life but we would need to take two samples 100 days apart. Your doctor can advised on whether this is important to you.  

The test is usually sold as part of a consultation in private healthcare to patients who believe they are immuno-compromised, preparing to travel, have vulnerable relatives or considering whether to have a booster jab or not.

biomark-app

Figure 5

Warning – Omicron BA.1 Variant UPDATE

There is now growing evidence from the Attomarker clinics that suggests the 3.4 mg/L threshold needs to be revised upwards perhaps to 6.8 mg/L because of vaccine escape. The highest un-protective level recorded so far is 9 mg/L on the spike-variant.

At the beginning of the pandemic N antibody levels were a good measure of past infection. We are now observing Omicron infections that do not produce N antibodies in our test, probably because infections are milder.

Conclusions

  • Antibody Immunity can be quantified and there is growing evidence that a threshold of 3.4 mg/L will protect against infection.
  • The antibody immunity wanes over time and this is estimated using the immunity days based on the shortest observed antibody half-life. It is the edge of immunity after which antibody levels may not be protective.
  • The immunity days can be made more accurate with a paired test measured 100 days apart.
  • The BA.1 variant probably shortens the days to the edge of immunity by up to 30 days.

The Allergy App

The barcode on food contains information about the composition and increasing details about the allergen content. The Attomarker test provides unique insight into how allergies may add up from different combinations of foods in a meal. The Allergy App allows you to scan the barcode of items in the supermarket and check their allergy risk against your profile, adding up the risks if any. The app will be interactive and irritable bowel or discomfort can be reported to the benefit of all Allergy App users. 

barcode-scanning-food
liver-game

The Liver Game

The frequent testing of liver function is converted into a Liver Game in our companion – and is part of a wider interest in the gamification of health. The Liver Game stores your results and lets you set up a profile, estimates calorie consumption and units of alcohol to produce a dashboard showing how interventions in your lifestyle help our  liver. There is an interactive barcode scanner that lets you look at the nutritional information for items as you buy them.

Patients in clinical trials that improver their lifestyle and improve their liver function test can lead to the remission of type 2 diabetes. Fatty Liver Disease is present in about 70% of type 2 diabetics and tracking liver performance may even offer a route to complete remission from diabetes – a cure. But as soon as the patients leave the trial the relapse and the benefits are lost. The future requires us to keep the interest of patients, especially children, to make a difference to the obesity pandemic.

References – to the COVID19 Antibody Immunity Test

  1. James-Pemberton PH, Helliwell MW, Olkhov RV, et al. Fully Quantitative Measurements of the Antibody Levels for SARS-CoV-2 Infections and Vaccinations calibrated against the NISTmAb Standard IgG Antibody. medRxiv 2022: 2022.07.12.22277533.
  2. James-Pemberton PH, Helliwell MW, Olkhov RV, et al. Vaccine, Booster and Natural Antibody Binding to SARS-CoV-2 Omicron (BA.1) Spike Protein and Vaccine Efficacy. medRxiv 2022: 2022.07.12.22277539.
  3. Dan JM, Mateus J, Kato Y, et al. Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection. Science 2021; 371(6529): eabf4063.