Interview with Dr. Robert Mozayeni, Director of the Foundation for the Study of Inflammatory Disease in the United States
Where do you work and what is your role there?
Dr. Mozayeni: I am a physician and researcher in Bethesda, Maryland, where I am a Director of the Foundation for the Study of Inflammatory Disease (FSID), Laboratory Director of a high complexity clinical testing laboratory (T Lab Inc.), Chief Medical Officer of Galaxy Diagnostics (GalaxyDx.com), and medical director of a private medical practice (Translational Medicine Group).
We are located in the heart of a major biotech region that includes the National Institutes of Health (NIH), the Food and Drug Administration (FDA), and more. I first came to this area to work at the NIH.
Tell us a bit about your research and work.
My work, in general, is focused on how inflammation may start and persist to cause acute and chronic diseases. More often than not, these diseases result from persistent infection.
My work with FSID is to oversee the foundation’s efforts to explore and illuminate the mechanisms of inflammation, how the human immune system becomes dysregulated or overwhelmed, and what we can learn from large sets of clinical data about the patterns of response to treatment of inflammatory diseases. In the clinical lab we have developed advanced microscope imaging tools and other techniques to detect pathogens that cause inflammatory diseases.
In my medical practice I focus on treating patients with chronic, complex and often debilitating inflammatory illnesses. This work informs the development of diagnostic tests that can be used to guide medical care for inflammatory diseases.
Many of my patients with chronic conditions now also have COVID-19. And many with COVID-19 are developing persisting chronic inflammatory illness. Thus, it has become exceedingly urgent for me and others to be able to determine if and how COVID-19 becomes a chronic disease. In patients with other chronic inflammatory diseases, their response to coronavirus helps us learn more about the pathophysiology of COVID-19, and our understanding of COVID is informed by our prior experience with chronic inflammatory conditions.
Why did you decide to use Aiforia’s AI software?
FSID is positioned to apply Aiforia’s AI-assisted analysis to thousands of high resolution microscope images of human blood and tissue samples containing specific pathogens (or, for example, the fluorescent tags of bacterial or viral RNA).
FSID has access to large sets of unique images generated by T Lab for such analysis. To date the visual analysis of such images has been up to teams of expert histopathologists, microbiologists, and microscopists to interpret.
We see the potential to train the Aiforia system to analyze such images with extreme precision and great efficiency. Aiforia’s AI training thus far will be used as background training to be able to discern patterns of COVID-related disease in microscope images of blood and skin tissues.
Tell us about your project with Aiforia.
As COVID-19 was emerging, FSID laid out a program to analyze high resolution images of blood and skin samples stained for COVID-19 RNA, and inflammatory markers, collected from hundreds of patients, and to put those results in the context of other testing, clinical and medical history data collected about those individuals in order to gain a better understanding of the mechanisms and impact of this disease. When we became aware that Aiforia might be available to generate extraordinary image analysis and high efficiencies, we reached out.
How is this significant to advancing our understanding of coronavirus?
Finding COVID-19 and related inflammatory responses anywhere in the body will
contribute to the understanding of this virus. Using AI to analyze images of either the novel coronavirus RNA in blood or any other tissues, as well as potentially co locating such viral RNA along with markers for immune response would be a very significant contribution to our understanding of the virus’ behavior, pathogenicity and potential treatment interventions.
What is novel about this project with Aiforia?
We see COVID-19 as an inflammatory systemic disease of sudden onset that exerts much of its damage in the vascular system with the formation of clots that impair blood flow. We are focused on the study of COVID in the vascular system and blood components; uncovering evidence of COVID-19 RNA in the blood, skin, vasculature, lymphatic system and other tissues. And in the context of patients’ clinical histories and other test results, these findings may reveal important patterns of immune response and significant opportunities for treatment.
How will AI help advance your research?
Using AI in this process is novel because AI can detect differences that are not obvious to humans. AI has the potential to increase the throughput of specimens to augment the human technologist’s visual analysis of thousands of microscope slides while reducing the inherent variabilities in the process.
So, although efficiencies are extremely important, it is the potential ability to detect subtle changes that are not otherwise seen by humans, and ultimately, allow for a big stepwise increase in the sensitivity and specificity.
How are you finding working with Aiforia so far?
The Aiforia team is extraordinary. Not only are they experts who have built an amazing technology, but they are great teachers and are passionate about helping their partners succeed. We are thrilled to be working with them.
Blood Smear Staining of Bartonella henselae 23s rRNA Probe
Image 1: captured on a Nikon A1R Confocal Microscope with a Plan Apo 60x/ 1.40 Oil objective. The red pseudocolor represents the endogenous fluorescence of erythrocytes. The green pseudocolor represents the fluorescent dye bound to the 23s rRNA probe for Bartonella henselae. (Scale bar = 10 microns) © 2020 T Lab Inc.
Aiforia Project Analysis Results
Image 2: Grayscale image of the red fluorescent channel seen in Image 1, which that has been uploaded and analyzed in the Aiforia Create AI development software. The project was designed to detect two fluorescent staining patterns. The red circles are diffuse staining patterns and the blue circles are punctate staining patterns recognized by Aiforia’s AI model. © 2020 T Lab Inc.