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Fetal Cells in Maternal Blood For Non-Invasive Prenatal Diagnosis RIPUDAMAN SINGH PhD, MBA Chief Technology Officer ARCEDI Biotech ApS, Denmark SRI Orlando 15 March 2017 1

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Page 1: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

Fetal Cells in Maternal BloodFor Non-Invasive Prenatal Diagnosis

RIPUDAMAN SINGH PhD, MBA

Chief Technology Officer

ARCEDI Biotech ApS, Denmark

SRI Orlando

15 March 2017

1

Page 2: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

Cell-based Noninvasive Prenatal Diagnosis

(cbNIPD)

2

Page 3: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

CVS/Amniocentesis

ARCEDI GOAL- Current Prenatal Testing/Diagnosis Technology Scenario

Page 4: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI GOAL- Current Prenatal Testing/Diagnosis Technology Scenario

Cell-based

4

Page 5: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI METHOD - OVERVIEW- Enrichment, Detection and Analyses of Circulating Fetal Cells

Scanning and

Identification of Fetal

Cells

Selection

and Staining

using

ARCEDI

markers

Pregnant

women

GA: 10 to

13 weeks

Blood

Processing

(30mL of

whole

blood)

Positively

Identified Fetal Cell

‘Picking’ the

Fetal Cell

Whole Genome

Amplification

(WGA)

CBNIPT

using

CMA/NGS 5

Page 6: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELLS IN MATERNAL BLOOD

6

• It’s known that Fetal Cells do circulate in Pregnant women’s blood

• Alternative to Invasive Prenatal Diagnosis was envisaged – Focus on Fetal Cells. Reasons:• Mitigate the risk of intervention associated with invasive methods

• Make prenatal diagnostics ‘simpler’ and cost-effective

• Attempts to isolate Fetal Cells from Maternal Circulation consistently and in good numbers were not very successful

Page 7: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELLS IN MATERNAL BLOOD- Challenges

7

Fetal Cell Type Markers

Rarity of the Fetal Cells

Page 8: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELLS IN MATERNAL BLOOD- A Love story rekindled

8

Page 9: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELLS IN MATERNAL BLOOD- A Love story rekindled

9

Beginning

Page 10: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELLS IN MATERNAL BLOOD- A Love story rekindled

10

Beginning Cb-NIPT

Page 11: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELLS IN MATERNAL BLOOD- A Love story rekindled

11

Beginning Cb-NIPT Enrichment from MB

Page 12: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELLS IN MATERNAL BLOOD- A Love story rekindled

12

Beginning Cb-NIPT Enrichment from MB

Skepticism

Page 13: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELLS IN MATERNAL BLOOD- A Love story rekindled

13

Beginning Cb-NIPT Enrichment from MB

Skepticism

ARCEDI

Page 14: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELLS IN MATERNAL BLOOD- A Love story rekindled

14

ARCEDI

Page 15: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

CHECKLIST- Technology to be approved as a cbNIPT/D should fulfil the following criteria

IDENTIFICATION OF FETAL CELL TYPE

MARKERS SENSITIVE AND SPECIFIC FOR FETAL CELLS

ACCESSIBILITY OF FETAL CELLS FOR DOWNSTREAM ANALYSIS

VIABILITY OF FETAL CELLS FOR PRENATAL TESTING/DIAGNOSIS

ROBUST METHOD TO ENRICH AND IDENTIFY FETAL CELLS

15

Page 16: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

CHECKLIST- Technology to be approved as a cbNIPT/D should fulfil the following criteria

IDENTIFICATION OF FETAL CELL TYPE

MARKERS SENSITIVE AND SPECIFIC FOR FETAL CELLS

ACCESSIBILITY OF FETAL CELLS FOR DOWNSTREAM ANALYSIS

VIABILITY OF FETAL CELLS FOR PRENATAL TESTING/DIAGNOSIS

ROBUST METHOD TO ENRICH AND IDENTIFY FETAL CELLS

16

Page 17: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

CHECKLIST- Technology to be approved as a cbNIPT/D should fulfil the following criteria

IDENTIFICATION OF FETAL CELL TYPE

MARKERS SENSITIVE AND SPECIFIC FOR FETAL CELLS

ACCESSIBILITY OF FETAL CELLS FOR DOWNSTREAM ANALYSIS

VIABILITY OF FETAL CELLS FOR PRENATAL TESTING/DIAGNOSIS

ROBUST METHOD TO ENRICH AND IDENTIFY FETAL CELLS

17

Page 18: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

CHECKLIST- Technology to be approved as a cbNIPT/D should fulfil the following criteria

IDENTIFICATION OF FETAL CELL TYPE

MARKERS SENSITIVE AND SPECIFIC FOR FETAL CELLS

ACCESSIBILITY OF FETAL CELLS FOR DOWNSTREAM ANALYSIS

VIABILITY OF FETAL CELLS FOR PRENATAL TESTING/DIAGNOSIS

ROBUST METHOD TO ENRICH AND IDENTIFY FETAL CELLS

18

Page 19: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

CHECKLIST- Technology to be approved as a cbNIPT/D should fulfil the following criteria

IDENTIFICATION OF FETAL CELL TYPE

MARKERS SENSITIVE AND SPECIFIC FOR FETAL CELLS

ACCESSIBILITY OF FETAL CELLS FOR DOWNSTREAM ANALYSIS

VIABILITY OF FETAL CELLS FOR PRENATAL TESTING/DIAGNOSIS

ROBUST METHOD TO ENRICH AND IDENTIFY FETAL CELLS

19

Page 20: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

CHECKLIST- Technology to be approved as a cbNIPT/D should fulfil the following criteria

IDENTIFICATION OF FETAL CELL TYPE

MARKERS SENSITIVE AND SPECIFIC FOR FETAL CELLS

ACCESSIBILITY OF FETAL CELLS FOR DOWNSTREAM ANALYSIS

VIABILITY OF FETAL CELLS FOR PRENATAL TESTING/DIAGNOSIS

ROBUST METHOD TO ENRICH AND IDENTIFY FETAL CELLS

20

Page 21: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELLS IN MATERNAL BLOOD

21

Fetal Cell Type

Page 22: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELL TYPE- Establishing the Fetal Cell gene expression profile

22

Page 23: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELL TYPE- Trophoblast mediated Uterine Vessel Remodelling

23

Moser et al. 2016(Histochem Cell Biol)

Page 24: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELL TYPE- Trophoblast mediated Uterine Vessel Remodelling

24

Moser et al. 2016(Histochem Cell Biol)

Page 25: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELL TYPE- Trophoblsat mediated Uterine Vessel Remodelling

25

Moser et al. 2016(Histochem Cell Biol)

Page 26: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELL TYPE- Trophoblsat mediated Uterine Vessel Remodelling

26

• EMT (Epithelial – Mesenchymal Transition)

• Fetal Cells that shed in the Maternal Circulation express markers for both:

• EPITHELIAL CELLS

• ENDOTHELIAL CELLS

• ARCEDI MARKER COMBINATION!

• 8 Markers for Enrichment and Staining of Fetal Cells

Moser et al. 2016(Histochem Cell Biol)

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FETAL CELL MARKERS- IP on the Fetal Cell Selection and Staining Markers

27

Page 28: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

FETAL CELLS IN MATERNAL BLOOD

28

Fetal Cell Markers

Page 29: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI METHOD – MARKER SENSITIVITY- Performance - Retrieval of Fetal Cells

• 190 PREGNANT WOMEN at NT SCAN- 30ml Blood.• 99 SAMPLES FROM ‘LOW RISK’ GROUP

• 91 SAMPLES FROM ‘HIGH RISK’ GROUP (offered CVS)

29

Page 30: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI METHOD – MARKER SENSITIVITY- Performance - Retrieval of Fetal Cells

• 190 PREGNANT WOMEN at NT SCAN- 30ml Blood.• 99 SAMPLES FROM ‘LOW RISK’ GROUP

• 91 SAMPLES FROM ‘HIGH RISK’ GROUP (offered CVS)

30

MATERNAL AGE

PAPP-A, beta-hCG

NUCHAL TRANSLUCENCY SCAN

1:300

Page 31: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI METHOD – MARKER SENSITIVITY- Performance - Retrieval of Fetal Cells

• 190 PREGNANT WOMEN at NT SCAN- 30ml Blood.• 99 SAMPLES FROM ‘LOW RISK’ GROUP

• 91 SAMPLES FROM ‘HIGH RISK’ GROUP (offered CVS)

PARAMETER VALUE

No of Fetal Cells 2440

Mean (per sample) 12.8/30ml blood

Median 10

Range 1-46

31

Page 32: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI METHOD – MARKER SENSITIVITY- Frequency Distribution (‘High Risk’ vs ‘Low Risk’)

32

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ARCEDI METHOD – MARKER SENSITIVITY- Frequency Distribution (‘High Risk’ vs ‘Low Risk’)

33

Fetal Cell from Every Sample

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FETAL CELLS IN MATERNAL BLOOD

34

Fetal Cell Morphology

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ARCEDI METHOD – FETAL CELLS- Gallery

35

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ARCEDI METHOD – FETAL CELLS- Gallery

36

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FETAL CELLS IN MATERNAL BLOOD

37

MethodRobustness

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ARCEDI METHOD – ROBUSTNESS- Turnaround time/sample

0 1 5

ARCEDI method: Processing Time per sample in Hours (continuous)

Sampling BloodProcessing

FetalCellEnrichment and

staining

Mounting andscanning

Visual inspection Picking

15.5

WGA

38

8

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ARCEDI METHOD – ROBUSTNESS- Sample Stability (Parameter/Platform Independant)

Fetal Cell Number and Distribution unaffected by:

• Blood collection tubes (BD vs Streck Tubes)

• Time before blood processed – 24 hrs and 48 hrs

• Transportation – air and road and processed after 48 hrs

• Fetal cells from every sample!

39

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FETAL CELLS IN MATERNAL BLOOD

40

Genetic Information from

Fetal Cells

Page 41: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI METHOD – VIABILITY- Decifering Genetic Information from Fetal Cells

41

WGAPicoplex /

Ampli1

CMA (180K) /

NGS

Page 42: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI METHOD – VIABILITY- Two ‘High Risk’ cases

42

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ARCEDI METHOD – VIABILITY- Two ‘High Risk’ cases

• Two ’High Risk’ Pregnancies offered CVS/Amniocentesis

• Maternal Blood collected before CVS/Amniocentesis

43

Page 44: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI METHOD – VIABILITY- Two ‘High Risk’ cases

• Two ’High Risk’ Pregnancies offered CVS/Amniocentesis

• Maternal Blood collected before CVS/Amniocentesis

• Fetal Cells enriched and identified using ARCEDI Method

• WGA and Array CGH (Agilent 180k microarray) performed at Baylor College of Medicine, Houston TX.

44

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ARCEDI METHOD – VIABILITY- Case I (HR33): Female Pregnancy (T21) – array CGH

45

Kølvraa et al. 2016(Prenatal Diagnosis)

Page 46: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI METHOD – VIABILITY- Case I (HR33): Female Pregnancy (T21) – array CGH

Array CGH on FC

46

Kølvraa et al. 2016(Prenatal Diagnosis)

Page 47: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI METHOD – VIABILITY- Case I (HR33): Female Pregnancy (T21) – array CGH

Array CGH on FC

Array CGH on CVS

47

Kølvraa et al. 2016(Prenatal Diagnosis)

Page 48: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI METHOD – VIABILITY- Case I (HR33): Female Pregnancy (T21) – array CGH

Array CGH on FC

Array CGH on CVS

48

Kølvraa et al. 2016(Prenatal Diagnosis)

NGS on FC

Page 49: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI METHOD – VIABILITY- Case III (NIPT413): Mosaicism [45,X/46,X,r(X)] – array CGH

377 450

49

Kølvraa et al. 2016(Prenatal Diagnosis)

377

Cell 1

Page 50: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI METHOD – VIABILITY- Case III (NIPT413): Mosaicism [45,X/46,X,r(X)] – array CGH

377 450

450

50

Kølvraa et al. 2016(Prenatal Diagnosis)

377

450

Cell 1

Cell 2

Page 51: Fetal Cells in Maternal Blood - ARCEDIarcedi.com/presentations/ARCEDI_PRESENTATION_SRI_Orlando...FETAL CELLS IN MATERNAL BLOOD 6 •It’s known that Fetal Cells do circulate in Pregnant

ARCEDI METHOD – VIABILITY- Case III (NIPT413): Mosaicism [45,X/46,X,r(X)] – array CGH

377 450

450

51

Kølvraa et al. 2016(Prenatal Diagnosis)

377

450

Cell 1

Cell 2

Amnio

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ARCEDI METHOD – VIABILITY- Case III (NIPT413): Mosaicism [45,X/46,X,r(X)] - NGS

45,X: cell 377

46,X,r(X): cell 450

52

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CVS vs cbNIPT - HR146: Male Pregnancy (Trisomy 21; Risk 1:2)

53

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CVS vs cbNIPT - HR146: Male Pregnancy (Trisomy 21; Risk 1:2)

54

47,XY,+21cbNIPT

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CVS vs cbNIPT - HR146: Male Pregnancy (Trisomy 21; Risk 1:2)

55

47,XY,+21

47,XY,+21

cbNIPT

CVS

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CVS vs cbNIPT

56

Resolution of Detection

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CVS vs cbNIPT - HO10 46,XX,t(4;8)(p16;p23)

• 2 Fetal Cells

57

Array CGH on CVS

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CVS vs cbNIPT - HO10 46,XX,t(4;8)(p16;p23)

• 2 Fetal Cells

58

Array CGH on CVS

Array CGH on FCs

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CVS vs cbNIPT - HR308 46,XY,Partial T21

• 4 Fetal Cells

59

Array CGH on CVS

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CVS vs cbNIPT - HR308 46,XY,Partial T21

• 4 Fetal Cells

60

Array CGH on CVS

Array CGH on FCs

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WHAT NEXT?- Validation Study (CVS vs cbNIPT)

61

Pregnancies

(6 Hospitals in DK)

CVSFetal Cells from maternal blood

• Recruit ‘High Risk’ pregnancies from 6 different hospitals in Denmark (which are offered CVS)

• Enrich Fetal Cells from the blood

• Perform cell based fetal DNA analysis on the the cells

• Check whether the results from two tests correlate

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WHAT NEXT?- Supporting Studies

62

• Fetal cell numbers affected by BMI?

• Fetal cell numbers as predictor of pregnancy related complications? (Eg. Pre-eclampsia) or even Preterm Birth?

• Fetal cells persisting post-partum?

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IN BRIEF- We have..

• Identified the Circulating Fetal Cell Type

• Tested Markers which are highly sensitive and specific

• Robust method of enriching fetal cells

• Picked the cells and perform downstream analyses (WGA/array CGH/NGS)

• Detected Aneuploidies as well as CNVs using Fetal Cells

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ACKNOWLEDGEMENTS

ARCEDI Biotech• PALLE• LOTTE• KATARINA• PETER• SIMON• MATHIAS• SOFIE• ANNE• MICHEL• MAIKEN• FILIZ• HAI QING• RIE• TINE• RIKKE

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AUH (Dept. Gyn/Obs)• NIELS• OLAV• MARIANNE• LOTTE• ALICE

AUH (Dept. Clinical Genetics)• IDA• ELSE MARIE• RIKKE

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CONTACT

[email protected]

www.arcedi.com

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