By Sarah Schmelling

 The Bond-maX from Vision BioSystems provides fully automated immunohistochemistry staining.

When Cindy Potts came on as a supervisor for WCP Laboratories, St Louis, 2 years ago, she immediately noticed some irregular costs. The immunohistochemistry department of the lab, which also has histology, cytology, and cutaneous pathology groups, used only one brand of staining instruments from a leading manufacturer. They had replaced all the older, different brand stainers with these products just 1 year before, something that proved frustrating to Potts.

“[This company] came in and sold the management team on the predilute

  • , saying, ‘You won’t need as many employees, you’ll have less tech time,’” she says. “They really sold them on this, and they got rid of all of the [old stainers] and replaced them with these new ones.”

    As a supervisor, Potts says she noticed “interesting costs that just did not make sense. One thing was the prep kit,” she explains. “[This company] sells you a prep kit for $100, and if it sat in the drawer for 6 months, it got outdated and you couldn’t use it again.”

    That was her first issue. Then she saw that the company appeared to have a corner on the staining market, and, “It was like you were married to them and didn’t have any options.” With this company, she adds, “I always felt like I couldn’t get anywhere. I couldn’t get their price to come down, and I couldn’t really do any negotiating because they had the market covered.” She says they told her they had no competition, and that they were the “big dogs.”

    Potts says she went to the lab director, asking if any of the old stainers were still around, so she would have another way to attempt a stain; but they were gone, so she started looking for other options. She noticed that the antibodies she ordered through the stainer’s company were marked with labels that had a different antibody company name, so she thought there might be a possibility of ordering from this company directly. She called and found out it was possible, but that she would be required to purchase the same prep kit she had to buy from the staining-equipment manufacturer. “And when I checked the price, it was more expensive to buy direct than to buy through [the staining manufacturer], so I was stuck,” she says.

    Then Potts received a sales call from an Australian company, Vision BioSystems. She says it was late in the day and she gets frequent sales calls from manufacturers, so she was wary, but they soon caught her attention. They first asked if her lab purchased antibodies from NovaCastra, a UK-based reagent company. Potts thought they did not; she was unaware that they did in fact use NovaCastra clones. They then offered her the possibility of buying the antibodies directly from them, as Vision BioSystems had acquired NovaCastra in 2002. “I said I’d love to buy direct, and cut out the middleman, because it’s less expensive,” Potts says. But while they continued to talk, the salesperson mentioned Vision BioSystems had a stainer—the Bond-X—but that they would soon release the Bond-maX Automated Immunohistochemistry System. Potts’ search for a new stainer had ended. And though the lab originally ordered the Bond-X, the Bond-maX came to market just in time, and WCP Laboratories was able to purchase the first instrument available.

    To the Max
    The Bond-maX, which was first released last fall, provides fully automated immunohistochemistry staining—from the dewaxing process to counterstaining—as well as in-situ hybridization. The company says its unique features, including continuous batch processing, optimized reagents, and a polymer-detection system, can literally “maximize” laboratory productivity.

    Michael Ohanessian, CEO of Vision BioSystems, says that one way to understand how the Bond-maX automates the pretreatment steps for lab staining is to compare a lab to a kitchen. Without an instrument that can preheat the samples, a lab would have to use a microwave or steamer, as if they were cooking food. “So you can imagine putting your samples in a steamer or microwave, it’s very hard to get consistency and reproducibility using that type of technology,” he says. Bond-maX, he says, automates the process, standardizes it, and “gives the customer in the laboratory a consistency and reliability they wouldn’t otherwise have.”

    Ohanessian says the Bond-maX is also more efficient because there is no longer so much time spent handling and moving the slides. “It is really a step forward,” he adds, explaining that the reason the company introduced the product was that they felt the market needed more variety.

    “We thought the market was lacking choice in terms of an instrument that could automate the process and, more importantly, we thought our technology approach affords some advantages that don’t currently exist,” he says. “What we’re talking about here is providing very advanced technology that automates the process, but still provides a lot of flexibility and excellent staining quality. We think it’s world class, and that it’s taking immunohistochemistry to a new level.”

    Potts says that when her lab first received the Bond-maX, they tried several side-by-side comparisons with the other company’s staining instruments. The lab’s pathologist, she says, immediately noticed that the Bond-maX showed more sensitivity, especially with Ki67 antibody stains. The lab had recently had a problem with Ki67 stains because the other manufacturer had changed from a NovoCastra MM1 clone to a K2 clone without alerting them, so the Ki67 stains had been too hot. But the Bond-maX resolved this problem. There were many antibodies that they could not previously get to stain that worked very well on the Bond-maX—some that were “beautiful on the first run,” she says. So the lab is continuing to try more and more antibodies.

    “It’s saving us a lot of money, and we’re getting a more sensitive test,” Potts says. “The [Bond] Polymer Detection Kit has really helped out a lot. We don’t have repeats—we had a lot of repeats on the [other stainer] that we don’t have on the Bond-maX—so that cost, and just the cost of the prediluted antibodies, is sometimes three or four times more expensive per slide [with other companies] than it is on the Bond-maX.”

    Potts says the lab is gradually “moving everything over,” and she doesn’t know where it will stop. She says that so far she has not been able to do immunofluorescence on the Bond-maX, but she may be able to do so eventually.

    For example, “We’ve had some herpes that didn’t stain before, and now we’re able to get them to stain the antibodies on the Bond-maX,” she says. “And we’re going back and slowly trying other things that never really worked, or that there were not a lot of orders for because people didn’t feel confident in the stain. Now we can go back, and we are able to revamp and redo them.”

    The lab has a large menu of antibodies—currently around 250, and rising. “I’m getting calls every day, because [pathologists] are getting so excited with the success,” she says. “They keep calling saying, ‘Can you try this one?’” The lab just purchased its second Bond-maX, and may move on to an additional instrument if the cutaneous department decides to use one as well.

    The Perks of Good Staining
    So far, the only problem Potts has had with the Bond-maX was when she arrived to the lab one day to find the probe mysteriously bent. She tried to straighten it by hand, but was not able to. Thankfully, however, Vision BioSystems sent a new probe the next day and Potts was able to attach it and fix it herself.

    She says it is definitely a product she would recommend to other labs—in fact, she has already mentioned it to several who have contacted her. She is glad that there is now competition in the market, as she found it frustrating with previous products to be limited to an expensive instrument with no other choices. The lab itself needs to stay competitive, too, she says. “We need to have a large volume of antibodies to keep on hand to stain. We want a good-quality stain, but it has to be at a decent price.” Other products had all the promises of decreasing costs, but didn’t meet those promises. Plus, “we were locked into contracts and had to live out the contracts,” Potts says.

    Now that the contracts are up and those companies are eager for her to resign with them, she will not do it. “We’ll use [their products] as long as we have them, but I don’t want to be back in the same boat that I just got out of,” she says.

    One nice feature of the Bond-maX is that “it’s not dirty,” she says. Other staining instruments use a great deal of oil. “When you lift up the lid, it’s just dripping, and you get it all over your counters and your floors,” she notes. “It can be like working at McDonald’s around the fryers.”

    She says she used to have to constantly clean the equipment, but with the Bond-maX, “we might wipe off the plates once a month. There’s nothing to clean—it’s nice.”

    It is also beneficial that the Bond-maX makes less hazardous waste. With the other company’s instruments, Potts says, great volumes of the waste had to be treated before it could be thrown away or poured in the sink. “And that can get expensive,” she says.

    This ability to separate hazardous waste from regular waste is just one way the Bond-maX can save labs money, Ohanessian says. Another is the instrument’s ability to provide “random access.” “In other words, you can present a number of samples to the instrument and start the staining, but you can then come back before too long while the runs are still going and add samples—you don’t have to wait for the run to finish,” Ohanessian continues. “This aspect of ‘random access’ provides increased asset utilization. And for laboratories with tight budgets, having instruments with high asset utilization when they have to do a lot of slides in a limited amount of time is very important.”

    He says the company has accomplished the “balancing act” of creating an automated instrument that is still very flexible and user-friendly. “We think customers do expect a certain amount of consistency, but they still like to be able to modify things to fit their specific needs,” he says. “It’s a very delicate balance, but we think we’ve done it in a clever way to give the right compromise between standardization on one hand and flexibility on the other.”

    Efficient Staining, Less Cost
    Ohanessian is pleased by the response to the release of Bond-maX, and says it only makes sense that labs would want efficient staining instruments that also save them money.

    “First of all, the volume of reagents that is required is less, and that saves them money,” he says. “It saves them money because they have a faster turnaround time, [and samples] get processed more quickly. It saves them money because we have a very sensitive polymer-detection system, which means they can dilute their primary antibodies further; and because the ‘random access’ feature of the instrument means that, on average, they will need less equipment to achieve the same throughput. It’s highly automated, so compared to competitors, it takes less time to prepare the instrument and load the instrument. So for those reasons, we think overall it is a very cost-effective solution that delivers what we think is the world’s best staining quality.”

    For Potts, the reason to use the instrument is simple. “You have better staining at a less expensive price,” she says. “What more could you ask for?”

    Sarah Schmelling is a contributing writer for Clinical Lab Products.