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Lindsey B.,Imperial College London | Kampmann B.,Imperial College London | Kampmann B.,Medical Research Council Unit | Jones C.,Imperial College London | Jones C.,St Georges, University of London
Current Opinion in Infectious Diseases | Year: 2013

Purpose of Review: Following on from the success of maternal tetanus vaccination, recent research has shown that other vaccines given in pregnancy can protect against vaccine-preventable infections in early infancy. This review will outline these recent developments and highlight the impact on current clinical practice. RECENT FINDINGS: Maternal immunization provides protection to the newborn through the transfer of vaccine-induced IgG across the placenta, a process that is affected by multiple variables. The safety of newly recommended maternal vaccines has been further tested in recent studies. Maternal vaccination against influenza and pertussis is recommended in the United Kingdom and United States, with new studies indicating their efficacy. A number of additional maternal vaccines are also in the pipeline, which could be used to combat neonatal infection. Recent research findings have highlighted some of the reasons for the poor uptake of current recommendations among pregnant women. SUMMARY: Tetanus, influenza and pertussis vaccines are now recommended for use during pregnancy, with new vaccines, such as group B streptococcus and respiratory syncytial virus, being developed to prevent important neonatal infections in the future. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Battersby A.J.,Imperial College London | Kampmann B.,Imperial College London | Kampmann B.,Medical Research Council Unit | Burl S.,Imperial College London
Clinical and Developmental Immunology | Year: 2012

A potential role for vitamin D as a therapeutic immunomodulator in tuberculosis (TB) has been recognised for over 150 years, but has only recently returned to the centre of the research arena due to the increasing awareness of the global vitamin D deficiency epidemic. As early as birth a child is often deficient in vitamin D, which may not only affect their bone metabolism but also modulate their immune function, contributing to the increased susceptibility to many infections seen early in life. Recent studies have begun to explain the mechanisms by which vitamin D affects immunity. Antimicrobial peptides are induced in conjunction with stimulation of innate pattern recognition receptors enhancing immunity to particular infections. In contrast the role of vitamin D within the adaptive immune response appears to be more regulatory in function, perhaps as a mechanism to reduce unwanted inflammation. In this paper we focus on the effect of vitamin D on immunity to TB. Where much of the attention has been paid by past reviews to the role of vitamin D in adult TB patients, this paper, where possible, focuses on research in paediatric populations. Copyright © 2012 Anna Jane Battersby et al.


Mehtala J.,Finnish National Institute for Health and Welfare | Antonio M.,Medical Research Council Unit | Kaltoft M.S.,Statens Serum Institute | O'Brien K.L.,Center for American Indian Health | Auranen K.,Finnish National Institute for Health and Welfare
Epidemiology | Year: 2013

BACKGROUND:: Vaccine-induced replacement by nonvaccine serotypes in pneumococcal colonization and disease poses a threat to the long-term effectiveness of pneumococcal vaccination. One of the main drivers for serotype replacement is likely to be the competitive interactions between pneumococcal serotypes. METHODS:: We used longitudinal datasets of pneumococcal colonization among infants (American Indian and The Gambia) and toddlers (Denmark) to study the strength and mechanism of competition between pneumococcal serotypes. We characterized the strength of competition as the relative reduction in the expected time spent colonized with two serotypes (double colonization) as compared with colonization with no competition. We also assessed the mechanism of competition, that is, whether reduction in double colonization is due to reduced rate of acquisition or enhanced clearance of colonization. The three datasets were analyzed assuming both perfect (100%) and imperfect (50%) sensitivity in detection of double colonization. RESULTS:: Each dataset showed strong between-serotype competition, and competition in acquisition was clearly identified. These findings remained in the secondary analysis assuming only 50% sensitivity to detect double colonization. Inferences about enhanced clearance due to competition were susceptible to the assumed sensitivity of detection. CONCLUSIONS:: Strong competition between pneumococcal serotypes can explain the prompt replacement by the nonvaccine serotypes in vaccinated persons and populations. The main mechanism of between-serotype interaction was identified as competition in acquisition, which suggests that replacement in pneumococcal disease depends largely on propensities of the replacing serotypes to cause disease through acquisition of colonization. Copyright © 2013 by Lippincott Williams & Wilkins.


Noulin F.,Institute of Tropical Medicine | Noulin F.,Stem Cell Institute | Borlon C.,Institute of Tropical Medicine | Van Den Abbeele J.,Institute of Tropical Medicine | And 3 more authors.
Trends in Parasitology | Year: 2013

The development of a continuous Plasmodium vivax blood cycle in vitro was first attempted 100 years ago. Since then, and despite the use of different methods, only short-term cultures have been achieved so far. The available literature has been reviewed in order to provide a critical overview of the currently available knowledge on P. vivax blood cycle culture systems and identify some unexplored ways forward. Results show that data accumulated over the past century remain fragmented and often contradictory, making it difficult to draw conclusions. There is the need for an international consortium on P. vivax culture able to collect, update, and share new evidence, including negative results, and thus better coordinate current efforts towards the establishment of a continuous P. vivax culture. © 2013 Elsevier Ltd.


Manyando C.,Tropical Diseases Research Center | Njunju E.M.,Tropical Diseases Research Center | D'Alessandro U.,Institute of Tropical Medicine | D'Alessandro U.,Medical Research Council Unit | Van geertruyden J.-P.,University of Antwerp
PLoS ONE | Year: 2013

Introduction: Cotrimoxazole (CTX) has been used for half a century. It is inexpensive hence the reason for its almost universal availability and wide clinical spectrum of use. In the last decade, CTX was used for prophylaxis of opportunistic infections in HIV infected people. It also had an impact on the malaria risk in this specific group. Objective: We performed a systematic review to explore the efficacy and safety of CTX used for P.falciparum malaria treatment and prophylaxis. Result: CTX is safe and efficacious against malaria. Up to 75% of the safety concerns relate to skin reactions and this increases in HIV/AIDs patients. In different study areas, in HIV negative individuals, CTX used as malaria treatment cleared 56%-97% of the malaria infections, reduced fever and improved anaemia. CTX prophylaxis reduces the incidence of clinical malaria in HIV-1 infected individuals from 46%-97%. In HIV negative non pregnant participants, CTX prophylaxis had 39.5%-99.5% protective efficacy against clinical malaria. The lowest figures were observed in zones of high sulfadoxine-pyrimethamine resistance. There were no data reported on CTX prophylaxis in HIV negative pregnant women. Conclusion: CTX is safe and still efficacious for the treatment of P.falciparum malaria in non-pregnant adults and children irrespective of HIV status and antifolate resistance profiles. There is need to explore its effect in pregnant women, irrespective of HIV status. CTX prophylaxis in HIV infected individuals protects against malaria and CTX may have a role for malaria prophylaxis in specific HIV negative target groups. © 2013 Manyando et al.

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