28 June 2017
MRC Unit The Gambia will be holding an open day at Serekunda General Hospital on Thursday 29th June 2017. The Open Day is an exciting opportunity to engage and sensitise the Serekunda community about the NeoInnate and EPIC HIPC Projects, which are two new and important MRCG projects, due to start in Serekunda soon.
NeoInnate Study- how is iron-regulated in the body of the newborn?
Currently, little is known about iron regulation and iron homoeostasis during the first week of life and even less is known about the comparisons of nutritional immunity between full term, preterm and low birth weight neonates. In an effort to study neonatal nutritional immunity and its role in neonatal susceptibility to infection, we will conduct an observational study in 450 Gambian full-term, preterm and low birth weight vaginally-delivered neonates born at Serekunda General Hospital, The Gambia.
The motivation for this study was produced from our preliminary data, which showed that during the first 96 hours of life, a full-term neonate will actively reduce the overall serum iron concentration of their blood by over half of the total amount in the blood.
We believe that this active reduction of iron is done in an effort to limit susceptibility to infection, a process referred to as nutritional immunity. We will fully characterise and quantify nutritional immunity during the early neonatal period and we will assess how this impacts bacterial growth in the laboratory setting. Very small amounts of blood will be collected from the umbilical cord and from the baby itself. We believe, this observational study will offer new avenues of research to reduce the burden of neonatal infections in The Gambia and the developing world at large.
EPIC HIPC- how is the immune system of the newborn regulated and what does it mean for vaccination?
No other age group is as severely affected by infection as newborn. Vaccines are currently the most effective intervention against infections, but few are given right after birth because we have limited understanding about the immunity in newborn babies. Our work has already shown that the immune system of the newborn changes very quickly in the first month of life. We now want to find out how this happens in much more detail and how these changes might impact vaccines that we are already using- like BCG and hepatitis B. If we understand exactly what the responses are to these already used vaccines we believe, we can apply the lessons learnt to the next generation of vaccines and optimise them to be used in newborns to achieve better protection and possibly predict very early on which vaccines are going to work best.
The proposed clinical study will apply very new technologies called “omics” to characterise the vaccine-induced transcriptomic, metabolomic and proteomic (OMIC) signatures on very small amounts of blood in the laboratory. Understanding what changes in the immune system happen in the first few days after vaccination will help us to predict the later (adaptive) responses which we know correlate with vaccine “take” and efficacy.
Our approach will recruit a cohort of 720 Gambian newborns to measure their OMIC profile in the lab and relate these early signatures to subsequent responses to immunisation with hepatitis B vaccine (HBV) in the presence and absence of BCG vaccination.
Our understanding of the mechanisms leading to vaccine-induced protection is limited in general, and most definitely so for the newborn. This study will ultimately define signatures that correlate with vaccine immunogenicity and will inform the development of vaccine formulations that are optimised for early life immunisation.
For the event, invitations have been extended to The Government of The Gambia through the Ministry of Health and Social Welfare, MRCG staff, Serekunda General Hospital Staff and the Serekunda local community.