i-sense: EPSRC IRC in Agile Early Warning Sensing Systems for Infectious Diseases and Antimicrobial Resistance

2017年，检测和限制传染病爆发的破坏性传感系统的需求占据了中心舞台--寨卡病毒和埃博拉病毒增加了大流行性流感、艾滋病毒和抗菌素耐药性的威胁，而世界对这些疾病仍未做好准备。感染是一个全球性问题，因此我们的应对措施必须是全球性的。英国下议院的埃博拉报告承认了科学家、研究人员和机构所做的“英勇”工作，但强调说，“英国的反应--就像国际反应一样--受到了系统性延误的破坏”，“我们现在必须抓住机会，确保英国不会在下一次疫情紧急来袭时措手不及。每一天的延误都可能造成生命损失。”I-sense2 EPSRC IRC旨在为传染病和抗菌素耐药性设计新一代灵活且具有全球影响力的早期预警传感系统。我们正在利用移动电话、生物医学工程、纳米技术、基因组学和大数据的力量，比以往任何时候都更早地发现疫情。下一步的资金对以下方面至关重要：最大限度地发挥我们目前IRC研究计划的影响，留住关键员工，并使我们应对新出现的感染和抗菌素耐药性的能力发生阶段性变化。这将反过来利用超过1000万GB的翻译“试验台”基础设施、新的实验室、学术职位、学生名额和行业合作伙伴关系，以帮助确保我们作为国家卓越中心的可持续性。我们将在我们目前的i-Sense IRC的基础上继续我们的开创性工作，该IRC专注于三种传染病--流感、艾滋病毒和艰难梭菌。我们现在提出的一步改变是设计出更灵活的系统，能够快速适应不同的疾病、抗菌素耐药菌株和不同的国家。认识到通过了解背景来开发新系统的必要性，i-sense2汇集了多个学科，英国公共卫生、非洲健康研究所、皇家全科医生研究监测中心、NIHR UCLH生物医学研究中心和行业，以：1.利用对在线报告的数百万症状(例如社交媒体、搜索)的深度学习来跟踪疫情，可能是在人们去看医生之前和在资源有限的情况下；2.建立智能手机连接的诊断测试，以支持一线卫生工作者和自我测试。我们将开发低成本的生物代码纸质微流控测试和手持测序技术，以检测最早的感染和耐药性生物标记物，并将结果安全地发送到在线传染病诊所；3.创建最先进的可视化工具，将患者与治疗联系起来，并通过融合mHealth、基因组、临床和流行病学数据绘制疾病“热点”；4.投资于我们有才华的研究人员的职业生涯，使其成为未来的领导者；5.发展成为由多种资金支持的国家英才中心。我们的疾病重点将扩大到流感样疾病、性传播感染和耐药细菌，作为急性、慢性和新发感染的范例。我们将在英国和南非建造人口级的‘试验床’，以试验我们的技术，然后为临床试验和产品开发争取下一阶段的转换资金。未来的IRC Next Steps Plus奖将探索新的研究方向，例如埃博拉和寨卡病毒的传感系统。i-sense2有可能为全球数百万人带来重大的人类和经济利益。患者将受益于更快地获得潜在的挽救生命的治疗。人口将受益于疾病传播的减少，卫生系统将受益于快速诊断和患者自我管理。工业将受益于有技能的人才和新的商业机会。公共卫生将受益于更及时的干预和大流行防备。

In 2017 the need for disruptive sensing systems to detect and limit infectious outbreaks has taken centre stage - Zika virus and Ebola add to the threat of pandemic influenza, HIV and antimicrobial resistance, for which the world remains unprepared. Infections are a global problem and our response must therefore be global in nature. The House of Commons Ebola report recognised the 'heroic' work of scientists, researchers and agencies but highlighted that 'the UK response - like the international response - was undermined by systemic delay' and 'we must take the opportunity now to ensure that the UK is not caught unprepared when the next disease emergency strikes. Lives can be lost for every day of delay.' The i-sense2 EPSRC IRC aims to engineer a new generation of agile and globally impactful early warning sensing systems for infectious diseases and antimicrobial resistance. We are harnessing the power of mobile phones, biomedical engineering, nanotechnology, genomics and big data to detect outbreaks much earlier than ever before. Next Steps funding is pivotal to; maximising the impact of our current IRC research programme, retaining key staff and delivering a step change in our capabilities to respond to emerging infections and antimicrobial resistance. This will in-turn leverage over £10M in translational 'test bed' infrastructure, new laboratories, academic positions, studentships and industry partnerships to help ensure our sustainability as a National Centre of Excellence. We will build on our pioneering work within our current i-sense IRC which focused on three infectious diseases - influenza, HIV and C. difficile. The step change we now propose is to engineer more 'agile' systems that are rapidly adaptable to different diseases, antimicrobial resistant strains and different countries. Recognising the need to develop new systems through an understanding of context, i-sense2 brings together multiple disciplines, Public Health England, the Africa Health Research Institute, the Royal College of General Practitioners Research Surveillance Centre, the NIHR UCLH Biomedical Research Centre, and industry to: 1. Harness deep learning of millions of symptoms reported online (e.g. social media, searches) to track outbreaks, potentially before people visit their doctors and in resource-limited settings; 2. Build smartphone connected diagnostic tests to support front-line health-workers and self-testing. We will develop low-cost biobarcode paper microfluidic tests and handheld sequencing technologies to detect the earliest biomarkers of infection and drug-resistance, and securely send results to online infectious disease clinics;3. Create state-of-the-art visualisation tools to link patients to treatment and map disease 'hot spots' by fusing mHealth, genomic, clinical and epidemiological data; 4. Invest in the careers of our talented researchers to become future leaders;5. Grow a National Centre of Excellence supported by a plurality of funding. Our disease focus will expand to influenza-like-illnesses, sexually transmitted infections and resistant-bacteria, as exemplars of acute, chronic and emerging infections. We will build population-level 'test beds' in the UK and South Africa, to pilot our technologies and then bid for next stage translational funding for clinical trials and product development. Future 'IRC Next Steps Plus Awards' will explore new research directions e.g. sensing systems for Ebola and Zika virus.i-sense2 has the potential to bring major human and economic benefits to millions of people worldwide. Patients will benefit from receiving faster access to potentially life-saving treatment. Populations will benefit from reduced disease transmission, health systems will benefit from rapid diagnostics, and patient self-management. Industry will benefit from skilled people and new commercial opportunities. Public health will benefit from more timely interventions and pandemic preparedness.