Immunological tools for a seroprevalence and immune status map of Burkholderia pseudomallei and thailandensis in Vietnam

牛顿基金的申请旨在加强河内和伦敦帝国理工学院免疫学/微生物学研究人员之间的现有研究联系。生物医学研究问题涉及在越南评估类鼻疽的风险。这是一种潜在的严重或致命的细菌感染，由假鼻疽伯克霍尔德氏菌引起，在许多温带国家的土壤和供水中发现。在邻国泰国，这种疾病每年造成数千人死亡。据预测，这种疾病可能在包括越南在内的其他几个国家诊断不足，但没有全面的数据。有了更精确的数据，就有可能制定适当的诊断计划和抗生素治疗方案。因此，这一建议汇集了来自河内和伦敦的对这一问题有强烈、持续兴趣的研究人员。我们计划在几个层次上评估形势。首先是从全国各地的地点采集土壤样本，确定细菌的分布和负荷。作为这项工作的一部分，我们还将评估一种密切相关但非致病性的细菌，称为Burkholderia thailandensis。这一点很重要，因为对这两种细菌的免疫力部分是交叉反应的，有观点认为，暴露于环境泰国可能会防止类鼻疽。然后，我们将与全国五家地区医院的合作者合作，在例行健康检查期间，从每个中心的200名志愿者中收集少量血液样本。该样本将用于检查两种细菌的抗体，给出“血清阳性率”的数据集-即人类暴露于细菌的区域地图，可以与地图上的土壤样本重叠。这并不能告诉我们有多少人患有类鼻疽病。相反，它将提供一个图片，是否确实有地区的越南类似的高风险地区的N。在泰国，大多数人在接触细菌后产生高水平的抗体。由于那些对细菌有免疫力但没有疾病迹象的人必须有功能性保护，我们将进行合作研究，以确定这种保护在称为“T细胞”的白色血细胞水平上的性质。“一个密切相关的问题是，糖尿病是迄今为止暴露于细菌的个体发生严重疾病的最强风险因素。出于这个原因，我们将使用血清样本建立一个平行的糖尿病患病率区域地图，据信在越南迅速增长。本研究将包括床旁血糖和胰腺自身抗体分析。工作的一个重要组成部分将是互动和培训部分，包括在越南举行的年度研讨会

This Newton Fund application seeks to enhance existing research links between immunology/microbiology researchers in Hanoi and at Imperial College London. The biomedical research question concerns appraisal in Vietnam of the risk of melioidosis. This is a potentially severe or lethal bacterial infection caused by the bacterium, Burkholderia pseudomallei, found in many temperate countries in the soil and in the water supply. The disease is associated with thousands of deaths annually in neighbouring Thailand. It has been predicted that the disease may be under-diagnosed in several other countries including Vietnam, but no comprehensive data exists. With more precise data, it would be possible to put appropriate plans in place for diagnosis and antibiotic treatment protocols. This proposal thus brings together researchers who have a strong, ongoing, interest in this question, from Hanoi and London. We plan to appraise the situation at several levels. The first is to take soil samples from sites across the country, determining distribution and load of the bacterium. As part of this work we will also assess presence of a closely related but non-pathogenic bacterium called Burkholderia thailandensis. This is important as immunity to the two bacteria is partly cross-reactive and there is a view that exposure to environmental thailandensis may protect against melioidosis. We will then work with collaborators at five regional hospitals across the country, collecting a small blood sample from 200 volunteer donors at each centre, during routine health-checks. This sample will be used to check for antibodies to the two bacteria, giving a dataset for 'seroprevalence' - that is, a regional map of human exposure to the bacteria, which can be overlaid with the mapped soil samples. This will not tell us how many people have melioidosis. Rather, it will give a picture of whether or not there are indeed regions of Vietnam similar to high-risk regions of N. Thailand, where a majority of people develop high levels of antibody after bacterial exposure. Since those people who show immunity to the bacterium but show no signs of disease must have functional protection, we will do collaborative studies to characterise the nature of this protection at the level of white blood cells termed 'T cells.' A closely related issue is that diabetes is by far the strongest risk factor for development of severe disease in individuals exposed to the bacterium. For this reason, we will use the serum samples to build a parallel, regional map of the prevalence of diabetes, believed to be growing rapidly in Vietnam. This study will include point-of-care blood glucose and analysis of pancreatic autoantibodies. A strong component of the work will be the interactive and training component, including annual workshops held in Vietnam