Universal flu vaccine 'blueprint'

22 September 2013 Last updated at 13:00 ETBy James Gallagher Health and science reporter, BBC News

Scientists say they have made a significant leap towards creating a vaccine that would protect against every form of flu.

The influenza virus is a constantly shifting target so seasonal flu vaccines rapidly become useless and new ones are needed each year.

A team at Imperial College London say they have made a "blueprint" for a universal flu vaccine.

Their discovery is published in the journal Nature Medicine.

Influenza is able to change the proteins that protrude from the surface of the virus as readily as people change outfits.

However, the material on the inside is common to many strains of flu. Vaccine researchers believe targeting the core of the virus may be the way to develop a universal vaccine.

A specific part of the immune system, called T-cells, is thought to be able to recognise proteins in the core. A team at Imperial used the 2009 swine flu pandemic to test the theory.

Milder symptoms

Swine flu was a new virus from a mix of bird and pig flu.

The outer shell should have been a completely new experience to the immune system, but the core may have been encountered before in other flu viruses.

The team compared levels of one kind of T-cells at the start of the pandemic with symptoms of flu in 342 staff and students at the university.

They showed that the higher the levels of the T-cells a patient had, the milder their symptoms were.

Researchers then teased out the specific part of the immune system that offered some pandemic flu protection and which part of the virus it was attacking.

Prof Ajit Lalvani, who led the study, told the BBC: "It's a blueprint for a vaccine. We know the exact subgroup of the immune system and we've identified the key fragments in the internal core of the virus. These should be included in a vaccine.

"In truth, in this case it is about five years [away from a vaccine]. We have the know-how, we know what needs to be in the vaccine and we can just get on and do it."

'Long journey'

This would be a distinct approach compared with other forms of vaccination, such as the MMR jab. These trigger the immune system to produce antibodies that can attack an invader.

The prize could be huge. Seasonal flu kills between 250,000 and 500,000 people each year and new pandemics have the potential to take doctors by surprise and kill large numbers of people.

Yet the researchers admit it is "generally harder" to develop a T-cell vaccine than provoke an antibody response. The challenge will be to get a big enough T-cell response to offer protection and a response that will last.

Prof John Oxford, of Queen Mary University of London, said: "This sort of effect can't be that powerful or we'd never have pandemics. It's not going to solve all the problems of influenza, but could add to the range of vaccines.

"It's going to be a long journey from this sort of paper to translating it into a vaccine that works."

Prof Sarah Gilbert, who is developing a universal flu vaccine at the

Jenner Institute in Oxford, said: "Live attenuated influenza vaccines which are given by nasal spray and will be used in children in the UK from this autumn are much better at increasing the number of influenza-specific T cells, but these vaccines only work in young children who haven't yet had much exposure to influenza virus, so we need an alternative approach for adults.

"The new publication contains information on the precise characteristics of the influenza-specific T cells which were protective, and this information will be useful in monitoring the immune response to vaccination when testing novel influenza vaccines which are designed to provide protection against pandemic as well as seasonal influenza viruses."

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Scientists closer to universal flu vaccine after pandemic 'natural experiment'

Sep. 22, 2013 — Scientists have moved closer to developing a universal flu vaccine after using the 2009 pandemic as a natural experiment to study why some people seem to resist severe illness.

Researchers at Imperial College London asked volunteers to donate blood samples just as the swine flu pandemic was getting underway and report any symptoms they experienced over the next two flu seasons.

They found that those who avoided severe illness had more CD8 T cells, a type of virus-killing immune cell, in their blood at the start of the pandemic.

They believe a vaccine that stimulates the body to produce more of these cells could be effective at preventing flu viruses, including new strains that cross into humans from birds and pigs, from causing serious disease.

The findings are published in Nature Medicine.

Professor Ajit Lalvani from the National Heart and Lung Institute at Imperial College London, who led the study, said: "New strains of flu are continuously emerging, some of which are deadly, and so the Holy Grail is to create a universal vaccine that would be effective against all strains of flu."

Today's flu vaccines make the immune system produce antibodies that recognise structures on the surface of the virus to prevent infection with the most prevalent circulating strains. But they are usually one step behind as they have to be changed each year as new viruses with different surface structures evolve.

Previously, experimental models had suggested that T cells may protect against flu symptoms but until now this idea has not been tested in humans during a pandemic.

Professor Lalvani's team rapidly recruited 342 staff and students at Imperial to take part in their study in autumn 2009. The volunteers donated blood samples and were given nasal swabs. They were sent emails every three weeks asking them to fill in a survey about their health. If they experienced flu symptoms, they took a nasal swab and sent it back to the lab.

They found that those who fell more severely ill with flu had fewer CD8 T cells in their blood, and those who caught flu but had no symptoms or only mild symptoms had more of these cells.

Professor Lalvani said, "The immune system produces these CD8 T cells in response to usual seasonal flu. Unlike antibodies, they target the core of the virus, which doesn't change, even in new pandemic strains. The 2009 pandemic provided a unique natural experiment to test whether T cells could recognise, and protect us against, new strains that we haven't encountered before and to which we lack antibodies.

"Our findings suggest that by making the body produce more of this specific type of CD8 T cell, you can protect people against symptomatic illness. This provides the blueprint for developing a universal flu vaccine.

"We already know how to stimulate the immune system to make CD8 T cells by vaccination. Now that we know these T cells may protect, we can design a vaccine to prevent people getting symptoms and transmitting infection to others. This could curb seasonal flu annually and protect people against future pandemics."

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Health research is essential for progress towards universal health coverage

15 August 2013 | Beijing - At the launch of the "World health report 2013: Research for universal health coverage", WHO today called on countries to continue investing in local research in order to develop a system of universal health coverage tailored to each individual country’s situation. With universal health coverage, countries can help ensure that citizens obtain the health services they need without suffering financial hardship when paying for them.

Dr Margaret Chan, Director-General of WHO, describes universal coverage as “the single most powerful concept that public health has to offer.” In launching the "World health report 2013: Research for universal health coverage", Dr Chan says “universal coverage is the best way to cement the health gains made during the previous decade. It is a powerful social equalizer and the ultimate expression of fairness.”

The role of research for universal health coverage

The report shows how countries, when developing a system for universal health coverage, can use research to determine what health issues should be addressed, how a system should be structured and how to measure progress according to their specific health situation.

Universal health coverage is the single most powerful concept that public health has to offer.

Dr Margaret Chan, WHO Director-General

The report reveals that, on average, domestic investment in research in low- and middle-income countries has been growing 5% each year. This trend is most visible in emerging economies such as Brazil, China and India, all of which have embraced the concept of universal health coverage.

Case studies from many countries demonstrate the importance of local and global research for improving health, ranging from the prevention and control of specific diseases to the better functioning of health systems. The results of these studies emphasize the critical need for research to be carried out locally, where researchers can consider specific factors critical to individual countries.

“Research for universal health coverage is not a luxury; rather, it is fundamental to the discovery, development and delivery of interventions that people need to maintain good health,” the report notes.

The growth of health research

The report also shows that more health research is being published as a result of international collaboration. Scientists from low- and middle-income countries are increasingly engaged in these collaborations, although high-income countries continue to play a prominent role in most studies. China is one example: from 2000 to 2010 the global share of Chinese researchers as co-authors on published research increased from 5% to 13%. Brazil, India and other countries have also increased their participation in published research. However, although research is increasing overall, growth is uneven.

“All nations should be producers as well as consumers of research. The creativity and skill of researchers are the backbone of academic and public health programs,” says Dr Christopher Dye, Director, Office of Health Information, HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases and lead author of the report. “A wide range of basic and applied research studies is essential to reach universal health coverage, but gaps between knowledge and action are being closed very slowly. We need to accelerate the process of bringing scientists and decision makers together to improve health service coverage.”

Universal health coverage requires a strong, efficient, well-run health system; a system for financing health services; access to essential medicines and technologies, and sufficient well-trained, motivated health workers.

To meet the challenges, WHO encourages international donors and national governments not only to invest in research, but also to support mechanisms for sharing information and data, to strengthen research training and institutions, and to measure progress against their own commitment to achieving universal health coverage.

For more information please contact:

Helen Yu
Communications Officer
WHO in China
Telephone: +86 10 65327191
Mobile: +86 139 1 1205167
Email: yuji@wpro.who.int

Glenn Thomas
Communications Officer
WHO, Geneva
Telephone: +41 22 791 3983
Mobile: +41 79 509 0677
E-mail: thomasg@who.int

Gregory Hartl
Coordinator
News, Social Media and Monitoring, WHO
Telephone: +41 22 7914458
Mobile: +41 79203 6715
E-mail: hartlg@who.int

View the original article here

Health research is essential for progress towards universal health coverage

15 August 2013 | Beijing - At the launch of the "World health report 2013: Research for universal health coverage", WHO today called on countries to continue investing in local research in order to develop a system of universal health coverage tailored to each individual country’s situation. With universal health coverage, countries can help ensure that citizens obtain the health services they need without suffering financial hardship when paying for them.

Dr Margaret Chan, Director-General of WHO, describes universal coverage as “the single most powerful concept that public health has to offer.” In launching the "World health report 2013: Research for universal health coverage", Dr Chan says “universal coverage is the best way to cement the health gains made during the previous decade. It is a powerful social equalizer and the ultimate expression of fairness.”

The report shows how countries, when developing a system for universal health coverage, can use research to determine what health issues should be addressed, how a system should be structured and how to measure progress according to their specific health situation.

Universal health coverage is the single most powerful concept that public health has to offer.

Dr Margaret Chan, WHO Director-General

The report reveals that, on average, domestic investment in research in low- and middle-income countries has been growing 5% each year. This trend is most visible in emerging economies such as Brazil, China and India, all of which have embraced the concept of universal health coverage.

Case studies from many countries demonstrate the importance of local and global research for improving health, ranging from the prevention and control of specific diseases to the better functioning of health systems. The results of these studies emphasize the critical need for research to be carried out locally, where researchers can consider specific factors critical to individual countries.

“Research for universal health coverage is not a luxury; rather, it is fundamental to the discovery, development and delivery of interventions that people need to maintain good health,” the report notes.

The report also shows that more health research is being published as a result of international collaboration. Scientists from low- and middle-income countries are increasingly engaged in these collaborations, although high-income countries continue to play a prominent role in most studies. China is one example: from 2000 to 2010 the global share of Chinese researchers as co-authors on published research increased from 5% to 13%. Brazil, India and other countries have also increased their participation in published research. However, although research is increasing overall, growth is uneven.

“All nations should be producers as well as consumers of research. The creativity and skill of researchers are the backbone of academic and public health programs,” says Dr Christopher Dye, Director, Office of Health Information, HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases and lead author of the report. “A wide range of basic and applied research studies is essential to reach universal health coverage, but gaps between knowledge and action are being closed very slowly. We need to accelerate the process of bringing scientists and decision makers together to improve health service coverage.”

Universal health coverage requires a strong, efficient, well-run health system; a system for financing health services; access to essential medicines and technologies, and sufficient well-trained, motivated health workers.

To meet the challenges, WHO encourages international donors and national governments not only to invest in research, but also to support mechanisms for sharing information and data, to strengthen research training and institutions, and to measure progress against their own commitment to achieving universal health coverage.

Helen Yu
Communications Officer
WHO in China
Telephone: +86 10 65327191
Mobile: +86 139 1 1205167
Email: yuji@wpro.who.int

Glenn Thomas
Communications Officer
WHO, Geneva
Telephone: +41 22 791 3983
Mobile: +41 79 509 0677
E-mail: thomasg@who.int

Gregory Hartl
Coordinator
News, Social Media and Monitoring, WHO
Telephone: +41 22 7914458
Mobile: +41 79203 6715
E-mail: hartlg@who.int

View the original article here