Mycobacterium Tuberculosis Infection Prevention - 24th March 2014

This event will discuss new ways being developed to control and prevent TB Infection. Including discussion about cost effectiveness of current treatments, developing vaccines and transmission prevention, this event will be an ideal setting for discussion , debate and discovering current thinking and what is new in the field. This event is part of the 2014 TB Summit: www.TBSummit2014.com. This event has CPD accreditation.

Meeting Chair: Dr Derek Sloan, Senior Clinical Academic in Respiratory Medicine, Liverpool School of Tropical Medicine, Liverpool Heart and Chest Hospital, UK

The deadline for abstract submissions for oral presentation has now passed. Abstracts for poster presentation only can be submitted up to two weeks before the event. You can download the instructions for authors at www.euroscicon.com/AbstractsForOralAndPosterPresentation.pdf

Talk times include 5 – 10 minutes for questions
9:00 – 9:45 Registration

9:45 – 10:00 Introduction by the Chair: Dr Derek Sloan, Senior Clinical Academic in Respiratory Medicine, Liverpool School of Tropical Medicine, Liverpool Heart and Chest Hospital, UK

10:00 – 10:30 Tackling TB in the Age of Austerity: ensuring we use novel tools and approaches cost-effectively
Dr Peter J White, (1) Head, Modelling and Economics Unit, Public Health England and (2) School of Public Health, Imperial College London, UK

TB diagnoses in the UK remain high, having risen for two decades, and novel approaches to control are urgently needed. Limited resources mean interventions must be cost-effective, which requires effective targeting of both case-finding and support for treatment adherence. Assessing cost-effectiveness involves considering not just the benefits to individuals who are diagnosed and treated, but also calculation of how much transmission is averted by earlier treatment of active disease, or treatment of latent infection, which prevents active disease from occurring at all. We use mathematical modelling to evaluate novel approaches to finding patients, new diagnostics, and treatment approaches.

10:30 – 11:00 Breaking the transmission of tuberculosis by active case finding
Professor Juraj Ivanyi, Professor of Immunology of Infectious Diseases, Kings College London, Guy’s Campus, UK

Tuberculosis (TB) infection is transmitted, due to late diagnosis of the most infectious, sputum-positive cases. Delayed reporting of illness symptoms results from their poor perception by vulnerable individuals. To overcome this barrier, active screening of vulnerable populations in selected urban areas with high TB incidence may be beneficial. The most suitable testing would be for specific serum antibody levels or sputum DNA amplification assays, which can detect 80-90% sputum-positive cases. It may be feasible to perform high throughput testing in well-equipped laboratories, located close to high TB incidence areas in large cities. Uptake for screening would need support from community campaigning, to overcome social/ethnic/cultural factors. The various challenging aspects of this approach, which could reduce transmission and ultimately lower the prevalence of TB will be discussed.

11:00 – 11:30 Speakers’ photo then mid-morning break and poster exhibition and trade show

11:30 – 12:00 An unbiased genome-wide Mycobacterium tuberculosis gene-expression approach to discover new antigens for human T cells that are expressed during pulmonary infection
Professor Tom HM Ottenhoff, Professor in Immunology, Leiden University Medical Center, The Netherlands
A prerequisite for candidate vaccine antigens is that they are immunogenic and expressed by Mtb during infection of the primary target organ: the lungs of susceptible individuals. We have used a genome-wide, unbiased antigen discovery approach to investigate the in vivo expression of 2170 Mtb genes during Mtb infection in the lungs of mice. To study the vaccine potential of these proteins, we analyzed their immunogenicity. These in vivo expressed TB antigens (IVE-TB) antigens, expressed during pulmonary infection in vivo, were immunogenic, induced strong (memory) T cell responses in long-term latently Mtb infected individuals and thus may represent attractive antigens for new TB vaccines. IVE antigen discovery approaches can be applied to other infectious diseases.

12:00 – 12:30 Genomic Diversity of Drug-Resistant Mycobacterium Tuberculosis Isolates in Lisbon Portugal: Towards Tuberculosis Genomic Epidemiology
Professor Isabel Portugal, Centro Patogénese Molecular / FFUL, Faculty of Pharmacy, Portugal

12:30 – 13:30 Lunch, poster exhibition and trade show

13:30 – 15:00 Discussion session
This discussion session is an informal question and answer session. This is an ideal opportunity to get advice and opinion from experts in this area. This session is not for questions about specific talks, which can be asked after the speakers session, but for discussing either general topics or specific issues. There are three ways you can ask questions:
1. Before the session you can submit your question to Euroscicon staff at the registration desk,
2. Before and during the session you can submit a question or comments, by email, which will be provided on the day of the event
3. During the session you can put your hand up and join in

15:00 – 15:30 Afternoon Tea, last poster session and trade show

15:30 – 16:00 Reducing transmission in the genomic age
Dr Philip Monk, Public Health England, UK

This presentation will look the use of whole genome sequencing in the investigation and management of TB incidents and clusters. It will update on the use of whole genome sequencing as part of the microbiological investigation of specimens. Drawing on this, new models of service delivery will be suggested to improve the control of TB through better targeting of nursing and utilisation of scarce healthcare resources.

16:00 – 16:30 Neutrophils and B-lymphocytes in experimental TB: from the outcast to competent players Professor Alexander Apt, Professor and Head, Laboratory for Immunogenetics, Central Institute for Tuberculosis, Moscow, Russia

Extremely short life span of neutrophils, rapid replacement of their pool, capacity to engulf and kill different bacteria without obvious cooperation with other cells of the immune system implied the conclusion that these cells have little to do with sophisticated immune responses during chronic TB. Similarly, classical animal studies based upon adoptive transfer of immune lymphocytes and sera tightly linked anti-TB immunity with macrophages activated by T-cells, leaving a very limited role for B-cells. Recent findings dramatically changed these views. A deeper insight in the involvement of neutrophils and B-cells in complex networks of granulomatous inflammation and immune response regulation is displayed in this talk.

16:30 - 17:00 Chairman’s summing up and Close of Meeting

About the Chair
Derek Sloan has worked in high and low income countries, accruing extensive experience in the management of tuberculosis and HIV. After spending time in Kenya, South Africa and Malawi he currently lives in Liverpool. He continues to engage in clinical and academic activities with a global perspective and his research has been funded by the Wellcome Trust. His work focusses on the clinical pharmacology of anti-TB drugs, the metabolic behaviour of TB bacilli under drug pressure and PK-PD modeling of patient responses to anti-TB chemotherapy.

About the Speakers
Peter White is a member of the UK government’s Scientific Pandemic Influenza advisory committee modelling sub-group (SPI-M), and during the 2009 pandemic he led real-time modelling to advise government, and contributed to ECDC and WHO modelling working groups. He led health economic modelling work contributing to recent NICE guidance on TB in hard-to-reach groups, performed an evaluation of the London TB Find and Treat Service for the Department of Health, and has ongoing work in TB funded by NIHR. He is leading modelling work funded by the Technology Strategy Board developing a user-friendly tool for planning chlamydia testing services.

Juraj Ivanyi obtained his MD and PhD degrees in Prague. He worked in basic immunology (1961-1980), before focusing on the immunobiology of tuberculosis. At the Wellcome Research Laboratories (1969-1984) his team was first in raising TB monoclonal antibodies, leading to become Director of the MRC Tuberculosis and Related Infections Unit (1984-1997) at the Hammersmith Hospital. Engaging in both experimental models and clinical aspects, his Unit pioneered the mapping of antigen epitopes and immunodiagnosis. He served on committees of WHO (IMMLEP chairman) and BSI (International Secretary). As honorary professor at Guys Hospital since 1998, worked on the passive immunotherapy of TB. He published 258 research papers and 60 reviews/chapters.

Tom HM Ottenhoff is a Professor in Immunology 2001-present at LUMC/Univ Leiden. He has been a visiting Professor at Stanford Univ. April-August 2008, Associate professor at LUMC 1993-2001 (LUMC), Visiting Professor at NIH. 1991-1993, Huygens Fellow 1989-1993 (LUMC), Senior Scientist at Armauer Hansen Research Inst 1986-1988 and carried out his PhD research training at LUMC 1982-1986.

Philip Monk has worked in Public Health for the last 20 years. During that time he has gained extensive experience in the control of TB and has lately being working with the Oxford University based research team led by Professor Derrick Crook on the use of whole genome sequencing to improve the control of TB. He is leading the development of the Public Health England strategy to implement whole genome sequencing into TB diagnosis.

Alex Apt graduated from Lomonosov Moscow State University in 1973 and joint TB community about 35 years ago after initial training in the MHC immunogenetics. He heads the Laboratory for Immunogenetics at the Central Institute for Tuberculosis, Moscow, since 1998. The main activity of his lab includes application of mouse TB models to identification of genes involved in TB control, gene expression analyses, lung tissue pathology and immune cell interactions. The models developed in the lab are also used for vaccine and drug testing.

Post expires at 2:01pm on Monday March 24th, 2014

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