iSpy LIFE

🧵 Our paper out today in @naturemedicine.bsky.social

www.nature.com/articles/s41...

On development of #StrepA #Immunity over life course in #TheGambia raising hope for #vaccines on the horizon

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#Immunosky #IDsky #MicroSky #globalhealth.

Please share my 1 min video on the importance of maintaining NIH funding of infectious diseases and drug discovery research vs rising antibiotic resistance

Drastic budget cuts harm our health and imperil the next generation of scientists

More @UCSanDiego “Behind Every Breakthrough” bit.ly/3FlXQs3

Evaluating clinical decision rules and rapid diagnostic tests for the diagnosis of Streptococcus pyogenes pharyngitis in Gambian children: a diagnostic accuracy study Accurate diagnosis of Streptococcus pyogenes (S. pyogenes) pharyngitis is imperative in high rheumatic heart disease-burden countries. We aimed to assess the diagnostic accuracy of two rapid diagnosti...

Latest from @mrcunitgambia.bsky.social #StrepA group. Show clinical decision rules developed elsewhere (mostly HIC) have poor performance in Gambia & molecular tests detect far more #StrepA than culture. Given burden of RhD in Africa we urgently need better & affordable tests for #StrepA diagnosis

This deep dive into the clinical phenotype of rheumatic fever highlights extreme diversity in presenting symptoms. An important observation from the START study, and highlights why better diagnostic tests are needed 🧪 @annapralph.bsky.social @rhcmcg.bsky.social

bmjopen.bmj.com/content/15/7...

Part of the recently completed PhD thesis of outstanding UC San Diego Medical Scientist Training Program student Alex Stream exploring Strep A molecular pathogenesis and vaccinology

journals.asm.org/doi/10.1128/...

Great discussions happening at the #iSpyNetworkMeeting #LISSSD2025! Collaborating around #Strep research. Huge thanks to the Leducq Foundation for making it all possible! @ispyexplore.bsky.social @ispylifenetwork.bsky.social @grampospath.bsky.social @thushan-desilva.bsky.social

Great to see everyone dialled in for Joe Kado's talk on "Diagnosing in Low Resource Settings" at #LISSSD2025 in Brisbane! So many #Strep enthusiasts in one place. Big thanks to @ispyexplore.bsky.social & @ispylifenetwork.bsky.social for putting this on! #Lancefield #iSpyNetworkMeeting

More cool penicillin data - A/Prof J Bennett presents NZ data for subcut BenPen for RHD/ARF
💉 Penicillin >20ng/mL for 56d & >10ng/mL for 70d
💉 Worked better in ⬆️ BMI
💉 No breakthrough infections
😊 Highly accepted - only 1 pt switched back to IM BenPen

#LISSSD25 #idsky

A/Prof Laurens Manning presents a human challenge study looking to define penicillin MIC to prevent strep throat.

💊 ~9ng/mL penicillin (lower then standard threshold 20ng/mL) prevents clinical strep throat and systemic inflammation as measured by CRP.

#LISSSD25 #idsky

Prof M Good & A/Prof M Pandey close #LISSSD25 thanking all the local committee, scientific advisory committee (led by Dr
T Lamagni & @joshosowicki.bsky.social), presenters, and delegates.

Prof A Steer announces #LISSSD28 is to be held in
📌 Limassol, Cyprus 🇨🇾 2028

I said no more #LISSSD25 posts but forgot a major highlight!

Most sessions started w/ a patient lived experience video, and you can see them all @ lisssd2025.org/patient-stories

Looking after patients during thier illnesses is v. stressful so it's great to hear their experiences when recovered.

Last of the #LISSSD25 presentations is Prof Victor Nizet imploring the community to think like streptococci in these times of authoritarianism USA anti-science

🍇 Evade host immunity (cont to do work)
🍇 Form biofilms (network)
🍇 Colonise diverse hosts (expand skill sets)

#strep #idsky

Another AUROC: L Carlton presents a possible ARF biomarker id'd from a series of bead array exp using START cohort samples.

Most accurate candidate TRAFIP with AUROC 0.79 solo or upto 0.845 in combo w/ other biomarkers.

Coming to a revised-revised Jones criteria? #LISSSD25 #idsky

PhD cand. J Iwasaki talks about mechanism behind strep throat recurrence.
👅 ~15% strep throat relapse
👅 Relapse strains can persist in ⬆️ [pen]
👅 Intracellular persistence in strep intracell. comm. [SIC]
👅 SICs are L-switch'd to lack cell wall hence recur post Pen Rx

#LISSSD25 #clinmicro

Dr K Gibney flys the flag for 🦘 clin trials by 🎺

ISAAC 🔎 at Abx prophylaxis of close iGAS contacts (enrolling soon)

STRAP 🔎 backbone Abx, adjunctive Abx, and IVIg (enrolling 2026ish)

Only enrolling in Aus for now but looking for int. collab.

#LISSSD25 #idsky #clinicaltrials #strep

Prof S Sriskandan finishes w/ sobering data from the '22 UK GAS outbreak probably driven by nonimmune unexposed birth cohorts and spread by aerosolised hydrophobic GAS. Rapidly fatal - Dx of GAS microbiologically conf. post mortem in 50% of peads deaths so window of opportunity very small

Prof A Steer speaks about the progress to a Strep A vaccine, and highlights the current Emm and non-emm candidates as well as the challenges in Strep A. Steer highlights new human challenge models, published trial complication guidelines and monitoring, and building momenum. #LISSSD25 #idsky

Prof de Silva & Dr Keeley speak on Strep A epi & immunity in the Gambia.
🗝️ Hyperendemicity of Strep A
🗝️ Index infections not explained by household contacts
🗝️ Early life immunity develops <2 y/o
🗝️ Ab response to carriage & infection
🗝️ ?protective immunity from SLO, SpyAD, SpyCEP

#LISSSD25 #IDsky

@earmitage.bsky.social leverages the SpyCATS platform to investigate WASH facilities on Strep A infection incidence

⬇️ w/ handwashing, freq. clothes changing, good wound care, access to soap.

Limited by no wealth data & small sub-group but options for interventions identified.

#LISSSD25

Prof N Moreland from NZ speaks through the ARF perturbed immune response in ARF.
🌍 All strep A serotypes assoc w/ ARF in NZ
🌍 Increased IgG3 ab phenotpes
🌍 Immune infiltration valves incl plasma cells.
🌍 DIifferences in immue activation in acute & chronic RHD

#LISSSD25

Start cohort bmjopen.bmj.com/content/11/9/e053720

📣💥Thrilled to share this preprint from our PhD student Yao Shi on the identification of a conserved motif in Strep suis cell wall glycan for possible vaccine protection. 👏 to team of dedicated international collaborators immunogenicity.https://www.biorxiv.org/content/10.1101/2025.06.02.656523v1

Congratulations to Tom Parks the new President of the Lancefield Society and Committee members ! #LISSSD2025 @ispylifenetwork.bsky.social

Evening kick off off at #Lancefield #LISSSD2025 in Brisbane for all #Strep enthusiasts @ispylifenetwork.bsky.social @ispyexplore.bsky.social

Points to a specific but I think meaningful immunity gap against two of the pathogens tested - strep A and RSV in 3-4 y olds. Age specific increment in anti Strep antibodies as you might hope. Just less in those post 2020. Preprint of interest to many of us in @ispylifenetwork.bsky.social

Immunity to Streptococcus pyogenes and Common Respiratory Viruses at Age 0-4 Years after COVID-19 restrictions: A Cross-Sectional Study Importance The upsurge in invasive disease caused by Streptococcus pyogenes among children reported in several European countries during 2022-2023 has not been fully explained. Objective To test the ...

Why did invasive #strepA infections increase in young children after the pandemic?

In this new @imperialinfect.bsky.social PREPRINT *not peer-reviewed* we look at antibody responses to #strepA and resp viruses in European children before and after the pandemic:

www.medrxiv.org/cgi/content/...

Pleased to share @chemo_king’s paper explaining why spycep does what it does !
www.sciencedirect.com/science/arti...

Great thread and paper:

Where #StrepA burden greatest frequent lineage replacement seen.

Interesting points:
"vaccines without broad cross-lineage protection may also lead to S. pyogenes lineage replacement."

"need to do better surveillance from carriage and non-invasive disease"

Quantifying potential immortal time bias in observational studies in acute severe infection We developed a tool to quantify the impact of misallocation of person time, then used it to demonstrate that published observational studies have likely ov

NEW PAPER with @tom-parks.bsky.social and @petedodd24.bsky.social in @ofidjournal.bsky.social

Our tool can estimate extent to which misallocation of person time will result in spurious or optimistic estimates of intervention effects

We find benefits of IVIG in STSS have likely been exaggerated

Early life serological profiles and the development of natural protective humoral immunity to Streptococcus pyogenes in a high burden setting Streptococcus pyogenes leads to 500,000 deaths annually; many due to rheumatic heart disease in low-income settings. Limited understanding of natural protective immunity to S. pyogenes hinders vaccine...

📢 Preprint - not peer-reviewed🤞:

Development of #immunity to #StrepA in The Gambia. We assessed IgG to conserved and M protein antigens across the life course, exploring association with protection against infection:

www.medrxiv.org/content/10.1...

#IDSky #Immunosky