Alex Keeley

so just reading the title - I would say there is a lot more to this than amnesia

A new study by @thushan-desilva.bsky.social @alexjkeeley.bsky.social & colleagues provides a framework for future Streptococcus pyogenes (Strep A) vaccine development by examining the natural acquisition of humoral immunity!

www.nature.com/articles/s41...
#Microbiology #Pathogen #VaccineDevelopment

I agree but #EMR is a core element of healthcare delivery... so you could (and we absolutely should) judge/select your EMR by how much it facilitates the human connection with patients vs how much it gets in the way.....

Early-life serological profiles and the development of natural protective humoral immunity to Streptococcus pyogenes in a high-burden setting - Nature Medicine Serological profiles from two observational cohort studies in The Gambia characterize surrogates of protection against Streptococcus pyogenes and reveal an antibody response against antigens that are currently in vaccine development.

Antibodies to conserved Streptococcus pyogenes antigens correlate with functional activity and protect Gambian children from culture‑confirmed infections, especially under age 2.

by Keeley AJ, Camara FE (...) de Silva TI et 33 al. in Nat Med #MedSky

👉 get more here

📖 read the article:

On this note:

Huge progress being made by Penda Johm in establishing a community advisory board for Strep A research...

Many new projects underway, lots of opportunity to collaborate...

And substantial momentum towards Strep A vaccine trials @mrcunitgambia.bsky.social

fin/

But biggest thanks to the families, the Alkalo, and community of Sukuta, The Gambia.

Sharing the first results with you was a special moment (x.com/edwinarmitag...)

We look forward to the next event to show just how impactful your contribution has been.

13/

So many collaborators and partnerships made this happen. Plus the amazing SpyCATS field team (led by Gabou de Crombrugghe and Musukoi Jammeh), lab teams and RSO @mrcunitgambia.bsky.social .

12/

Huge thanks to @wellcometrust.bsky.social and BactiVac for the funding.

All this work from x2 clinical PhD fellowships and a pump priming grant. Has led to so much more research and collaborations underway already...

👀 Preprint from Fatoumata Camara on mucosal responses coming any minute...

11/

🧫 For Strep A nerds:

Protection from IgG to SLO, SpyAD & SpyCEP held even after accounting for type-specific responses. Type-specific IgG also mattered. Complex w/ technical and analytical limitations. Read the paper & reach out with❓s

Or hear it at #Bactivac conference in Nov

10/

These data give hope that vaccines with these antigens could protect people from Strep A infection.

But:
We need to give more attention to children under 2.
We need vaccine trials.

And there are still so many questions to answer.

9/

➡️ In this setting, so much immunological action is in the under 2s

Maternal antibody wanes rapidly after birth

Exposure is intense

Antibody levels rocket up

Antibody rises around infection most pronounced in under 2s regardless of symptoms or site (throat/skin)

8/

What did we find?

🖐️📢 Higher IgG levels to SLO, SpyAD, SpyCEP, but not GAC were associated with protection.

We defined protective thresholds allowing comparison with upcoming phase 1 vaccine trials. But.. to be more relevant we need universal reference sera.

7/

We measured IgG antibodies 1987 timepoints, linked to dense culture-based surveillance for Strep A. This allowed us to explore the association between antibody level and risk of infection.

Collaboration with @adamjkucharski.bsky.social and @hsalje.bsky.social

6/

Thanks to a collaboration with GSK Vaccines Institute for Global Health and @njmoreland.bsky.social, and along with our team (esp lab superstar Fatoumata Camara) @mrcunitgambia.bsky.social, we measured antibodies to vaccine-relevant antigens, including:

GAC
SLO
SpyAD
SpyCEP
DNAseB
M proteins

5/

SpyCATS recap:

We did a household cohort study in The Gambia - funded by @wellcometrust.bsky.social as a clinical PhD fellowship to @earmitage.bsky.social to detect Strep A carriage and disease

And.. it is a unique platform to understand immunity.

Read about that: tinyurl.com/4d9pfxwc

4/

# StrepA kills >500,000 people a year via:
Invasive Strep A (e.g UK 2022)
and
Rheumatic heart disease (RHD).

RHD occurs where there’s:
+++ Strep A skin infections
+++ bacterial diversity
+++ poverty

Children the world over would benefit from a safe effective vaccine.

3/

This is work from a @wellcometrust.bsky.social funded PhD with:

@mrcunitgambia.bsky.social
@lshtm.bsky.social
@floreyinstitute.bsky.social

My amazing supervisors: @thushan-desilva.bsky.social, Beate Kampmann and @claireyt.bsky.social

2/

🧵 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

1/

#Immunosky #IDsky #MicroSky #globalhealth.

Beatriz Grinszetjn
Opens #ias2025!

While she can't provide a recipe for success in current climate, there are key factors
1. EVIDENCE
2. SOLIDARITY
3. TRUTH

Let us make the most of our time together at the conference to "reaffirm, refocus & rebuild!"

@iasociety.bsky.social

📌

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

Tip rather than bootcamp:

Have you tried using the package librarian?

It manages this issue quite well.

library(librarian)
shelf(<list of packages your script requires>)

Not tried it for packages that require different R versions etc so not sure if this is what you're after?

This post just hits the nail on the head for me right now:

Pin for later!

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Impact of an international HIV funding crisis on HIV infections and mortality in low-income and middle-income countries: a modelling study Unmitigated funding reductions could significantly reverse progress in the HIV response by 2030, disproportionately affecting sub-Saharan African countries and key and vulnerable populations. Sustaina...

Also - tweeting into an algorithmic void is certainly not the best response!

It's just hard not to feel totally overwhelmed at the imminent catastrophe:

www.thelancet.com/journals/lan...

and then see #ESCMID2025 thread looking like business as usual:

#ESCMIDGlobal2025 threads:

Buckets of cool research and breaded meats....

Not seen a single post on #PEPFAR / #USAID cuts. How do we stand together as a community to strongly condemn this tragedy, and work on solutions?

If it's not our problem #ESCMID "global" NOW, then who? and when?

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"