June 3–4, 2010
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A workshop, “Challenges in Infant Immunity,” organized by NIAID and co-sponsored by NIAID’s Division of Allergy, Immunology, and Transplantation (DAIT) and the Bill & Melinda Gates Foundation (BMGF), was convened on June 3–4, 2010. Participants discussed the subject of infant (age from birth to 12 months) immunity and how to develop improved prevention and therapeutic strategies against infection for infants throughout the world.
The specific goals of the workshop were the following:
This report summarizes the key knowledge gaps identified in each of four topic areas.
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Following introductory presentations by NIAID and BMGF on their perspectives of infant immunity, the workshop was divided into four sessions based on the following topic areas:
The final session was an open discussion to identify the key knowledge gaps that emerged from each topic area.
Mercy Prabhudas, Ph.D., from DAIT, discussed the importance of understanding immune system development in infants and the unique immune characteristics at this stage that, if understood, would provide a basis for designing better interventions for improving the health and mortality of this vulnerable population. Globally, approximately 4,000,000 children less than 6 months of age die each year at a rate of 450 deaths per hour. In addition, high hospitalization costs for infected infants are incurred in the United States with an annual estimated cost of $690,000,000.
Although the infant immune system most often suffices to allow survival to adulthood, a significant number of newborns and infants are vulnerable to severe infections due to impaired responses to a range of pathogens and vaccine. For example, polysaccharide-encapsulated bacteria, such as Streptococcus pneumoniae, Haemophilus influenzae type b, and Neisseria meningitidis, are leading causes of serious infection in young children worldwide. Moreover, vaccines are lacking for some childhood pathogens, such as respiratory syncytial virus, that often cause acute infections in infants. Furthermore, studies evaluating bacterial and viral vaccines have shown that immunity wanes after vaccination and requires multiple boosters to maintain immunological memory and protection in this population. The need for more comprehensive study of the newborn and infant immune system is particularly important in light of the fact that the majority of vaccines are given in the pediatric age range, yet the basis for age-specific vaccine efficacy is very poorly understood.
An integral part of NIAID's mission (PDF) and NIH's mission is to understand the mechanisms involved in immune regulation and immune protection. This knowledge base will enable the development of better treatments and strategies to prevent infectious, immunologic, and allergic diseases that afflict millions in the United States and around the world.
NIAID’s Advisory Council recently approved a 2012 concept on the "Infant Immune System: Implications for Vaccines and Response to Infections."
Chris Wilson, M.D., from BMGF, presented the interests and mission of BMGF that complement those of NIAID in developing ways to fight and prevent diseases in infants living in resource-limited countries. BMGF focuses on supporting studies where there are gaps in knowledge and science and creating critical technologies in areas where current tools are lacking. Dr. Wilson provided a global health perspective using vaccines to enteric infections as an example. Reduced efficacy of certain vaccines, such as rotavirus and poliovirus vaccines, appears to be related predominantly to environmental causes, including impaired nutrition, immune status, and concurrent infections, likely in concert with genetic differences. Thus, a global view and approach is essential for understanding why neonates and young infants are unduly susceptible to infection-related death and disability.
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Topics in this session covered the current understanding of infant innate and adaptive immune responses, peripheral lymphoid organ development, development of the mucosal immune system, and maternal-fetal immune interactions in utero.
The speakers in this session included the following investigators:
The second session covered immune development in urban neighborhoods and the risk of allergic diseases; the impact of nutritional status, infant transplantation, and congenital immune deficiencies on infant immune development. In addition, an alternative method was proposed for diagnosis of infections in infants.
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Topics in this session covered the development of immunity to vaccines and infections, mechanisms to enhance vaccine efficacy, and alternative modes of immune protection for the infant.
Topics in this session covered infant immune responses to infections, vaccines, and co-infections, and fetal parasitic infections in developing countries.
Key knowledge gaps from Session 4 are summarized below.
Last Updated January 07, 2011
Last Reviewed January 04, 2011