Mechanisms and characteristic management of Influenza and its related pneumococcal pneumonia in JapanTohoku UniversityJapan
Masafumi Seki has been graduated from Department of Medicine, Nagasaki University, as Medical Doctor, with the specialties including Internal Medicine, Infectious Diseases, and Infection Control. Later on he obtained his post-graduation, started working at Osaka University. Presently he has been working at the Tohoku Medical and Pharmaceutical University, Sendai City, Japan.
Influenza-related pneumonia is an important complication of influenza, and it has been suggested that excessive inflammatory reactions, including “cytokine storm”, may contribute to the mechanisms underlying severe pneumonia. Human data and mouse model which co-infected with influenza virus and Streptococcus pneumoniae show increased the severity of illness caused by the elevation of cytokines/chemokines, and mice with the genetic knock-out of immune molecules such as Toll-like receptor-related IRAK-M also show hyper-immune responses and reduced survival following influenza virus infection. Such findings suggest that innate immune responses and excessive neutrophil activation might be related to severe inflammatory changes in the lungs, and immune-modulatory therapy, including macrolides, may thus be effective against severe influenza-related pneumonia. In Japan, we have five anti-influenza agents and can choose each agent dependent on influenza and pneumonia severity. Among them, peramivir can be administered by drip infusion and used not only for the most severe patients but also for the ambulatory outpatients who have some medical issues. The insurance system supports the early administration of them with antibiotics, and as a result, we might be able to have very low influenza-related mortality. Today, our management style for influenza, including vaccination and infection control team activity, will be introduced.
Influenza and Clinical Impact
prof.masafumi sekiTohoku Medical and Pharmaceutical UniversityJapan
Discrimination of Subtypes for Influenza Surveillance Using a Peptide-Based Detection Platform (FluType)
Dr.Henry MemczakUniversity of Potsdam c/o Fraunhofer IZI-BB Am Muehlenberg 13 14476 PotsdamGermany
Henry Memczak studied nanotechnology at the University of Kassel, Germany and completed his Ph.D. in biochemistry in 2014 at the University of Potsdam, Germany and the Fraunhofer Institute for Cell Therapy and Immunology, Germany. He has worked on the development of analytical biosensors for influenza detection and methods for peptide-based biointeraction analysis for several years, published several papers, holds two patents and co-founded the company qpa bioanalytics GmbH for the commercialization of novel peptide biochips. For his dedicated translational research, he received several awards and scholarships.
The only cost-effective protection against influenza is vaccination. Due to rapid mutation continuously new subtypes appear, what requires annual reimmunization. For a correct vaccination recommendation, the circulating influenza strains have to be detected promptly and exactly and characterized regarding their antigenic properties. Due to recurring incidents of vaccine mismatches, there is a great need to speed up the process chain from identifying the right vaccine strains to their administration. The monitoring of subtypes as part of this process chain is carried out by national reference laboratories within the WHO Global Influenza Surveillance and Response System (GISRS). To this end, thousands of viruses from patient samples (e.g. throat smears) are isolated and analyzed each year. Currently this analysis involves complex and time-intensive (several weeks) animal experiments to produce specific hyperimmune sera in ferrets, which are necessary for the determination of the antigen profiles of circulating virus strains. These tests also bear difficulties in standardization and reproducibility, which restricts the significance of the results. To replace this test a peptide-based assay for influenza virus subtyping is developed. The differentiation of the viruses takes place by a set of specifically designed peptidic recognition molecules which interact differently with the different influenza virus subtypes. The differentiation of influenza subtypes is performed by pattern recognition guided by machine learning algorithms, without any animal experiments.
Immunology of Influenza
Cross-protection to new drifted influenza A(H3) viruses and prevalence of protective antibodies to seasonal influenza, between 2014 in Portugal
Dr.Raquel GuiomarInstituto Nacional Saúde Dr. Ricardo Jorge Av. Padre Cruz 1649-016 LisboaPortugal
Immune profile for influenza viruses is highly changeable over time. Serological studies can assess the prevalence of influenza, estimate the risk of infection, highlight asymptomatic infection rate and can also provide data on vaccine coverage. The aims of the study were to evaluate pre-existing cross-protection against influenza A(H3) drift viruses and to assess influenza immunity in the Portuguese population. Materials and methods: We developed a cross-sectional study based on a convenience sample of 626 sera collected during June 2014, covering all age groups, both gender and all administrative health regions of Portugal. Sera antibody titers for seasonal and new A(H3) drift influenza virus were evaluated by hemagglutination inhibition assay (HI). Seroprevalence to each seasonal influenza vaccine strain virus and to the new A(H3) drift circulating strain was estimated by age group, gender, and region and compared with seasonal influenza-like illness (ILI) incidence rates before and after the study period. Results: Our findings suggest that seroprevalences of influenza A(H3) (39.9%; 95% CI: 36.2–43.8) and A(H1)pdm09 (29.7%; 95% CI: 26.3–33.4) antibodies were higher than for influenza B, in line with high incidence rates for A(H3) followed by A(H1)pdm09, during 2013/2014 season. Low pre-existing cross-protection against new A(H3) drift viruses were observed in A(H3) seropositive individuals (46%). Both against influenza A(H1)pdm09 and A(H3) seroprotection were highest in younger than 14-years old. Protective antibodies against influenza B were highest in those older than 65 years old, especially for B/Yamagata lineage, 33.3% (95% CI: 25.7–41.9). Women showed a high seroprevalence to influenza, although without statistical significance when compared to men. A significant decreasing trend in seroprotection from north to south regions of Portugal mainland was observed. Conclusions: Our results emphasize that low seroprotection increases the risk of influenza infection in the following winter season. Seroepidemiological studies can inform policymakers on the need for vaccination and additional preventive measures.