Infection and Immunity
Professor Ajit Lalvani
+44 (0)20 7594 0883
What we do
We address the world’s most severe respiratory infections – tuberculosis, pandemic influenza, Respiratory Syncytial Virus (RSV), sarcoidosis and other acute respiratory infections.
Our mission is to develop and rigorously evaluate new tools for improved screening, diagnosis and prevention of tuberculosis (TB), other granulomatous respiratory diseases and influenza by undertaking cutting-edge translational research into the immunological and genetic components of these diseases in patients and their contacts at risk of infection.
Why it is important
One in three people on the planet are infected with Mycobacterium tuberculosis (MTB). Tuberculosis is a long-standing world-wide epidemic with 8-10 million cases a year, 2-3 million of which are fatal. TB incidence in the UK has increased over the last 15 years, therefore, there is an urgent need for improved diagnosis and screening for TB infection both in the NHS and throughout the world.
Respiratory infections are among the top five causes of death globally and influenza virus infections contribute substantially to this burden of mortality. Influenza infects on average 10 – 20% of the population in any seasonal influenza epidemic and the disease spectrum ranges from asymptomatic infection, through acute respiratory Influenza-like illness (ILI) with symptoms such as fever, cough and sore throat, to serious respiratory illness requiring medical attention or hospitalisation and even death.
Influenza results in about three to five million cases of severe illness and about 250,000 to 500,000 deaths worldwide every year. Death occurs mostly in the young, the old and those with other health problems. Larger outbreaks known as pandemics are less frequent. In the 20th century three influenza pandemics occurred: Spanish influenza in 1918, Asian influenza in 1958, and Hong Kong influenza in 1968, each resulting in more than a million deaths. The World Health Organization declared an outbreak of a new type of influenza A/H1N1 to be a pandemic in June 2009.
Flu vaccine is the best protection we have against an unpredictable virus which can cause severe illness and deaths each year among at-risk groups, including older people, pregnant women and those with a health condition. Current influenza vaccines need to change every year to overcome rapid viral mutation and further research is therefore needed to identify how the human immune system responds to infection with influenza and to understand how viral infections are controlled so that we can design new therapies and possibly create better vaccines against flu.
The most significant practical output to date has been the development and clinical validation of the first T cell-based diagnostic test in medicine. The ELISpot assay for diagnosis of TB infection is recognised as the new gold standard for diagnosing latent TB infection and has mostly replaced the 100 year old tuberculin skin test. The regulatory-approved version of the assay is approved by NICE and several European guidelines and is entering clinical practice in the UK and Europe.
Our ongoing translational research into fundamental immunology has great potential to generate further advances in screening, diagnosis and monitoring of TB, sarcoidosis and Influenza. We focus on systematic translation of cutting-edge scientific biomedical advances.
How it can benefit patients
Our translational research outputs have continuously impacted clinical practice and public health policy nationally and internationally for more than 15-years. Prof Lalvani has harnessed scientific discoveries for patient benefit, systematically translating his innovations from bench to bedside to public health policy to deliver the first T cell-based diagnostic test in medicine (IGRA), the 100-yr upgrade for latent TB diagnosis. His landmark publications underpin national (NICE 2006; HPA 2008; NICE 2011) and international (CDC; ECDC) guidelines which endorse his paradigm as the new standard-of-care for latent TB diagnosis and screening. Deployment of this rapid cost-effective blood test in the last 5 yrs has transformed clinical practice nationally (and internationally), improving the quality of NHS TB services, the patient experience and the health of the nation. The group’s work on immigrant screening since 2010 set the new national clinical agenda for tackling TB, providing the blueprint (including evidence-base and health-economic analysis) for the new PHE/NHS national TB strategy (Tuberculosis: Collaborative Strategy for England 2015-20) and NICE’s guidelines for latent TB screening (NICE 2011). Prof Lalvani communicated its societal implications to the public via interviews on BBC TV News, Radio 4 Today Programme and a Radio 4 documentary that focused specifically on this work (File on Four, Aug 2012).
Our work in pandemic influenza was conducted in emergency response mode in real-time at the start of the 2009 ‘swine flu’ pandemic to learn key lessons from this unique natural experiment. The study uncovered the mechanism of natural resistance to pandemic influenza illness and delivered the blueprint for a universal influenza vaccine. The discovery attracted intense, extensive international broadcast, print and digital media coverage including all UK newspapers and BBC and ITV news. The vaccine blueprint now forms a key component of the evolving toolkit for future pandemic preparedness being developed by WHO.
Summary of current research
The section has state-of-the-art facilities for cutting-edge immunological research, including a large flow cytometry suite, confocal microscopy, real-time RT-PCR as well as biosafety category 3 containment facilities for working with M. tuberculosis.
- University of East London
- Queen Mary University
- Public Health England
- Heart of England NHS Foundation Trust
- The London School of Economics and Political Science
- Greater London Authority
- Refugee and Migrant Forum of Essex and London (RAMFEL)
- Barts Health NHS Trust
- East London NHS Foundation Trust
- Community Health Action Trust (CHAT)
- TB Alert
- Doctors of the World
- Redbridge CVS
Professor Onn M Kon
Professor Onn M Kon
Professor of Respiratory Medicine
Professor Ajit Lalvani MA MBBS DM FRCP FSB
Professor Ajit Lalvani MA MBBS DM FRCP FSB
Chair in Infectious Diseases