The Lancet, Volume 382
, Page S35, 29 November 2013
doi:10.1016/S0140-6736(13)62460-5Cite or Link Using DOI
Copyright © 2013 Elsevier Ltd All rights reserved.
Infection and immunity from a lifecourse perspective: Life Study Enhancement
Perinatal and childhood acquisition of micro-organisms, both pathogens and the colonising microbiota, constitute major exposures that affect morbidity and mortality throughout the lifecourse. We are only beginning to understand the crucial role that microbial colonisation of the newborn (particularly in the gut) has as a determinant of future health and disease. Equally, the immune system is both modified by and modifies our response to pathogens according to the composition of early microbial colonisation, the source and timing of infection, the nature of the organism, host and microbe genetics, and the immune repertoire inherited or acquired from the mother and father. As such, there is growing awareness of the importance of microbes and the immune system as powerful causative agents in human disease. We aim to test a wide range of specific scientific hypotheses relating to associations between human health and the microbiota, acquisition of pathogens, development of the innate and adaptive immune systems, and the fetal and maternal genome and epigenome. We also aim to create a future-proofed biological archive of up to 90 000 mother and baby paired samples for longitudinal research on the associations between early life exposures and subsequent health and developmental outcomes.
We are developing an Infection and Immunity Enhancement to Life Study, a new birth cohort study aiming to recruit up to 90 000 pregnant women across the UK, starting in 2014. Life Study is unique in both size and breadth, providing the statistical power to investigate associations that could not otherwise be explored, with extensive data collection planned across a wide range of research domains, including social, environmental, clinical, and basic sciences. Biological samples will be collected, including cord blood, placenta, faeces, saliva, vaginal swabs, and urine, at birth from mother or child, or both, with further sampling in the first year of the child's life. This study provides an ideal opportunity to explore the importance of early infectious and immunological events in the development of disease using a range of objective biomedical measures. The use of nested case-control designs will lend particular efficiency because analysis will be undertaken on a subset of biological samples, preserving most for subsequent scientific outputs.
The Infection and Immunity Enhancement to Life Study will have substantial scientific, clinical, and public health implications, including on social and policy questions about early life. It will provide an essential resource, in the data generated immediately and in subsequent decades. We anticipate that the science will inform a wide range of interventions and clinical practice, will lead to the generation of scientific hypotheses, and will inform the development of novel targeted therapies, such as small molecules, antibodies, and vaccines. This Enhancement therefore has translational potential across the spectrum of disease to reduce morbidity and mortality and improve human health. We are undertaking piloting and development work to establish this project, and wish to highlight the research and collaboration opportunities that are afforded, both in the short and long term.
The Infection and Immunity Enhancement is funded by the Wellcome Trust; Life Study is funded by the Economic and Social Research Council and the Medical Research Council.
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a Research Department of Infection and Population Health, University College London, London, UK b Institute of Child Health, University College London, London, UK c Institute for Women's Health, University College London, London, UK d Wellcome Trust Sanger Institute, Cambridge, UK e Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, UK Correspondence to: Dr Nigel Field, Research Department of Infection and Population Health, University College London, London WC1E 6JB, UK
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