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Laboratory and clinical facilities

The Lung Infection and Immunity Unit has fully equipped and staffed research laboratories including a P3 bio-safety laboratory, molecular biology platform, tissue culture facilities and BD LSRII 9 colour flow cytometer. Clinical samples and information is collated from several recruitment sites in Cape Town and elsewhere in Africa. The UCT Lung Institute has facilities for clinical phenotyping including digital x-ray facilities and an inpatient ward. Proteomic studies are conducted in collaboration with the Centre for Proteomic and Genomic Research
(Prof Jonathan Blackburn) at the IIDMM.

At the launch of the unit's new BD LSR-II 9-colour flow cytometer. From L-R: Lynn Semple, Bernhard Fromme, Alice Maredza, Danni Ramduth, Brent Jennings

Research

The Lung Infection and Immunity Unit focuses on clinical, epidemiological, immunological and molecular biological aspects of the common and serious inflammatory lung conditions, using biological samples obtained directly from the site of disease, the lung. The lung-health-research programme focuses on the pulmonary immunology, pathology and physiology of four diseases (tuberculosis, HIV, pneumonia and COPD), all of which predominantly or significantly involve the lung and are public health priorities in Africa.

Outline and summary of selected research projects:
Studies of pulmonary host immunity: These studies are evaluating the role of regulatory immune pathways including Th2 cytokines and Treg in pulmonary tuberculosis, using cells from the lung and peripheral blood.

LIN-TB (Lung Innate Immunity in TB infection): This study investigates the immunopathogenesis underlying the failure of substantial numbers of close contacts developing laboratory evidence of LTBI.

TB-NEAT Study (Tuberculosis- novel and emerging technologies for diagnosis): The performance outcomes and feasibility of several new TB diagnostics (T cell assays, antigen detection assays, NAAT, breath analysis and LED microscopy etc) are being evaluated in pulmonary and extra-pulmonary TB, and in cohorts with a high seroprevalence of HIV. Longitudinal studies are also being conducted.

Drug-resistant TB: Comparative prospective outcome, PK and cost analysis studies of drug-sensitive and resistant tuberculosis as part of the Western Cape Drug-resistant TB Research Group.

Health care workers: Evaluation of newer screening tools for LTBI and their predictive value for the development of active TB.

Smoking and tuberculosis: Immunological studies evaluating the role of cigarette smoke in subverting pulmonary mycobactericidal host immune responses.

SAIGRA study (SA IFN-gamma release assay study) examines TST-mediated boosting and the utility of T cell immune assays in the diagnosis of pulmonary and extra-pulmonary TB using cells from peripheral blood, the lung, the pleural space and cerebrospinal fluid. .

Diagnostic Biomarkers in Pleural Effusion: examines the utility of several novel biomarkers, including proteomics, for the diagnosis of malignant and TB-related pleural effusions.

Performance outcomes of sputum induction and rapid immunodiagnosis: a randomised controlled trial evaluating the outcomes of sputum induction in HIV + and HIV negative suspects in primary care.

Novel technologies for the diagnosis of TBM: evaluates the utility and performance outcomes of newer technologies for the diagnosis of TBM.

Outcome studies of infectious and non-infectious pneumonitis in HIV + subjects: evaluation of the immunological profile and treatment-related outcomes of community acquired pneumonia and lymphocytic interstitial pneumonitis.

New TB drug-development: Phase 2 and 3 studies of the novel drug SQ109 led by Dr Rod Dawson of the CTBRI.

Collaborative projects with Dr J Huggett at UCL on urine PCR and PCP: these studies, led by Dr Jim Huggett, as part of the UCL-UCT collaboration, are evaluating the utility of trans-renal and peripheral blood DNA amplification for the diagnosis of TB and PCP.

Cutaneous adverse drug reaction to anti-tuberculous drugs: RCT evaluating step-wise versus simultaneous re-challenge of anti-TB drugs and predictive variables for the development of drug reactions (in collaboration with Prof Gail Todd).