Thread by @JoshOsowicki

A few thoughts, as promised to @syctong...
First, check out @DanielPellicci 🧵 summarising the key immunology results

https://twitter.com/DanielPellicci/status/1491536211147730951?s=20&t=Tt_2Ljcf2LOIPbxrkmr69g

And now...with apologies to immunology collaborators & #StrepA science legends like @nikkijmoreland @victornizet @markdavies... /1

Here’s a clinician’s view:
- Human infection models are powerful tools
- Humans survive exposure to #StrepA because of dynamic, proportional, and well-timed innate & adaptive responses on our surfaces (mucosa, skin) and inside our bodies (‘systemic’) /2

- #StrepA causes superficial (mucosal colonisation, impetigo), local (pharyngitis, cellulitis), and deep or disseminated invasive infections***
- Mechanisms of immune protection & pathology can be difficult to distinguish - a matter of timeliness & proportionality /3

- It is rare for humans of any age with #StrepA pharyngitis (unlike🐭) to progress to deep or disseminated invasive infection, even without💊
- We think a timely mucosal & systemic immune response like what we found in this paper is the reason why, and… /4

- ...we expect parenteral and/or mucosal #StrepA vaccination might promote an even earlier & better mucosal response to prevent local disease in the first place /5

- The responses we found had a ‘Th1’ flavour
- Protective Th1 vaccine responses have been seen in preclinical #StrepA models, eg this awesome work by @tania_riv_her journals.asm.org/doi/abs/10.112…
- Expect interest in antigens & adjuvants promoting a similar Th1 response to grow /6

- ***I have left out the entire story of post-infectious GN, ARF, RHD and other elements of the VERY BIG #StrepA picture
- Check out this previous thread for more info

https://twitter.com/JoshOsowicki/status/1383628278414462981?s=20&t=IzVz97puNay1zILR_CJGGw

/end

Apologies @MarkDavies this should have been for @MDaviesLab … 😬