research

T. Eoin West

Associate Professor
Adjunct Associate Professor of Global Health

MD, MPH

Faculty Web Page

Authored articles (PubMed)

Last updated:  June 11, 2014

Research Focus

Bacterial lung infections and – more generally – sepsis, contribute massively to worldwide morbidity and mortality. Most of this impact occurs in the poorer regions of the world. My research incorporates several different approaches to address the burden of bacterial lung infection and sepsis in these settings. These activities comprise some of the projects in a new multidisciplinary initiative called the UW International Respiratory and Severe Illness Center (INTERSECT).

First, a better understanding of innate immunity may permit the development of new strategies or targeted therapies combating lung infection and sepsis. Toward this end, I investigate the role of pathogen recognition receptor signaling in melioidosis, a particularly nasty disease caused by the intriguing Gram-negative bacterium Burkholderia pseudomallei. Melioidosis is endemic in parts of southeast Asia and tropical Australia, and often presents as a lung infection or sepsis. I combine murine models of disease and in vitro studies with analyses of human genetic variations in Thai patients with melioidosis to gain insights into innate immune responses precipitated by B. pseudomallei. The clinical significance of another better known pathogen, Staphylococcus aureus, is unfortunately underestimated in much of Asia. In related work, I engage in studies examining the association of functional innate immune genetic variation with outcome in invasive S. aureus infection in rural Thailand. These projects are all undertaken in very close cooperation with researchers from the Mahidol-Oxford Tropical Medicine Research Unit, Bangkok and Sappasithiprasong Hospital, Ubon Ratchathani, Thailand.

Second, improved recognition and management of septic patients has the potential to save huge numbers of lives in low resource environments, where outcomes from sepsis are dire. Unfortunately, most sepsis care efforts are not directed at these settings. I participate in the development and testing of severe illness and sepsis management strategies modified for low resource regions. This work is performed with members of the World Health Organization’s Integrated Management of Adolescent and Adult Illness team and the Global Alert and Response group.


Thailand Hospital

Sappasithiprasong Hospital, Ubon Ratchathani, Thailand

 

MORU Researchers

Researchers at the Mahidol-Oxford Tropical Medicine Research Unit
(MORU) identify about 400 cases of melioidosis annually at
Sappasithiprasong Hospital. This is the largest existing cohort of
melioidosis patients. Here, laboratory staff screen patient samples
for B. pseudomallei using selective Ashdown agar.


Thailand Research Unit

MORU study team members


Rice Farmers

Rice farmers comprise the majority of patients diagnosed with
melioidosis in northeast Thailand

 

Relevant Publications


Ortiz JR, Rudd KE, Clark DV, Jacob ST, West TE. Clinical research during a public health emergency: a systematic review of severe pandemic influenza management. Crit Care Med. 2013 May;41(5):1345-52.

West TE, Chantratita N, Chierakul W, Limmathurotsakul D, Wuthiekanun V, Myers ND, Emond MJ, Wurfel MM, Hawn TR, Peacock SJ, Skerrett SJ. Impaired Toll-like receptor 5 functionality is associated with survival in melioidosis. J Immunol. 2013 Apr 1:190(7):3373-9.

Jacob ST, Lim M, Banura P, Bhagwanjee S, Bion J, Cheng A, Cohen H, Farrar J, Gove S, Hopewell P, Moore CC, Roth C, West TE. Integrating sepsis management recommendations into clinical care guidelines for district hospitals in resource-limited settings: the necessity to augment new guidelines with future research. BMC Med. 2013 Apr 18;11:107.

Ortiz JR, Jacob SJ, West TE. Clinical care for severe influenza and other severe illness in resource-limited settings: the need for evidence and guidelines. Influenza Other Respi Viruses. 2013 Sep:7(Suppl. 2):87-92.

Chantratita N, Tandhavanant S, Myers ND, Seal S, Arayawichanont A, Kliangsa-ad A, Hittle LE, Ernst RK, Emond MJ, Wurfel MM, Day NP, Peacock SJ, West TE. Survey of innate immune responses to Burkholderia pseudomallei in human blood identifies a central role for lipopolysaccharide. PLoS One. 2013 Nov 26;8(11):e81617.

Chantratita N, Tandhavanant S, Myers ND, Chierakul W, Robertson JD, Mahavanakul W, Singhasivanon P, Emond MJ, Peacock SJ, West TE. Screen of whole blood responses to flagellin identifies TLR5 variation associated with outcome in melioidosis. Genes Immun. 2013 Nov 28. doi: 10.1038/gene.2013.60. [Epub ahead of print].

Myers ND, Chantratita N, Chierakul W, Limmathurotsakul D, Wuthiekanun V, Robertson JD, Berrington WR, Liggitt HD, Peacock SJ, Skerrett SJ, West TE. The role of NOD2 in murine and human melioidosis. J Immunol. 2014 Jan 1;192(1):300-7.

Chantratita N, Tandhavanant S, Myers ND, Chierakul W, Wuthiekanun V, Mahavanakul W, Limmathurotsakul D, Peacock SJ, West TE. Common TLR1 genetic variation is not associated with death from melioidosis, a common cause of sepsis in rural Thailand. PLoS One. 2014 Jan 2;9(1):e83285. 

 

Active Funding

Funding Source

Project Title

Investigator Role

Funding Dates

NIH/NHLBI

Regulation of host inflammatory responses and outcome in melioidosis by TLR5

PI

05/15/2012 – 04/30/2017

Doris Duke Charitable Foundation

Exome Sequencing of Melioidosis Patients to Illuminate Mechanisms of Host Susceptibility to Severe Sepsis

PI

07/01/2011 – 06/30/2015

Firland Foundation

Melioidosis in Individuals with Suspected Tuberculosis in Cambodia

PI

07/01/2013 – 06/30/2015

NIH/NIDDK

Pulmonary Host Defense in Diabetes

PI

07/01/2013 – 06/30/2015

 


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