research
T. Eoin West
Assistant Professor
Adjunct Assistant Professor of Global Health
MD, MPH
Last updated: October 11, 2010
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.
Sappasithiprasong Hospital, Ubon Ratchathani, Thailand
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.
Research specimens collected at Sappasithiprasong Hospital
by members of MORU
Rice farmers comprise the majority of patients diagnosed with
melioidosis in northeast Thailand
Relevant Publications
West TE, Goetghebuer T, Milligan P, Mulholland EK, Weber MW. Long-term morbidity and mortality following hypoxaemic lower respiratory tract infection in Gambian children. Bull World Health Organ. 1999;77(2):144-8. PMID: 10083713
West TE, Ernst RK, Jansson-Hutson MJ, Skerrett SJ. Activation of Toll-like receptors by Burkholderia pseudomallei. BMC Immunol. 2008 Aug 8;9:46. PMID: 18691413
Cheng AC, West TE, Limmathurotsakul D, Peacock SJ. Strategies to reduce mortality from bacterial sepsis in adults in developing countries. PLoS Med. 2008 Aug 19;5(8):e175. PMID: 18752342
Haraga A, West TE, Brittnacher MJ, Skerrett SJ, Miller SI. Burkholderia thailandensis as a model system for the study of the virulence-associated type III secretion system of Burkholderia pseudomallei. Infect Immun. 2008 Nov;76(11):5402-11. PMID: 18779342
West TE, Frevert CW, Liggitt HD, Skerrett SJ. Inhalation of Burkholderia thailandensis results in lethal necrotizing pneumonia in mice: a surrogate model for pneumonic melioidosis. Trans R Soc Trop Med Hyg. 2008 Dec;102/S1:S119-S126. PMID: 19121672
Nickerson EK, Hongsuwan M, Limmathurotsakul D, Wuthiekanun V, Shah KR, Srisomang P, Mahavanakul W, Wacharaprechasgul T, Fowler VG Jr, West TE, Teerawatanasook N, Becher H, White NJ, Chierakul W, Day NP, and Peacock SJ. Staphylococcus aureus bacteraemia in a tropical setting: patient outcome and impact of antibiotic resistance. PLoS ONE. 2009 Jan 30;4(1):e4308. PMID: 19180198
Nickerson EK, West TE, Day NP, Peacock SJ. Staphylococcus aureus disease and drug resistance in resource-restricted countries in South and East Asia. Lancet Infect Dis. 2009 Feb;9(2):130-135. PMID: 19179228
West TE, Hawn TR, Skerrett SJ. Toll-like receptor signaling in airborne Burkholderia thailandensis infection. Infect Immun. 2009 Dec;77(12):5612-5622. PMID: 19797072
Schwarz S, West TE, Boyer F, Chiang W-C, Carl MA, Hood RD, Rohmer L, Tolker-Nielsen T, Skerrett SJ, Mougous JD. Burkholderia type VI secretion systems have distinct roles in eukaryotic and bacterial cell interactions. PLoS Pathog. 2010 Aug 26;6(8):e1001068. PMID: 18779342
West TE, Myers ND, Limmathurosakul D, Liggitt HD, Chantratita N, Peacock SJ, Skerrett SJ. Pathogenicity of high dose enteral inoculation of Burkholderia pseudomallei to mice. Am J Trop Med Hyg, in press.
Active Funding
Funding Source |
Project Title |
Investigator Role |
Funding Dates |
Parker B. Francis Fellowship in Pulmonary Research |
Pulmonary Host Defense in Melioidosis |
PI |
07/01/08-06/30/11 |
NIH/NHLBI: K08 HL094759 |
Pulmonary Pathogen-Recognition Pathways in Melioidosis |
PI |
08/01/09-07/31/14 |
Wellcome Trust Intermediate Fellowship in Public Health and Tropical Medicine |
Associations between genetic polymorphisms, innate immune responses and outcomes from sepsis in Thai patients with melioidosis and S. aureus infection |
Co-Investigator |
08/01/09-07/31/14 |
University of Washington Royalty Research Fund |
Investigation of a Common TLR5 Stop Codon Polymorphism in Melioidosis |
PI |
10/01/10-9/30/11 |