- Pasteur Institute Dakar
- Dr Ronald Perraut, Dr Marie-Louise Varela, Babacar Diouf - Immunology Unit
- Muriel Vray, Fatoumata Diène Sarr - Epidemiology Unit:
- Raymond BERCION -Medical Biological Analysis Laboratory
- Cheikh Loucoubar- G4 Biostatistics
In the determinants of health in general, susceptibility to infection, severity of disease, and response to drugs and vaccines vary widely from individual to individual. Due to the complexity of immune responses, it has so far not been possible to define factors (including genetic and environmental) characterizing a "healthy" immune system and determining its natural "normal" variability. The efforts to reintroduce the “individual” dimension towards personalized medicine, and a deep understanding of the determinants of the heterogeneity of an individual's response to stimuli from the Healthy Human Global Project (HHGP). This project is already underway in France with the Interior Environment study must be extended to non-Caucasian populations, particularly Africans, of which Senegal is a part (HHGP-Senegal) through a first pilot study on the sites of Dielmo and NDiop - villages located in the Sokone district of the Fatick region about 250 km south-east of Dakar and followed longitudinally since the 1990s.
Medical practices and public health policies are based on a unique model of disease management and drug development. However, there is great individual variation in diseases, vaccines, treatments, and general treatments.
Individual heterogeneity in the immune response can have a major influence on the risk of a response or on the occurrence of side effects following administration of vaccines. It is unlikely that it will be possible to define the factors (especially generic and environmental) with the "healthy" and determined immune system. natural variability. Central to the Human Project in Global Health (HHGP) project is efforts to reintroduce an “individual” dimension into medical decisions. This approach necessary in a custom custom services, is guide in one of the complete studies.
HHGP is an international project supported by the Institut Pasteur and the Institut Pasteur international network. It is for a ambition to it the place to cohortes of subjects to sains. This project is already underway with the Milieu Interior study (http://www.milieuinterieur.fr/) which has already been recruited 1000 times.
In order to increase the understanding of the impact of genetic background, environment, and latent infections on the immune system, this type of study should be conducted in populations other than the one previously studied. This project is a logical continuation of HHGP's overall strategy to collect and analyze data from "healthy" subjects from multiple sites around the world.
The present study proposes to constitute a standardized collection of samples and to study the correlations between immune phenotypes, genetic, and microbiota in Senegal.
A first pilot study will take place in Senegal (HHGP-Senegal 2016-2018) aimed at validating its feasibility and ensuring the technical and logistical implementation for a larger-scale study.
Operationally, the choice fell on the Dielmo and NDiop sites - villages located in the Sokone district of the Fatick region about 250 km south-east of Dakar and a few kilometers from the border with the Gambia. Indeed, the research platform established in these two villages since the 1990s has enabled longitudinal monitoring of the population as part of a project focused on malaria. Monitoring data relates not only to malaria but also to the individual history of various pathologies. This precise personal history will make it possible to identify a mini-cohort of "healthy" voluntary donors between the ages of 20 and 50.
A large panel of analyzes is planned, in particular an extensive clinical and biological assessment. The objectives are:
- Characterize and quantify the main immune cell populations (T, B, NK cells, monocytes, PMN and CD).
- Determine and measure the cytokines / chemokines induced by 3 stimulants mimicking the viral, bacterial, and T lymphocyte immune responses.
- Characterize the microbiota in the study population (bacterial, parasitic and fungal digestive and nasopharyngeal carriage).
- Measure the seroprevalence of common persistent infections (viral - including EBV, CMV; bacterial - including H. Pylori; parasitic - including toxoplamosis).
- Compare the population of the two villages in terms of epigenetic expression.
- Generate the necessary data to be able to determine the number of donors required for a large-scale study, the objective of which will be to analyze and understand the impact of genetic and environmental factors on the variability of the immune response.
- Evaluate the fecal and nasal microbiota, by genomic sequencing of bacterial, fungal, and viral populations in these samples.
- To study the relationship between the immune response and nutritional data.
- Build a biobank of blood, nasal and stool samples and associated data.
- Transfer the technologies and skills necessary for a large-scale study.
This complex project was approved by the National Ethical Committee for the Study of Health Research (CNERS) for 2016. The training and the technology of cytology in flux, standing in 2016 were completed in 2017. Recruitment started in November 2017.