Current Research and Scholarly Interests
The overarching theme of our research activities is human response to natural virus infection and to vaccines. We have conducted several studies of adult, toddler and infant immune response to initial infection with human cytomegalovirus (HCMV). Our largest was a project in which we screened 20,000 newborn infants at Stanford, El Camino and Santa Clara Valley Hospitals for evidence of congenital HCMV infection. Those infants identified as being infected were enrolled into a 3-year prospective study for medical, audiology and immunology screening. The hearing screening portion was designed to identify, as early as possible, infants who develop sensorineural hearing loss as a result of this infection.
A second area of clinical research is supported by Dr. Mark Davis' NIH-funded CCHI U19 project entitled "Protective Mechanisms Against Pandemic Respiratory Virus" and the newer HIPC U19 project entitled "Vaccination and Infection: Indicators of Immunological Health and Responsiveness". To provide samples for the lab projects we immunize children and adults (including elderly) with one of four different, licensed influenza vaccines (Fluzone, Fluzone high-dose, Fluzone Intradermal or FluMist) to study in detail the immune response to immunization given by various routes. Blood samples collected from study subjects are analyzed for influenza-specific B and T-cell responses as well as gene expression studies and cytokine analyses. Our latest studies have focused on genetic vs. environmental influences by enrolling fraternal and identical twins. Under the HIPC U19, we are conducting a study of the shingles vaccine in twins and non-twin adults for a close examination of T-cell responses. We also have conducted a study of natural influenza infection for the past 3 years in children and adults to collect NP swabs and blood samples in collaboration with researchers in the Greenberg lab who study how B cells and T cells respond to influenza virus infection.
Our group also is funded as part of the Vaccine Treatment and Evaluation Units by NIH through our collaborators at Vanderbilt University. We have conducted studies of avian, novel H1N1 and seasonal influenza vaccines and a new malaria vaccine under this subcontract. A study of a new DNA vaccine against influenza is ongoing under sponsorship by EMMES Corporation and the Vaccine Research Center at NIH.
A fourth area of interest has been vaccine safety. Stanford was one of six designated Centers for Immunization Safety Assessment (CISA) sponsored by the CDC for a 10 year period. The network provided consultation to CDC on evaluation and treatment of adverse events following immunization with licensed vaccines, developed protocols to study certain events that occur following immunization (including hypersensitivity reactions, safety of live viral vaccines in immunodeficient children, genetics study of Guillain-Barre syndrome patients). We also collaborate with Dr. Greg Enns on a study of the safety of influenza vaccine and its metabolic effects in patients with the MELAS mtDNA polymorphisms.
For further information about ongoing studies, please refer to our website at http://vaccines.stanford.edu.