Dr Anja Saso
MA (Cantab) MSci MBBS MRCPCH DTM&H
Research Degree Student
Wellcome-Trust Global Health Clinical PhD Fellow
I am a paediatrician and Wellcome-Trust Clinical PhD Fellow based in The Gambia. My work focuses on improving maternal and child health outcomes, specifically through translational research within infection, immunity and vaccinology.
I have completed my undergraduate medical degree at Cambridge University (pre-clinical) followed by Imperial College London (clinical), qualifying as a doctor in 2013. During this time, I also completed a MSci at Cambridge University in the History and Philosophy of Science, focussing on bioethics (informed consent), the history and philosophy of the mind, and medical humanitarianism (Médecins Sans Frontières). Subsequently, I worked as a foundation year doctor in North-West Thames deanery in London before undertaking specialist paediatric training in London since 2015. I completed my Membership for the Royal College of Paediatrics & Child Health and I have the Diploma in Tropical Medicine & Hygiene.
Since 2018, I have been based at the MRC Unit The Gambia, working with the Infant Immunology research group within the Vaccine & Immunity Theme. I was awarded the one-year Wellcome Trust Institutional Strategic Support under Imperial College London in 2018-19, followed by the Wellcome Trust Clinical PhD Fellowship in Global Health Research with LSHTM in 2019.
In addition to my PhD project, I am also involved in the Clinical Services Department at the MRC Unit The Gambia, running paediatric clinics, helping with clinical paediatric guidelines and leading regular paediatric/neonatal resuscitation courses (particularly the 'Help Babies Breathe' programme).
Despite widespread vaccine rollout, pertussis remains one of the least well-controlled vaccine preventable diseases worldwide, with a recent resurgence even in highly vaccinated populations. Although the exact underlying reasons are still not clear, emerging evidence suggests that a key factor is the replacement of whole-cell (wP) by acellular pertussis (aP) vaccines. Neither vaccine induces the same robust, long-lasting protection as natural infection, with aP-mediated immunity waning more rapidly than wP. Moreover, data from animal models suggest that aP vaccines fail to prevent upper airway colonisation and induce sterilising mucosal immunity, thereby facilitating transmission of Bordetella pertussis in settings with high vaccine coverage rates. There is no clear correlate-of-protection, but differences between pertussis vaccines are hypothesised to be cell-mediated, with polarisation of T-helper cell responses determined by infant vaccine composition.
The title of my PhD project is 'Vaccine-induced systemic and mucosal immunity to Bordetella pertussis in infancy: bringing B- and T-cell responses together.' It is nested within a maternal/infant vaccine trial in The Gambia (Gambian Pertussis Study, GaPs, NCT03606096), capitalising on its unique design to provide a robust and in-depth characterisation of pertussis vaccine-induced T-helper cell immunity, and its contribution to long-term B-cell and antibody responses. These relationships will be evaluated in aP- compared to wP-vaccinated infants, using both blood and mucosal samples to understand the mechanisms underlying waning immunity and inadequate protection against infection/transmission.
I hope that my findings will help to inform the design and testing of the next generation of more immunogenic and longer-lasting infant pertussis vaccines.
I am delighted to work with my supervisors Professor Beate Kampmann, Associate Professor Thushan de Silva, Dr. Sophie Roetynck as well as advisors and collaborators from MRC Unit The Gambia, Radboud University Medical Centre, Pertussis Correlates of Protection Europe (PERISCOPE) consortium and LSHTM.