David Speert

Department of Pediatrics

Dr. David Speert is a Professor in the Department of Pediatrics, and Senior Clinician Scientist and Head, Centre for Understanding and Preventing Infection in Children, CFRI Sauder Family Professor, Division of Infectious and Immunological Diseases. Research in Dr. Speert’s laboratory is directed at gaining a clearer understanding of function of the human innate immune system and the control of inflammation in health and disease. Investigations are currently underway to identify host determinants of dysfunctional inflammation. Work in Dr. Speert’s laboratory has focused on the causes of bacterial infections in cystic fibrosis. His work has identified a number of bacterial and host factors which likely conspire to create an environment in the CF lung which favors infection with the bacteria. These studies are ultimately directed at identifying novel strategies to prevent or enhance therapy of such infections.

Dr. Speert has worked in collaboration with colleagues in South Africa where childhood disease is far more common than in North America. His group is studying children born to, but not infected by, HIV-positive mothers. He has established a birth cohort study in Cape Town and is planning a cohort study of older children in Paarl, Western Cape Province to understand the causes for morbidity and mortality in these infants and to determine if they are protected against HIV when exposed later in life.

Primary Recipient Awards

Major Thematic Grant, David Speert, 2011

David Speert

Infection with HIV has had a devastating effect on sub-Saharan Africa with large segments of the population infected, especially women of child-bearing age. Highly effective strategies have been introduced to prevent spread of HIV infection from mothers to their babies; of the 1.5 million babies born annually to HIV-infected mothers, the vast majority are not themselves infected. Nonetheless these HIV-Exposed but Uninfected (HEU) babies are at greatly increased risk of death during the first year of life and appear to suffer from a weakness in their immune defenses. Several theories have been offered to explain the very poor health of these HEU babies, but none has been proven to be the sole one responsible; as a result there is no effective intervention to prevent the many deaths that occur annually. South Africa has the highest burden of HIV/AIDS in the world, and a very large proportion of HEU babies.

This Major Thematic Grant will fund research over three years to identify the immunological explanation for the impaired defense against infection of HEU babies. To achieve this goal the team of researchers from UBC and the Health Sciences Faculty and Tygerberg Hospital, University of Stellenbosch, South Africa will study 100 HIV-exposed babies and 100 babies born to women who are not HIV infected. Blood samples will be obtained, frozen and evaluated at the CFI Centre for Understanding and Preventing Infections in Children, BC Children’s Hospital. The team will study the innate (present from birth) and the adaptive (learned) immune system of all babies at several time points from 2 weeks of age to 24 months. Investigation of nutrition, infant development and maternal depression will also be performed. These studies will be guided by the results of a small pilot study conducted in 2009 and 2010 in which 60 babies were investigated. With information gained from these studies, and future major studies arising from them, it should be possible to suggest interventions to protect these very vulnerable children during the first year of life, when most of the fatal infections occur.

This project builds on the momentum generated by a highly successful Wall Exploratory Workshop, Exploring Development of a Birth Cohort to Understand and Prevent Disease of Children in the Developing World, held at the Peter Wall Institute which helped to identify and refine the themes of this project.

The Stellenbosch Institute for Advanced Study, associated with this project, is a partner of the Peter Wall Institute and in 2009 co-hosted a Peter Wall Colloquium Abroad on the topic of HEU infants.

Wall Colloquia Abroad, David Speert, 2009

David Speert

The HIV-Exposed but Uninfected Infant: How Can Excess Morbidity and Mortality be Explained?

Principal Investigator: David Speert, Department ofPediatrics, UBC. Local organizers: Monica Esser, Tygerberg Hospital; Ben Marais and Mark Cotton, Pediatrics, Stellenbosch University.

The Institute held its first Colloquium Abroad November 3-5, 2009 at one of the Institute’s partner institutes, the Stellenbosch Institute for Advanced Study, Stellenbosch South Africa. The colloquium sought to explain why babies exposed to HIV but uninfected (“HEU”) by their mothers are at enhanced risk of poor health and development during the first year of life. At this international workshop were discussed the multiple dimensions of this problem in an attempt to plan a study in South Africa to explain this phenomenon. The collaborative aspects of the meeting contributed substantially to the preparation of a Wall Major Thematic Grant on the topic of HEU.

Exploratory Workshops, David Speert, 2007

David Speert

The workshop took place on October 22 - 25, 2007.

In many parts of the developing world, more than 70% of childhood deaths occur in the first year of life, and annually 10.6 million children die before the age of five years. Many of these deaths are preventable and are due to poverty, lack of access to health care and a very high rate of transmissible infectious diseases. Although social factors play a major role in the high mortality in the developing world, many illnesses occur for no obvious reason and are therefore very hard to predict and prevent.

The goal of the proposed workshop for a birth cohort study is to identify the factors, both genetic and environmental, which predispose to potentially fatal disease in childhood. Armed with the new knowledge from the eventual study, it should be possible to devise effective strategies to address the major problem of childhood mortality in the developing world. The purpose of the workshop is to gather experts from a range of specialties at and outside of UBC (Cape Town, Canada, Sweden) to lay the plans for developing an ambitious and unique, collaborative research project in South Africa. We wish to establish a birth cohort study in which 10,000 children will be investigated from birth until 20 years of age. Genetic, epidemiological and environmental assessments will be performed on the entire cohort. The basic question we wish to address with the proposed ambitious study is: why do some children become ill, but others remain healthy, when all are exposed to the same potentially disease-causing conditions? 

We will test the hypothesis that specific factors, both endogenous and exogenous, predict susceptibility to illness in childhood. Such factors can be identified by intensively evaluating all infants in a defined geographical area and then following each child for acquisition of specific illnesses throughout childhood and early adulthood.

Exploratory Workshops, David Speert, 1998

David Speert

Antibiotics, once hailed as a miracle of modern science, are rapidly losing their ability to combat infection. The emergence of bacterial superbugs, against which antibiotics are proving powerless, forewarns of a coming era in which infectious disease will once again pose a major threat to human life. Many factors drive the development of resistant bacteria, notably the overuse of antibiotics in both developed and developing countries. However, despite dire predictions and a proliferation of academic publications and warning in the poplar media, no coherent course of action has evolve.

This proposal recognizes the necessity of approaching the problem of antibiotic resistance not through isolated discipline-specific research, but with a collective vision drawing on the expertise of many professional fields. Such an effort must promote changes in attitude and behaviour of the public and the medial profession, develop strategies to maintain the viability of existing antibiotics and to develop effective new agents, and create a climate which stimulates research into innovative approaches to the prevention and treatment of infectious disease. The exploratory workshop will bring together a broadly-based group of UBC participants and internationally-recognized experts in basic, applied and social sciences, including medicine, health economics, microbiology, psychology, health promotion and animal sciences. The workshop will enhance UBC research strengths in this area, encourage collaboration among faculties, explore ways to build on UBC's potential to become a major centre of expertise on this topic and define research questions for a major thematic grant application to the Wall Institute.