DOI: 10.1097/INF.0b013e31815141fb
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PMID: 17984801
Issn Print: 0891-3668
Publication Date: 2007/11/01
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Excerpt
As you might have guessed by now, our Distinguished Physician awardee is Carol J. Baker, MD. Dr. Baker’s name is almost synonymous with group B Streptococcus (GBS). I can think of no single person who has had a greater impact or more pivotal role in elucidating a disease process and progressing toward its prevention than has Carol Baker for GBS. She was among the first to recognize this, then new, infection in neonates and published in 1973 a seminal report describing the clinical features of GBS meningitis in 33 infants. Approximately one-half of her nearly 300 peer-reviewed publications, or 145 by my count, are manuscripts that, taken together, comprise a wealth of insight into GBS disease. Her initial descriptions of the presentation and epidemiology of GBS disease stand as benchmarks. She described the maternal-to-infant transmission, the importance of various serotypes in early-onset and late-onset infections and, in a landmark New England Journal of Medicine article in 1976, the correlation between maternal antibody deficiency and neonatal susceptibility to GBS disease.
Working at the Channing Laboratory in Boston with Dennis L. Kasper, MD, an internist who remains her good friend and collaborator, Dr. Baker identified sialic acid as critical to the antigenic structure of the “native” capsular polysaccharide of type III GBS. She developed a quantitative assay to measure antibodies to GBS in human sera, all with the goal of developing a GBS vaccine.
To serotype GBS isolates, Dr. Baker spent a month at the Rockefeller University in New York City and learned directly from Dr. Rebecca Lancefield how to raise antibodies by immunizing rabbits with formalin-killed GBS. However, when she learned that you could raise lots of antisera at one time, she briefly went into the large animal business. We immunized a goat, dubbed William, or Billy for short, and also immunized a donkey. All these years later, our laboratory still uses antiserum to type III GBS from that donkey!
Carol has passionately pursued vaccine development as a means to prevent GBS disease for more than a quarter of a century, believing that anything short of prevention means that infants continue to die or have sequelae as a result of infection. The first GBS vaccine was administered to human volunteers in 1978. When it became evident from the results of early these trials that unconjugated capsular polysaccharides (CPS) were not sufficiently immunogenic in immunologically naïve individuals to move forward toward licensure, she shifted her focus to assessing polysaccharide-protein conjugate vaccines. In the past decade, she has conducted phase 1 and 2 testing of CPS-tetanus toxoid conjugate vaccines for each major GBS serotype, documenting their safety and superior immunogenicity over uncoupled CPS. Antibodies from women immunized in the third trimester of pregnancy with type III CPS tetanus toxoid conjugate persist in infants through the age of susceptibility proving, in concept, that immunization during pregnancy is a feasible approach to prevention of early- and late-onset disease.
Not content to wait upon the uptake of GBS vaccine by the pharmaceutical industry, Dr.
