A. Need for an Immunology course : 

Immunology is a major topic of biomedical research in the 21st century that provides a framework for better understanding of the immune mechanisms underlying infections, malignancies, allergic and autoimmune diseases including inflammatory conditions. Several Nobel prizes in medicine and physiology have been attributed to the field of Immunology including the first ever to Emil von Behring in 1901 for his discovery of serum autotoxins and also the 2018 award to James Allison (USA) and T. Honjo (Japan) for their discovery of the check-point inhibitors like the CTLA4 and PD-1 respectively towards effective cancer immunotherapy. 

The science of Immunology stands to provide workable solutions to the early diagnosis of a host of diseases on one hand and to provide effective therapeutic modules towards their control including the successful development of vaccines on the other.  New understanding has been reached on the various cell types involved along with their functional network in bringing about a successful immune response.  The fundamental principles of normal immune responses are now better understood in sophisticated details, and many novel therapies have been developed on the elucidation of basic principles.  

Nevertheless, major failings of Immunology are in its translation to human disease. For instance, the underlying pathogenesis of autoimmune and allergic diseases is not fully understood, and despite the rapid advances in identifying susceptibility genes for several diseases, the connection between genetics and pathogenesis remains elusive. Vaccine development remains an empirical art, and it has proved difficult to apply scientific principles to the development of improved vaccines; as a result, we have failed to make effective vaccines against the three most devastating infections of mankind: HIV, tuberculosis and malaria. Controlling immune responses to newly introduced genes and viral vectors has been a significant problem for gene therapy, and is a major reason why all systemic gene therapy protocols have been curtailed.  Further, despite the worldwide excitement about the potential regenerative medicine, stem cell therapies (with the exception of hematopoietic stem cell transplants, the HSCTs) will very likely face the daunting problem of rejection, and unless we resolve this concern, stem cell therapy may never realize its full potential.

The fundamental reasons for these limitations is that inadequate attention has been paid to understanding and rationally manipulating the human immune system, particularly its immense potential of tackling problems of human disease. Indeed human resource development through novel education modules and technology updates are key to the application of growing knowledge in immunology in the control and treatment of human diseases.  Unfortunately, the science of Immunology has remained underdeveloped in India despite its very vast canvas. While the west has moved forward in promoting immunology research in all its spheres, countries such as India where the tools of this science are needed the most, have lacked behind. 

In recent years, there has been a concerted effort to promote the subject the world over through theme based educational activities, workshops and seminars. The International union of immunological societies (IUIS) and the Federation of immunological societies of Asia-Oceania (FIMSA) have been encouraging national societies to organize basic and advanced training courses in their respective countries and regions with a view to train manpower and promote an atmosphere of coordinated collaborative research. 

In this direction, the Education Committee of the IUIS had invited Narinder Mehra, Shubhada Chiplunkar and the Indian Immunology Society to conduct a ‘Training course on Basic and Advanced Translational Immunology’ in India from Oct 12-16, 2019. The course was organized under the aegis of the Indian Immunology Society (IIS) with support from IUIS and FIMSA, and Jaipur was selected as the venue due to several factors. The selection of Jaipur came as a boon because of the overwhelming support from the local institutes, most importantlythe Rajasthan University of Health Sciences (RUHS) through it’s worthy Vice Chancellor Prof. Raja Babu Panwar, who offered all the resources and facilities at the College of Medical Sciences besides, Prof Mohan Lal Swarankar, Emeritus Chancellor of Mahatma Gandhi University of Medical Sciences and Technology (MGUMST) also supported the event personally as well as through involvement of his faculty most generously.

B. Course Format 

The venue of the 5-day course was the College of Medical Sciences, Rajasthan University of Health Sciences (RUHS) with equal participation by the Mahatma Gandhi University of Medical Sciences and Technology (MGUMST), Jaipur. The Rajasthan Medical council awarded ten credit hours to the participants attending the course. The course was also supported by the national funding agencies like Indian council of Medical Research (ICMR), Council of Scientific and Industrial Research (CSIR), Indian National Scientific Academy (INSA), Medical Council of India and the Immunology Foundation. The course-curriculum was carefully articulated by the scientific committee into regular podium lectures intervened with the Technology sessions, which were handled by well-known immunology product companies like BD Biosciences, BioLegend, Premas Life Sciences and Thermo Fisher. Major tracks of the course included focus on recent insights in innate and adaptive immune system, infectious and autoimmune diseases, immuno-oncology, organ and hematopoietic stem cell transplantation, viral immunity and vaccinology, immunotherapy and inflammation, along with recent translational leads therein. The course included a total of 30 lectures (30-45 minutes each) by the world-renowned faculty (N=22) from various countries including India, Australia, Germany, USA, Spain, France, Austria and South Africa.

The course was attended by of a total of 93 participants out of the selected pool of 108 candidates. A large majority of these (N=87) were from India representing 16 different states, while the remaining six were International participants; one each from Australia, Tunisia and Ethiopia and three from Iran. 

The course participants included both basic scientists and clinicians at various levels of their career viz. PhD students, faculty (early, mid and senior level) and program specialists as well as technological experts. They benefitted immensely through online pre course modules organized through Immunopedia (courtesy Clive Gray and Bon Holtak). 

More than 80% of the course participants received bursaries (N=75) through one of the various available options as below:

a) Federation of Immunological Societies of Asia Oceania (FIMSA) Travel Bursary: A total of 33 FIMSA bursaries were awarded which included four international travel bursary awards of USD 1000/- each to three Iranian and one participant from Australia and 29 travel bursary support of Rs 10,000/- each to Indian participants, mostly students and early career post-docs. 

b) Indian Immunology Society Bursary awards: Nineteen IIS bursary awards of Rs 5000/- each were presented to Indian participants to cover the course registration fee.

c) Organizers’ Bursary: This included waiver ofcourse registration fee of Rs 5000/- for 23 participants (6 international and 17 from India). 

All the participants were asked to submit an abstract, which were screened by the Course Scientific Committee, which short-listed 10 abstracts based on the scientific content and nature for a short oral presentation in a special session on 3rd day of the course. Specific time slots were kept for poster-reading and oral presentations and the posters as well oral presentations were evaluated separately by three expert reviewers for each session. The idea was to encourage early career researchers. The cash awards along with certificates of appreciation were presented to the winners during the closing ceremony. 

Abstracts and research highlights of all the participants were compiled in the form of an e-abstract book and the same was circulated to all faculty and participants for reference.

An important highlight of the course was the networking sessions whereby the participants had ample opportunities of free and frank discussion with the course faculty and the ‘technology update sessions’ by the immunology companies. These were well appreciated by the participants. 

Accommodation, local transport, hospitality and all meals of the faculty as well as participants was covered under the course organization for the course duration.

C. DAYWISE COURSE HIGHLIGHTS

October 12, 2019 (Day 1): The course opened with two keynote lectures: i) Narinder Mehra (Course Convener) summarized the historical aspects of Immunology in Asia-Oceania, highlighting the genesis and establishment of FIMSA during 1990-92 through efforts made by him and other senior Immunologists from the Indian Immunology Society. He gave a brief description of the crucial role played by Pran Talwar, Jacob Natvig, Sir Gustav Nossal and Tomio Tada in making FIMSA a reality and the various courses and conferences organized by the Federation as well as activities of the IUIS. ii) Dieter Kabelitz, who emphasized on different strategies for applying gamma delta T cells in immunotherapy. Following the keynote lectures, the course was formally inaugurated with the traditional lamp lighting and welcome addresses by invited dignitaries including Sunil Arora (President, IIS), Narinder Mehra (Course convener), Mohan Lal Swarankar (Chancellor, MGUMST), Raja Babu Panwar (Vice Chancellor, RUHS), Shubhada Chiplunkar (Course convener). The chief guest Vinod Paul, Member Niti Aayog discussed about the importance of this course and the role of immunology in reducing the disease burden from India. The course secretary Gaurav Sharma presented the vote of thanks acknowledging the contributions of course organizing team, scientific committee and support from various scientific bodies/societies and companies.

October 13, 2019 (Day 2): A total of 9 lectures were delivered to cover various modules of innate and adaptive immunology. The first lecture was of Pran Talwar who discussed the historical aspects of how the field of Immunology developed in India and the developing of vaccine and therapeutic strategies for leprosy. This was followed by Vishwa Dixit (USA) who highlighted the role of metabolic checkpoints in inflammation.Amit Awasthi talked about various subsets of the T-cells while Bernhard Fleischer (Germany) talked about Co-stimulation of T-cells. Pablo Engel (Spain) gave a full lecture on B cells while Joshy Jacob (USA) spoke about the applications of the antibodies in treatment. Gabrielle Belz (Australia) covered role of innate lymphoid cells in homeostasis, inflammation and tumor surveillance. Lastly, Abul Abbas (USA) delivered a talk on immunological tolerance. Importantly, the posters were mounted by the participants for display and discussions. Another major highlight was the networking session in the evening for meeting with the speakers. Also, a lunch time technical session lecture was delivered by a company representative.

October 14, 2019 (Day 3): A total of 6 lectures were delivered and the main focus was on Autoimmunity. Abul Abbas (USA) delivered excellent talks on Treg cells, autoimmunity, inflammatory diseases and therapeutics.Bernhard Fleischer (Germany) andOlivier Boyer (France) covered topics of autoimmunity in CNS and myositis, respectively. Lastly, Neena Kapoor (USA)elaborated and discussed her experience on hematopoietic stem cell transplantation. A special session was dedicated for short oral presentations from ten selected abstracts by the organizers to encourage early career researchers. Importantly, the posters of participants remained displayed and were available for viewing and discussions.

October 15, 2019 (Day 4): A total of 6 lectures were delivered and the main focus was on Tumor immunology.Shubhda Chiplunkar and Sunil Arora spoke about the cancer microenvironment and immune evasion strategies adopted by tumors. Hannes Stockinger (Austria) discussed the role of lipid rafts in cell signalling while Abul Abbas (USA) gave a lecture on cancer immunotherapy. Thereafter Olivier Boyer (France) andHannes Stockinger (Austria) very eminently discussed the role of CAR-T cells and the role of microbiome in healthrespectively. A special sightseeing and speaker-participant networking tour was organized to provide glimpses of major attractions of the world heritage city “Jaipur”. 

October 16, 2019 (Day 5): A total of 9 lectures were delivered and the main focus was on Transplant immunology and primary immunodeficiency diseases. The day started with a lecture by Narinder Mehra on evolution of transplant immunology. This was followed by lectures on histocompatibility matching and the role of NK cells in transplantation and cancer immunotherapy by Raja Rajalingam. Thereafter Clive Gray (South Africa) delivered a talk about placenta as a transplantation model, while Mukesh Desai and Manisha Madikaikar talked about primary immunodeficiency diseases and their diagnosis respectively. Further, Reinhold Schmidt (Germany) covered the Autoimmunity and Immunodeficiencies while Srini Kaveri (France) presented historical developments and importance of intravenous immunoglobulins. The last lecture delivered by Joanna Groom (Australia) who discussed recent developments in the field of 3-D imaging of immune cells. 

Finally the course ended with a formal closing ceremony during which best oral and poster presentation awards, FIMSA bursary awards as well as participation certificates were distributed. Narinder Mehra concluded the course and acknowledged the contributions of course organizing team, scientific committee and support from various scientific bodies/societies and companies.

D. The IUIS-IIS-FIMSA course had a number of novel features: 

i) The course was fundamentally translational in nature with separate tracks focusing on autoimmunity, immune-oncology, immunology in relation to organ and hematopoietic stem cell transplantation, viral immunity and vaccinology, immunotherapy and inflammation. Besides this there were basic lectures covering important aspects of innate and adaptive immunity, 
ii) The course was open to both medical graduates and biomedical scientists, providing a unique forum for interaction and scientific collaboration, 
iii) The course faculty included a mix of international highly acclaimed immunology teachers and researchers and an equally renowned group of immunologists from India. The course format was designed in a way that the participants hadample opportunity of free and frank discussion and problem solving sessions, 
iv) Among the Asian countries, India has been chosen as the preferred venue by theInternational Union of Immunological societies (IUIS) and the Federation of immunological societies of Asia-Oceania (FIMSA) because of the vastness of the country with a dedicated lot of young scientists and medical graduates and also because of the spectrum of diseases prevalent in the sub-continent. It is perceived that human resource development in Immunology is much needed in India so that future scientists and clinicians are able to focus on translational uses including institution of immunotherapy and other similar tools in disease control, 
v) A novel aspect of this course was the inclusion of participants from other countries (Australia, Iran, China, Taiwan and Korea) sponsored by FIMSA and thisencouraged active interaction and possible future collaboration 
vi) Anotherhighlight of the course was the inclusion of lunch time Technology sessions highlighting recent advancements and evening ‘meet the speakers sessions’. 

E. Acknowledgements: 

The organizers wish to thank the Education committee of IUIS, Indian Immunology Society and the Federation of Immunological Societies of Asia-Oceania for the kind support for execution of the course. The organizers are thankful to the authorities of Rajasthan University of Health Sciences (RUHS) through it’s worthy Vice Chancellor Prof. Raja Babu Panwar, who offered all the resources and facilities at the College of Medical Sciences and to Prof Mohan Lal Swarankar, Emeritus Chancellor of Mahatma Gandhi University of Medical Sciences and Technology (MGUMST) for supporting the event. Most importantly the organizers hereby express deep sense of appreciation to all the speakers for travelling across various regions of the world and delivering excellent talks as well as to the participants for their active and enthusiastic participation. The organizers hereby acknowledge the contributions and support of various scientific bodies including Immunology Foundation of India, Indian Council of Medical Research (ICMR), Council of Scientific and Industrial Research (CSIR), Board of Governers in supersession of Medical Council of India and Indian National Science Academy (INSA). The organizers also thank various companies (BioLegend, BD Bio Sciences, Premas Life Sciences and Thermo Fisher) for their support and participation in lunch time Technical Sessions.