England have made five changes to their team to face Italy in the Six Nations on Sunday, with powerhouse prop Andrew Sheridan the latest to join the injury list.

Sheridan (pictured) is one of four changes forced upon England coach Brian Ashton which also results in a first start for Tongan wrecking ball Lesley Vainikolo.

With Sheridan the latest to join the growing list of injuries that has already deprived Ashton of Mike Tindall (bruised liver), Lewis Moody (Achilles), David Strettle (foot) and Tom Rees (knee ligaments) for the remainder of the tournament, Tim Payne comes in for his sixth cap.

Sheridan has an abcess adjacent to his right Achilles tendon and was taken to a local hospital near England's Bath University training camp for treatment on Tuesday.

Ashton lost the experienced Moody in the defeat to Wales last weekend and his place goes to Bath's in-form openside Michael Lipman, who wins his third cap.

Wasps Tom Rees came on for Moody against Wales but was himself forced off with an injury that has since been confirmed as a partial tear of the medial collateral ligament in his left knee.

Also up front, fit-again World Cup number eight Nick Easter returns for Luke Narraway, who won his debut cap against Wales and drops to the bench for the trip to Rome.

England's defeat at Twickenham was further compounded by injuries to Tindall and Strettle.

Jamie Noon takes the place of the influential centre Tindall, forming a midfield axis with club team-mates Toby Flood and Jonny Wilkinson.

Vainikolo comes in on the left wing for Strettle, who looked in promising form before limping off with a hairline fracture to the fifth metatarsal in his left foot

League convert Vainikolo came on for Strettle against Wales and made an immediate impact by setting up a try for Flood.

Wilkinson keeps his place at stand-off despite increasing pressure from Danny Cipriani, who again starts on the bench.

World Cup winner Wilkinson had arguably his worst game in an England shirt against Wales and needs a much improved display against the Azzurri to keep ahead of Cipriani.

Newcastle's versatile back Matthew Tait returns to the squad on the bench. Tait was an ever-present for England during the World Cup before losing his place for the Wales game.

England:

15-Iain Balshaw (Gloucester), 14-Paul Sackey (Wasps), 13-Jamie Noon (Newcastle), 12-Toby Flood (Newcastle), 11-Lesley Vainikolo (Gloucester), 10-Jonny Wilkinson (Newcastle), 9-Andy Gomarsall (Harlequins); 1-Tim Payne (Wasps), 2-Mark Regan (Bristol), 3-Phil Vickery (Wasps - capt), 4-Simon Shaw (Wasps), 5-Steve Borthwick (Bath), 6-James Haskell (Wasps), 7-Michael Lipman (Bath), 8- Nick Easter (Harlequins).

Replacements: 16-Lee Mears (Bath), 17-Matt Stevens (Bath), 18-Ben Kay (Leicester), 19-Luke Narraway (Gloucester), 20-Richard Wigglesworth (Sale), 21- Danny Cipriani (Wasps), 22-Mathew Tait (Newcastle).

Terence O'Rorke / Eurosport