A5032978470- Myasthenia Gravis and Thymoma
- Peripheral Neuropathies and Disorders
- Autoimmune Neurological Disorders and Treatments
- Parkinson's Disease and Spinal Disorders
- Antifungal resistance and susceptibility
- Cancer Treatment and Pharmacology
- Genetics and Neurodevelopmental Disorders
- Multiple Sclerosis Research Studies
- Hereditary Neurological Disorders
- Glioma Diagnosis and Treatment
- Pituitary Gland Disorders and Treatments
- Brain Metastases and Treatment
- Vasculitis and related conditions
- Genetic Neurodegenerative Diseases
- Glycogen Storage Diseases and Myoclonus
- Ophthalmology and Eye Disorders
- Infectious Encephalopathies and Encephalitis
- Retinal and Optic Conditions
- Amyotrophic Lateral Sclerosis Research
- Neurogenetic and Muscular Disorders Research
- Migraine and Headache Studies
- Neuroscience and Neuropharmacology Research
- Glycosylation and Glycoproteins Research
- Cancer Immunotherapy and Biomarkers
- Botulinum Toxin and Related Neurological Disorders
University Hospitals Birmingham NHS Foundation Trust
2015-2025
University of Birmingham
2013-2025
NIHR Surgical Reconstruction and Microbiology Research Centre
2016-2025
JSS Academy of Higher Education and Research
2025
JSS Medical College and Hospital
2025
Queen Elizabeth Hospital Birmingham
2014-2024
Queen Elizabeth Hospital
2017-2024
Institute of Immunology
2024
NIHR Birmingham Biomedical Research Centre
2022
Queen Elizabeth University Hospital
2021
Only around 80% of patients with generalized myasthenia gravis (MG) have serum antibodies to acetylcholine receptor [AChR; antibody positive (AChR-MG)] by the radioimmunoprecipitation assay used worldwide. Antibodies muscle specific kinase [MuSK; MuSK (MuSK-MG)] make up a variable proportion remaining 20%. The neither AChR nor are often called seronegative (seronegative MG, SNMG). There is accumulating evidence that SNMG similar AChR-MG in clinical features and thymic pathology. We...
<h3>Background</h3> There is increasing recognition of antibody-mediated immunotherapy-responsive neurologic diseases and a need for appropriate immunoassays. <h3>Objectives</h3> To develop clinically applicable quantitative assay to detect the presence aquaporin-4 (AQP4) antibodies in patients with neuromyelitis optica characterize anti-AQP4 antibodies. <h3>Design</h3> We compared simple new fluorescence immunoprecipitation (FIPA) both indirect immunofluorescence an AQP4-transfected...
Eculizumab is effective and well tolerated in patients with antiacetylcholine receptor antibody-positive refractory generalized myasthenia gravis (gMG; REGAIN; NCT01997229). We report an interim analysis of open-label extension REGAIN, evaluating eculizumab's long-term safety efficacy.Eculizumab (1,200 mg every 2 weeks for 22.7 months [median]) was administered to 117 patients.The profile eculizumab consistent no cases meningococcal infection were reported during the period. Myasthenia...
Corona Virus Disease 2019 (COVID-19) is a new illness caused by novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Symptoms are variable but typically include fever, cough, symptoms, diarrhea, reduction of smell and taste sensation. Severity ranges from mild to the virus may lead pneumonia, distress death, in some patients. Nearly every country world has been affected this currently defined as pandemic, World Health Organization. There no known proven therapies...
Background We report our experience of patients with generalised myasthenia gravis (gMG) treated efgartigimod, an neonatal Fc receptor antagonist, under the Early Access to Medicine Scheme (EAMS) in UK. Methods Data from all UK efgartigimod EAMS July 2022 2023 were collected retrospectively. Efgartigimod was administered as per ADAPT protocol (consisting a treatment cycle four infusions at weekly intervals further cycles given according clinical need). Results 48 acetylcholine...
Clustered acetylcholine receptor antibodies (clustered AChR-Abs) have been detected in a proportion of patients with previously "seronegative" (SN) generalized myasthenia gravis (GMG), but their presence ocular MG (OMG) and pathogenicity vivo are unknown.To test the clustered AChR-Abs pathophysiologic properties SNMG.Screening diagnostic tests.Regional specialist center clinical laboratory.Serum samples from 16 SN OMG were tested for binding to AChRs. Results 28 further (14 OMG) correlated...
The recent biochemical distinction between antibodies against leucine-rich, glioma-inactivated-1 (LGI1), contactin-associated protein-2 (CASPR2) and intracellular epitopes of voltage-gated potassium-channels (VGKCs) demands aetiological explanations. Given established associations human leucocyte antigen (HLA) alleles adverse drug reactions, our clinical observation frequent drugs reactions in patients with LGI1 antibodies, we compared HLA healthy controls (n = 5553) 111 Caucasian...
Antibodies directed against the post-synaptic neuromuscular junction protein, muscle specific kinase (MuSK) are found in a small proportion of generalized myasthenia gravis (MuSK-MG) patients. MuSK is receptor tyrosine which essential for clustering acetylcholine receptors (AChRs) at junction, but mechanisms by antibodies (MuSK-Abs) affect transmission not clear. Experimental models MuSK-MG have been described there no detailed electrophysiological studies and comparisons between typical...
Background: Azathioprine (AZA) is a common immunosuppressive drug used for relapse prevention in neuromyelitis optica (NMO). Objectives: The objective of this paper to assess efficacy, tolerability and retention AZA large NMO cohort. Methods: We conducted retrospective review medical records 103 aquaporin-4 antibody-positive spectrum disorder (NMOSD) patients treated with AZA. Results: This the largest reported cohort AQP4-Ab positive Eighty-nine per cent ( n = 92) had reduction median...
During the COVID-19 pandemic, patients with neuromuscular disorders, especially autoimmune myasthenia gravis, might be at greater risk of worse outcomes than otherwise healthy people because an immunocompromised state related to immunotherapy and possible respiratory bulbar muscular weakness. However, cessation in neuroinflammatory disorders has severe risks as well.1Korsukewitz C Reddel SW Bar-Or A Wiendl H Neurological era COVID-19—looking for consensus literature.Nat Rev Neurol. 2020; 16:...
Magnetic resonance imaging has linked chronic voltage-gated potassium channel (VGKC) complex antibody-mediated limbic encephalitis with generalized hippocampal atrophy. However, autoantibodies bind to specific rodent subfields. Here, human subfield (subiculum, cornu ammonis 1-3, and dentate gyrus) targets of immunomodulation-treated LGI1 VGKC-complex were investigated using in vivo ultra-high resolution (0.39 × 0.39 1.0 mm3) 7.0 T magnetic [n = 18 patients, 17 patients (94%) positive for...
Neocortical-hippocampal interactions support new episodic (event) memories, but there is conflicting evidence about the dependence of remote memories on hippocampus. In line with systems consolidation and computational theories memory, from model organisms suggests that cornu ammonis 3 (CA3) hippocampal subfield supports recent, not remote, retrieval. this study, we demonstrated recent were susceptible to a loss detail in human participants focal bilateral damage CA3. Graph theoretic...
Abstract Background The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), its open-label extension. Methods Attainment ‘minimal symptom expression’ was evaluated using patient-reported outcome measures gMG symptoms [MG activities daily living scale (MG-ADL), 15-item MG quality life questionnaire (MG-QOL15)]...
Patients with generalized myasthenia gravis (MG) often experience debilitating exacerbations, the possibility of life-threatening respiratory crises requiring hospitalization. Long-term longitudinal studies are needed to understand burden MG, including in patients whose disease is refractory conventional treatment.A retrospective, longitudinal, cohort study was conducted England aged ≥ 18 years treatment-refractory or non-refractory using data recorded during 1997-2016 Clinical Practice...
Abstract Patient‐reported quality‐of‐life (QoL) and carer impacts are not reported after leucine‐rich glioma‐inactivated 1‐antibody encephalitis (LGI1‐Ab‐E). From 60 patients, 85% (51 out of 60) showed one abnormal score across QoL assessments 11 multimodal validated questionnaires. Compared to the premorbid state, significantly deteriorated ( p < 0.001) and, at a median 41 months, fatigue was its most important predictor = 0.025). In total, 51% (26 51) carers significant burden. An...
Antibodies to muscle‐specific kinase (MuSK) are found in a variable proportion of patients with myasthenia without typical acetylcholine receptor (AChR) antibodies, but their characteristics and pathogenic mechanisms not fully understood. We discuss the incidence pathogenicity MuSK antibodies how clinical studies, animal models, cultured cell lines can be used elucidate mechanisms. Patients either AChR or (seronegative myasthenia) appear present another disease subtype that is highly similar...
Intravenous immunoglobulins (IVIg) have been shown in a number of trials, to be an effective treatment for the three main types inflammatory neuropathies: Guillain-Barre Syndrome (GBS), chronic demyelinating polyneuropathy (CIDP), and multifocal motor neuropathy (MMN). IVIg is thought exert its immunomodulatory effects by affecting several components immune system including B-cells, T-cells, macrophages, complement, cytokines cellular adhesion molecules. This article reviews published...
Abstract Checkpoint inhibitor medications have revolutionized oncology practice, but frequently induce immune‐related adverse events. During autoimmune neurology practice over 20 months, we prospectively identified four patients with likely antibody‐mediated neurological diseases after checkpoint inhibitors: longitudinally extensive transverse myelitis, Guillain–Barré syndrome, and myasthenia gravis. All shared three characteristics: symptoms commenced 4 weeks drug administration, responses...