Peripheral nerve specific biomarkers and in vitro models of neuropathy for the evaluation of IVIg treatment response and dependency

Project summary

The inflammatory neuropathies are a group of conditions where the immune system, the body’s natural defense against infections, mistakenly attacks the nerves, causing problems such as weakness, numbness and pain. In severe cases, people can lose their ability to walk and breathe, some people die, and many are left with long-term disability. Patients often require several years of treatment with intravenous immunoglobulin (IVIg), a costly and scarcely available treatment made from plasma donations, given to help stop the harmful antibodies damaging the nerves.

Strategies are urgently needed to identify patients who are most likely to benefit from immunoglobulin, and to assess whether they are responding to therapies, to avoid overtreatment, risking unnecessary side effects, or undertreatment, with a consequent impact on long-term outcome. In order to address this unmet need, I am currently developing ultrasensitive assays to measure biomarkers (naturally occurring molecules) of peripheral nerve disease in the blood of patients with inflammatory neuropathies. 

In my project, I will investigate whether blood levels of the biomarkers can predict response to IVIg in patients with inflammatory neuropathies (GBS and CIDP). I am also growing human nerve cells in a dish in the laboratory using stem cells, which can turn into different cell types, including those of the nerves. I plan to use these cells to study how well the biomarkers reflect visible injury to the nerve cells, and to see whether these models and markers can help test if and how IVIg treatment work.
 

Biographical sketch

Dr Roberto Bellanti is a research fellow in Clinical Neurosciences at the University of Oxford and an honorary neurology registrar at Oxford and University College London Hospitals. He is currently undertaking his doctoral training within the Oxford Inflammatory Neuropathy group, in collaboration with the Queen Square Institute of Neurology at London UCL. He is supervised by Professor Simon Rinaldi and Professor Michael Lunn. 

He qualified in Medicine at the University of Turin (Italy) and has undertaken his clinical training in neurology between Cambridge, London, and the East of England. 

Dr Bellanti’s research focuses on the immune-mediated neuropathies Guillain-Barré syndrome and chronic inflammatory demyelinating polyradiculoneuropathy. He is working to develop serum peripheral nerve specific biomarker assays which he validates in vitro and clinically, using cell-based models of antibody-mediated nerve injury and serum samples from patients with inflammatory neuropathies. 

He has a keen interest in medical education and public engagement. He is a Public Engagement Ambassador at the Nuffield Department of Clinical Neurosciences in Oxford. Through public engagement, he hopes to share the results of his research with patients, families and the wider public.