Ocular immunology, Dendritic cells, Aqueous humour, Clinical Trials, Outcome Measures, Core Outcome Sets, Optical Coherence Tomography, EMEDOCT, VITAN, EQUATOR
The goal of Alastair’s research is directed to:
- Uncovering fundamental mechanisms of ocular inflammation
- Translating these discoveries into novel therapies that will be of real benefit to patients.
- Identifying reliable measures of disease acitivitiy and damage that can be used to assess treatment response , predict outcome and stratify therapy.
1) Immunity and its regulation in the eye
Specifically he has investigated the immunosuppressive effects of human aqueous humour on cellular function, and how this is altered in intraocular inflammation, proposing that these early events in the adaptive immune response may explain both the vulnerability of some patients to uveitis, and their natural history - why some resolve quickly and others develop a chronic course.
2) Clinical studies in uveitis and other potentially blinding diseases
Alastair is chief investigator on the study Defining Outcome Measures in Ocular Inflammatory Disease (DOMINO-ID), and principal investigator on numerous observational and interventional clinical studies at University Hospitals Birmingham and Co-Investigator with Prof Philip Murray at the Birmingham & Midland Eye Centre.
3) Imaging and other novel outcome measures for inflammatory eye disease
In the clinic with his collaborator Pearse Keane (University College London, UK), Alastair has demonstrated the potential for newer forms of imaging such as Optical Coherence Tomography (OCT) to provide much-needed objective markers for intraocular inflammation (uveitis). He is a passionate advocate of the need to develop better measures for inflammatory eye diseases which are objective and quantifiable. This will significantly improve the power of clinical trials (smaller, faster trials with a higher chance of success) and inform day-to-day treatment decisions. Establishing an international collaboration of researchers working on ‘Extended OCT-Quantification of Uveitis Activity for Trial Outcomes and Reporting’ (EQUATOR) has been a key part of advancing this.
Further information on EQUATOR is available from their webpage: www.equator.vision.
This work is balanced by a prioritisation of patient reported outcomes (PROs) for ocular inflammatory disease (with his collaborator Prof Mel Calvert, Head of PROs Group University of Birmingham). Alastair is also leading on the development of a consensus Core Outcome Set for Uveitis for use across all future trials for patients with uveitis, to reduce research waste and ensure that maximum value can be gathered for each study.