• PhD Medicine, 2008
• Specialization as Rheumatologist, 2007
• Medical Degree, 2001

During her undergraduate course in Italy, Francesca developed a strong interest in research and once obtained her degree she decided to suspend her clinical training to do a PhD. She move to London in the laboratory of Professor Pitzalis to investigate the mechanisms that regulate the acquisition of lymphoid organ features in the salivary gland inflammatory infiltrates of Sjogren’s Syndrome patients, with particular focus on the factors that regulate lymphocyte organization and survival within the gland.

She obtained her Specialization and PhD in 2007 and 2008, respectively. She then embarked on a period of post-doctoral studies looking at the physiological biology of mucosal B cells, under the supervision of Doctor Jo Spencer at KCL. During this period she has also worked as Honorary Rheumatology Consultant in close contact with the Oral Medicine unit at Guy’s Hospital in London.

In 2010 Francesca moved to Birmingham to study the mechanisms regulating leukocyte/stromal cell interaction in humans and animal models of inflammatory diseases. She obtained a Wellcome Trust Clinician Scientist fellowship in July 2010 to develop her research interest as clinician scientist and start her own independent group.

She works as Consultant Rheumatologist in the UHB and Sandwell and West Birmingham Trusts, with a main clinical interest in inflammatory arthritis and Sjogren’s syndrome.

Since 2014 she has been the Head of the eSSential – EULAR Sjogren’s Syndrome Experimental aNd Translational Investigative Alliance (EULAR) study group.

In the summer 2016 Francesca obtained a Senior Research Fellowship from ARUK to exploit the mechanisms enabling the persistence of tertiary lymphoid structures (TLS) in inflamed tissue and to investigate the pathogenicity of the stromal cells in TLS associated diseases. 

Teaching Programmes

• Pharmacy - 3:1 Module Leader
• MBChB - IIH (2^nd year) Tutor
• Immunology and Immunotherapy MSc - Lecturer

Francesca is interested in supervising doctoral research students in the following areas:

• Role and regulation of stromal cell function during inflammation and resolution
• Generation, organisation and maintenance of ectopic lymphoid structures in target organs of autoimmune disease
• Clinical and pathogenic aspects of Sjogren’s syndrome

If you are interested in studying any of these subject areas please contact Francesca on the contact details above, or for any general doctoral research enquiries, please email: dr@contacts.bham.ac.uk or call +44 (0)121 414 5005.

For a full list of available Doctoral Research opportunities, please visit our Doctoral Research programme listings.

RESEARCH THEMES

Inflammation, tertiary lymphoid structures, stromal cells, histological aspects of chronic inflammation in particular Sjogren’s syndrome. Pathogenesis and histological features of Sjogren’s syndrome.

RESEARCH ACTIVITY

Francesca’s research is focused on understanding the mechanisms regulating the complex interaction between stromal cells and leukocytes in different phases of the inflammatory process and its resolution.

Leukocyte stromal cell interaction in ectopic lymphoneogenesis
During organogenesis, the interaction between leukocytes and stroma is critical for stromal cell activation and formation of lymphoid organs. In target organs of autoimmune diseases the inflammatory cells infiltrating the issue organized themselves in structures that closely resemble secondary lymphoid organs in a process called ectopic lymphoneogenesis. While physiologic lymphoneogenesis has been largely defined in its mechanisms, little is know about the cells/signals that regulate the formation of ectopic lymphoid structures during disease. Francesca research is aimed to understand, using both in vivo models of inflammation and human samples of patients, the mechanisms regulating the formation of ectopic lymphoid structures with particular emphasis on the signals that regulates the activation of stromal cells to the acquisition of a lymphoid-like phenotype.

Role of ectopic lymphoneogenesis in inflammation
The role of ectopic lymphoid structures in the dynamic of the inflammatory process is not clear. Some evidence even suggests that ectopic germinal centres might support lymphoma development during chronic inflammatory processes. Francesca group aim to understand the functional role of ectopic lymphoneogenesis in the balance between persistence and resolution of the inflammatory process and the role that stromal cells, including blood endothelial and lymphatic cells play in this process.

Immunophenotyping and histological characterization and analysis
Part of Francesca's group is focused on the use of histology as biomarker for disease stratification and outcome in clinical trials. The experience acquired on salivary gland analysis has recently been implemented by the use of digital system of analysis to generate reproducible data to be used for report in clinical trials and to perform patient-driven stratification.

• Since 2014 Head of the EULAR study group
  “eSSential – EULAR Sjogren’s Syndrome Experimental aNd Translational Investigative Alliance Study Group”. http://www.eular.org/myUploadData/files/Investigative_Study_Group_Sjogren.pdf
• Consultancy for GSK, Celgene, UCB

Barone F and Colafrancesco S (2016) Sjögren's syndrome: from pathogenesis to novel therapeutic targets. Clin Exp Rheumatol 34(4 Suppl 98):58-62

Nayar S, Campos J, Chung MM, Navarro-Núñez L, Chachlani M, Steinthal N, Gardner DH, Rankin P, Cloake T, Caamaño JH, McGettrick HM, Watson SP, Luther S, Buckley CD and Barone F (2016) Bimodal Expansion of the Lymphatic Vessels Is Regulated by the Sequential Expression of IL-7 and Lymphotoxin α1β2 in Newly Formed Tertiary Lymphoid Structures. J Immunol 197(5):1957-67

Campos J, Hillen MR and Barone F (2016) Salivary Gland Pathology in Sjögren's Syndrome. Rheum Dis Clin North Am 42(3):473-83

Lugonja B, Yeo L, Milward MR, Smith D, Dietrich T, Chapple IL, Rauz S, Williams GP, Barone F, de Pablo P, Buckley C, Hamburger J, Richards A, Poveda-Gallego A, Scheel-Toellner D and Bowman SJ (2016) Periodontitis prevalence and serum antibody reactivity to periodontal bacteria in primary Sjögren's syndrome: a pilot study. J Clin Periodontol 43(1):26-33

Hillen MR, Barone F, Radstake TR, van Roon JA (2016) Towards standardisation of histopathological assessments of germinal centres and lymphoid structures in primary Sjögren's syndrome. Ann Rheum Dis 75(6):e31

Oni C, Mitchell S, James K, Ng WF, Griffiths B, Hindmarsh V, Price E, Pease CT, Emery P, Lanyon P, Jones A, Bombardieri M, Sutcliffe N, Pitzalis C, Hunter J, Gupta M, McLaren J, Cooper A, Regan M, Giles I, Isenberg D, Saravanan V, Coady D, Dasgupta B, McHugh N, Young-Min S, Moots R, Gendi N, Akil M, Barone F, Fisher B, Rauz S, Richards A and Bowman SJ; UK Primary Sjögren’s Syndrome Registry (2016) Eligibility for clinical trials in primary Sjögren's syndrome: lessons from the UK Primary Sjögren's Syndrome Registry. Rheumatology (Oxford) 55(3):544-52

Barone F and Lories R (2015) Preface. Best Pract Res Clin Rheumatol 29(6):681-2

Barone F, Campos J, Bowman S and Fisher BA (2015) The value of histopathological examination of salivary gland biopsies in diagnosis, prognosis and treatment of Sjögren's Syndrome. Swiss Med Wkly 145:w14168

Barone F, Nayar S, Campos J, Cloake T, Withers DR, Toellner KM, Zhang Y, Fouser L, Fisher B, Bowman S, Rangel-Moreno J, Garcia-Hernandez ML, Randall TD, Lucchesi D, Bombardieri M, Pitzalis C, Luther SA and Buckley CD (2015) IL-22 regulates lymphoid chemokine production and assembly of tertiary lymphoid organs. Proc Natl Acad Sci U S A 112(35):11024-9

Lowe KL, Navarro-Nuñez L, Bénézech C, Nayar S, Kingston BL, Nieswandt B, Barone F, Watson SP, Buckley CD and Desanti GE (2015) The expression of mouse CLEC-2 on leucocyte subsets varies according to their anatomical location and inflammatory state. Eur J Immunol 45(9):2484-93

Bénézech C, Luu NT, Walker JA, Kruglov AA, Loo Y, Nakamura K, Zhang Y, Nayar S, Jones LH, Flores-Langarica A, McIntosh A, Marshall J, Barone F, Besra G, Miles K, Allen JE, Gray M, Kollias G, Cunningham AF, Withers DR, Toellner KM, Jones ND, Veldhoen M, Nedospasov SA, McKenzie AN and Caamaño JH (2015) Inflammation-induced formation of fat-associated lymphoid clusters. Nat Immunol 16(8):819-28

Fisher BA, Brown RM, Bowman SJ and Barone F (2015) A review of salivary gland histopathology in primary Sjögren's syndrome with a focus on its potential as a clinical trials biomarker. Ann Rheum Dis 74(9):1645-50

Chimen M, McGettrick HM, Apta B, Kuravi SJ, Yates CM, Kennedy A, Odedra A, Alassiri M, Harrison M, Martin A, Barone F, Nayar S, Hitchcock JR, Cunningham AF, Raza K, Filer A, Copland DA, Dick AD, Robinson J, Kalia N, Walker LS, Buckley CD, Nash GB, Narendran P and Rainger GE (2015) Homeostatic regulation of T cell trafficking by a B cell-derived peptide is impaired in autoimmune and chronic inflammatory disease. Nat Med 21(5):467-75

Buckley CD, Barone F, Nayar S, Bénézech C and Caamaño J (2015) Stromal cells in chronic inflammation and tertiary lymphoid organ formation. Annu Rev Immunol 33:715-45