Sarosh Irani is an Associate Professor, Consultant Neurologist and Wellcome Trust Intermediate Fellow with clinical and laboratory interests in the field of autoantibody-mediated diseases of the central nervous system. He sees patients with these disorders in a UK referral clinic and runs the Oxford Autoimmune Neurology research group to learn more about the origins and treatments of these diseases.
His research has particularly focused on the phenotypes and immunology around autoantibodies found in forms of encephalitis which target LGI1, CASPR2 and the NMDA-receptor, and, in patients with Neuromyelitis optica and antibodies against aquaporin-4. In particular, he described ‘Faciobrachial dystonic seizures’ as pathognomonic for the underlying LGI1-antibodies. These seizures show a superior response to immunotherapies versus antiepileptic drugs. Furthermore, their prompt cessation appears to alter the natural history of the condition, and prevent onset of cognitive impairment. Also, his group have described phenotypes and prognostic correlations in patients with CASPR2-, NMDAR-, GABAAR- and MOG-antibodies.
More recently, his team have developed in vitroassays to understand the relative contributions of B cell subsets and plasma cells to the production of the pathogenic antibodies. These models may provide a platform to predict and assess the efficacy of therapeutic interventions. In addition, alongside several close collaborators, his group have described striking HLA associations in patients with LGI1- and CASPR2-antibodies, and associations of these diseases with T cell checkpoint inhibitors. Therefore, their ongoing studies aim to better characterise the B and T cells in patients with autoantibody-mediated neurological diseases.