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A photo of Lakshanie Wickramasinghe

Dr Lakshanie C Wickramasinghe is an Oxford-Janssen Postdoctoral Fellow who works with Janssen Pharmaceuticals in the Eye Team of the Coles-Buckley Group and ORBIT Consortium to discover new therapies for patients with anterior uveitis, an under-studied inflammatory eye condition which has a major impact on vision. She talks about the mysterious immune cells of the eye and the fascinating areas of research her and her team are delving into. Lakshanie shares why her research is important to her and what keeps her motivated, as well as the joys of inspiring the next generation of scientists. Lakshanie also explains how her Postdoctoral Fellowship with Janssen keeps her focused on her biological research while keeping sight of the big picture: finding new treatments to improve the lives for patients with debilitating ocular conditions such as anterior uveitis. 

 

Q: Hi Lakshanie! Can you describe your research with Janssen?

A: Yes of course! I study the immune system within the eye, specifically in an inflammatory condition called anterior uveitis which affects the iris and ciliary body of the eye. The goal is to better understand how it develops and to identify new disease targets that could be translated into new treatments. I work within the Oxford-Janssen Eye Group (ORBIT consortium) which is funded by Janssen.

 

Q: I never thought of the eye having an immune system! Can you tell me more?

A: Absolutely – so many people are surprised that there are immune cells within the eye! For a long time the eye has been considered an immune-privileged site, similar to the brain, but we and others have now shown that there are innate and adaptive immune cells found within the different regions of the eye and play an important role in maintaining immunological homeostasis. Our team first identified the presence of conventional T cells as well as innate-like Mucosal Associated Invariant T cells (MAITs) in the anterior uvea, which is pretty exciting and now we are trying to determine their specific function in the eye.

  

Q: How is the immune system involved in anterior uveitis?

A: Patients who are diagnosed with anterior uveitis initially come to the clinic with symptoms such as eye redness and pain, but also blurred or cloudy vision which is due to the presence of ‘unregulated’ immune cells in the aqueous of the front of the eye. Although the development of anterior uveitis is largely associated with injury or infection, according to The College of Optometrists, in approximately 50% of cases, no cause can be found, which tells us that we still have a lot to discover about the immune process in this disease. What is also interesting is that there are some patients with anterior uveitis who also have inflammation in other areas of their body such as the joints, skin or the gut, which may suggest there is a common immune link between the eye and other sites. This is something that we in the eye team are fascinated about exploring further as it may reveal the missing puzzle pieces that can give us a more wholistic picture of how anterior uveitis develops. So stay tuned for this work…

 

Q: What is important to you about your research?

A: This research is important to me because anterior uveitis is often deprioritised compared with other immune-related or ocular conditions. The reason for this is anterior uveitis is not considered fatal and corticosteroids can be used to dampen the initial inflammation in the eye. However, flare-ups are common in patients and anterior uveitis causes the same amount of visual impairment as other more well-known eye diseases such as macular degeneration or diabetic retinopathy. In contrast to the latter conditions which predominantly impact patients in elderly life, the main demographic affected by anterior uveitis are people in their working age (20 to 50 years) and can persist across decades. You can imagine that this has a significant social and economic burden on these individuals, hindering their overall quality of life. Another aspect of this research that I consider important to keep in consideration is that uveitis-related blindness and visual morbidity are more common in developing nations. Therefore, the time we spend at the Kennedy Institute to understand the aetiology of this debilitating disease and discover better treatments, will hopefully, mean that one day our efforts will lead to the prevention of visual disability and sight-loss in a diversity of individuals from around the world. This is a strong motivator for me to pursue this line of work.

 

Q: How are you working with Janssen to understand this disease?

A: The ORBIT consortium, funded by Janssen, brings together eye groups in Oxford, Liverpool, London and Bristol into a big collaborative network. In this network we share ideas, resources and technologies to discuss cutting-edge science relating to uveitis. We meet online once a month to discuss upcoming priorities and we have an in-person symposium every year where we share our research findings and plan out the next steps.

The goal of our collaboration is to translate biological research into new therapies, and we are well set up to do that! Working with a pharmaceutical company like Janssen gives us access to their commercial expertise and processes. This also means that we get to see the big picture of what we are aiming for, to identify new target for therapeutic intervention, while still being able to stay focused on our biological research. This provides quite a bit of space and creative freedom to explore what we are passionate about and what we think is important in pursuing to achieve the bigger goals.

 Lakshanie C Wickramasinghe is in a blue lab coat and safety goggles, and operates a microscope

"I get to see the big picture of what are hoping to achieve, which is to develop new treatments for anterior uveitis, while still having the creative freedom to explore the pieces that make up that big picture."

Q: How has the collaboration shaped your journey as a scientist?

A: Working with Janssen provides a really nice way to bridge the gap between academia and industry. It is helpful to get a taste of industry, especially if you want to form future industrial collaborations as an academic or to even transition into pharma down the line.

There are some really great opportunities for postdocs with industry partners, including courses on leadership and career coaching. We had a workshop that allowed us to better understand our own professional strengths and weaknesses, and how these could be applied to both an academic and an industrial setting, which was very helpful.

 

Q: Earlier you mentioned boosting awareness of anterior uveitis, are there any charities that do that?

A: Fight for Sight is a leading UK charity that highlights the devastating impact of eye diseases and the need for novel treatments by supporting pioneering research.

I also think we are also responsible for being advocates for our research and in ensuring patients and carers are involved in the development of our research. This is essential to gain their valued perspective on areas they think are important for us to study, as ultimately, we are hoping to improve the quality of lives of patients affected by anterior uveitis. For our research, we connect with different patient focus groups; NDORMS OPEN ARMS, PInGU (Patient Involvement Group in Uveitis) and UNCSG (Uveitis National Clinical Study Group) to refine our research focuses.  Also, NDORMS has been great in organising public engagement activities, which helps us communicate our science to the public, such as sharing how amazing the immune system is in the eye, at science fairs, seminars and other public events.

 Two students at a table are using kits for basic scientific techniques. A researcher guides them and stands further away.

Last week we had some UNIQ students interested in pursuing biological sciences at university visit the Botnar Institute to learn some suturing skills and another set of Year 12 high school students visit the Kennedy Institute, as a part of the NDORMS Work Experience programme.  Immediately, I was blown away by their enthusiasm! It is not just about learning scientific facts, it is about knowing the people behind the scientists. It can be powerful for students of this age interested in research to find out what makes us passionate about biomedicine and to understand the different pathways to becoming a scientist! It is quite fulfilling to inspire the future generation of scientists.

You can follow Lakshanie on Twitter (@LakshanieW) for more science and public engagement updates.