I spent most of my childhood in Balaklava, a small country town north of Adelaide and my scientific career that started in Adelaide has taken me to the UK, the US, back to Brisbane and now Canberra. Except for the two years in the US, where I walked most days, I have mostly ridden a bike to school, uni. and work every day, rain or shine.
My career so far has been spent researching viruses and how the immune system fights viruses. My first personal encounter with MS was when my supervisor was diagnosed while I was doing my PhD in the mid-‘90s. This gave me a greater awareness of MS, but it remained on the periphery of my interest as an immunologist. I was diagnosed with relapsing remitting MS myself in 2011 and since then have been wondering how I might apply my scientific expertise to MS research. My particular interest in understanding susceptibility to viruses and infection, and finding better ways of tracking responses to MS therapies comes from my experience as a person with MS. Making decisions about treatments has been a recurring part of my MS journey and I Iook forward to a future where a better understanding of therapies reduces the uncertainty and stress surrounding these choices and improves outcomes.
Historically, the introduction of disease modifying therapies and the emergence of evidence that these not only reduce relapses, but dramatically reduce progression when started early after diagnosis. Going forward, seeing the leaps in understanding that can be enabled by new genomic technologies and when barriers created by traditional differences in perspective between neurology and immunology are broken down.
An Incubator Grant is enabling me to initiate a new collaborative project where we are going to look in the blood of people being treated with Cladribine for signs of infections, especially viruses and also for evidence of the impact of the treatment. We are testing two cutting-edge methods based around the detection and sequencing of genetic material to determine if one is better than the other for application in larger trials. At the same time, we hope that the results will reveal new information about the impact of the immunosuppression caused by Cladribine. We are interested in viruses particularly, because some are known to be causes of side effects in immunosuppressive treatments (e.g. shingles), but also because others have had a long association with susceptibility to MS (e.g. Epstein-Barr virus).
The increase in treatment options for relapsing remitting MS, a number of which have high efficacy against relapses, has been a game changer for people living with MS. However, all of these treatments have risks as well as benefits. For this reason the choice of treatment is not simple and can be a source of anxiety. Further, once a choice is made there is a waiting game to see if the treatment is tolerable and for the next MRI or perhaps relapse (hopefully remission) and then the next, until it is clear there is efficacy. Good treatment choices require good information. This research will provide more information about the effect of Cladribine as a treatment, but will also pioneer an approach that can be used to examine other therapies.
As a senior researcher, I do not get into the lab any more, but I direct a program of research that is carried out by others. When I was in the lab, I used to love the thrill of discovering something new. Of seeing the data come in from a long-planned experiment and the moment of realisation that this will change the way we understand a small part of the world. Now I have to settle for enjoying this part of science vicariously through the success of those in my lab. Instead I love having a bigger picture view and putting together many small results, sometimes from quite different sources, to make a more complete picture where previously there was a gap. Also increasingly thinking about how these discoveries and more complete pictures might be used in a practical way to fight disease and improve people’s lives.
Updated: 19 October, 2020