Contact information
Sarosh Irani
FRCP DPhil FEAN
Professor of Autoimmune Neurology
- Professor of Autoimmune Neurology
- Head, Oxford Autoimmune Neurology Group
- MRC Senior Clinical Fellow
- Honorary Consultant Neurologist
- Senior Fellow, Oxford BRC
- Associate Editor @Brain
Autoantibody-mediated neurological diseases
Autoantibody-mediated neurological diseases
Research Summary
I am a Clinician-Scientist and Consultant Neurologist who leads the Oxford Autoimmune Neurology Group to improve treatments and outcomes for patients with autoantibody-mediated diseases of the nervous system, and understand the biology behind these conditions.
In my clinical work, I run the UK's major clinic which has cared for >200 patients with these disorders. I welcome referrals of patients with possible autoimmune neurological conditions.
From a research perspective, my team of ~15 talented clinicians and scientists brings together patient-focused and more basic observations to understand multiple aspects of these diseases. We have studied autoantibodies which target LGI1, CASPR2, aquaporin-4, and the NMDA-, GABAA- and glycine-receptors. More specifically, we have:
- Discovered new autoantibodies such as those which target LGI1 and CASPR2 and hence defined immunotherapy-responsive conditions.
- Shown that autoantibody specificities can have a remarkably close relationship with the patient phenotype. For example, the psychopathological features and movement disorder in patients with NMDAR-antibodies, and the seizure semiologies in patients with LGI1-antibodies notably Faciobrachial dystonic seizures. These observations improve recognition of patients with encephalitis.
- In conjunction, we study the cellular and humoral human immunology to understand the basis of these diseases. To date, we have described some of medicine’s strongest genetic (HLA) associations in patients with these autoantibodies and the potential of patient B cells in circulation to produce the autoantibodies in these conditions. In addition, we have used the immune cells within patient ovarian tumours to better understand the aetiology of these diseases.
- Used these foundations to understand the breaks in immune tolerance and developing methods to rapidly generate patient-derived monoclonal antibodies to precisely explore the neuroscience mechanisms by which the antibodies cause disease. We anticipate ongoing work towards determining the mechanisms underlying aetiology and propagation of these conditions will allow the rational selection of future immunotherapies.
I have been awarded the Graham-Bull Prize in Clinical Science / Goulstonian Lectureship, from the Royal College of Physicians, and awards including the NIHR BRC Senior Clinical Fellowship and both Wellcome Intermediate and MRC Senior Clinical Fellowships. Our work has also been funded by the British Medical Association, Association of British Neurologists, multiple industry partners and by the very kind and generous donations from many of our patients.
Key publications
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Journal article
Ramberger M. et al, (2020), Brain, 143, 1731 - 1745
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Journal article
Sun B. et al, (2020), Nature Reviews Neurology, 16, 481 - 492
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Journal article
Binks S. et al, (2018), Brain, 141, 2263 - 2271
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Journal article
Wilson R. et al, (2018), Brain, 141, 1063 - 1074
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Journal article
Makuch M. et al, (2018), Annals of Neurology, 83, 553 - 561
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Journal article
Thompson J. et al, (2018), Brain, 141, 348 - 356
Recent publications
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Clinical value of cell-based assays in the characterisation of seronegative myasthenia gravis.
Journal article
Damato V. et al, (2022), J Neurol Neurosurg Psychiatry
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Association Between a Distinctive Autoantibody-Associated Brainstem Sensory Syndrome and Immune Checkpoint Inhibitors.
Journal article
Damato V. et al, (2022), JAMA neurology
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The clinical relevance of serum versus CSF NMDAR autoantibodies associated exclusively with psychiatric features: a systematic review and meta-analysis of individual patient data.
Journal article
Blackman G. et al, (2022), J Neurol
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Encephalitis: diagnosis, management and recent advances in the field of encephalitides.
Journal article
Alam AM. et al, (2022), Postgraduate medical journal
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Patient-derived antibodies reveal the subcellular distribution and heterogeneous interactome of LGI1.
Journal article
Ramirez-Franco J. et al, (2022), Brain
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Rituximab abrogates aquaporin-4–specific germinal center activity in patients with neuromyelitis optica spectrum disorders
Journal article
Damato V. et al, (2022), Proceedings of the National Academy of Sciences, 119
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Immunotherapy in autoimmune encephalitis.
Journal article
Trewin BP. et al, (2022), Current opinion in neurology, 35, 399 - 414
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Naïve B cells followed by aquaporin-4 antibodies characterise the onset of neuromyelitis optica: evidence from stem cell transplantation.
Journal article
McNaughton P. et al, (2022), J Neurol Neurosurg Psychiatry
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Diagnosis and Management of Opsoclonus-Myoclonus-Ataxia Syndrome in Children: An International Perspective.
Journal article
Rossor T. et al, (2022), Neurol Neuroimmunol Neuroinflamm, 9
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Detection and significance of neuronal autoantibodies in patients with meningoencephalitis in Vientiane, Lao PDR.
Journal article
Uy CE. et al, (2022), Trans R Soc Trop Med Hyg