Researchers
Dr Saif Huda
Consultant Neurologist
Dr Saif Huda completed undergraduate medical training in Liverpool in 2005 and completed neurology specialist training at The Walton Centre in 2017. Between 2012-2015 he undertook a DPhil in neuroimmunology at The University of Oxford before completing a post-CCT fellowship in neuromyelitis optica in 2018.
Dr Huda is the clinical lead for the UK NMOSD highly specialised service. His research focuses on immune tolerance mechanisms and biomarkers in NMOSD and MOG-antibody associated disease, particularly clinical and serological biomarkers that help predict relapse risk and prognosis. He is also interested in immune tolerance mechanisms and identifying novel symptomatic therapies that can improve patient quality of life. Dr Huda is a principal investigator for several Phase III clinical trials in NMOSD, MOGAD, and autoimmune encephalitis.
Dr Mark Ellul
NIHR Clinical Lecturer in Neurology
Dr Ellul is a Clinical Lecturer (NIHR) in Neurology and a Specialist Registrar in Neurology at the Walton Centre in Liverpool. He works on autoimmune disorders of the central nervous system and central nervous system infections. In particular, Dr Ellul focuses on improving the diagnosis of encephalitis, a devastating neurological condition characterised by inflammation of the brain.
Encephalitis is most often caused by either a viral infection of the brain (viral encephalitis), or the bodies own immune defences attacking the brain (autoimmune encephalitis). My work focuses on understanding the mechanisms by which viruses and the immune system can damage the brain, identifying targets for future therapies to improve patient outcome.
Understanding pathogenesis and outcome of encephalitis using multiomic analyses of cerebrospinal fluid (CSF) and blood
Through multicentre UK studies over several years we have recruited patients with encephalitis (both viral and autoimmune), mimicking conditions including delirium, toxic and metabolic disorders, and controls with headache disorders. Using samples from these patients we studied the CSF and blood, focusing on the proteome (using liquid chromatography-mass spectrometry), the metabolome (using 1H nuclear magnetic resonance spectroscopy) and the transcriptome (using gene expression microarray). These powerful datasets are combined with clinical data and imaging to illuminate pathogenic mechanisms in encephalitis, as well as to identify markers of aetiology and prognosis. Markers identified from these analyses of human samples provide hypotheses to test in murine models of encephalitis.
Understanding disease mechanisms of postinfectious autoimmunity in herpes simplex virus encephalitis
Herpes simplex virus (HSV) encephalitis, the most common cause of encephalitis in the UK, is a devastating central nervous system infection with high morbidity and mortality. Around a third of patients who recover from HSV encephalitis later experience an autoimmune relapse, sometimes associated with autoantibodies against the N-methyl-d-aspartate receptor (NMDAR) or against unknown targets. It is unclear why some patients develop autoimmune relapse and others do not, or whether corticosteroid treatment can avoid relapse. This study uses unique samples, with detailed clinical data, collected during a recent randomised controlled trial of adjunctive dexamethasone for HSV encephalitis (DexEnceph). We aim to investigate the mechanisms underpinning secondary autoimmunity in encephalitis, to understand the mechanisms by which the adaptive immune response contributes to the pathogenesis of HSV encephalitis. This study will pave the way for targeted immune therapy for HSV encephalitis, and has broad translational implications for other post-viral autoimmune conditions.
Intravenous Immunoglobulin in Autoimmune Encephalitis in Adults –A Randomised Double-Blind Placebo-Controlled Trial
The ENCEPH-IG trial is a study led by investigators from the University of Liverpool looking at whether or not early treatment with Intravenous Immunoglobulin improves recovery in autoimmune encephalitis. Autoimmune encephalitis is inflammation and swelling of the brain caused by the body’s own immune defence system. It affects about 1 in 100,000 people per year in the UK.
Autoimmune encephalitis is treated with steroids, which reduce inflammation and swelling. If patients are not improving, intravenous immunoglobulin (IVIG) is often also given, usually after a couple of weeks. The ENCEPH-IG trial is a study looking at whether or not early treatment with IVIG improves recovery. Read more about the ENCEPH-IG trial.
Dr Yun Huang
NIHR Academic Clinical Fellow
There is emerging evidence of links between COVID-19 infections and immune-related brain and nerve injuries. These conditions include inflammation and demyelination of the central and peripheral nervous system. They can have significant impact on patient’s quality of life; however, we have little understanding of the biological processes underlying these conditions.
Dr Huang's project focuses on characterising the group of patients who developed immune-related brain and nerve injuries related to COVID-19. She aims to identify clinical risk factors to developing these immune-related complications. She will also be analysing blood samples to identify possible biomarkers as well as mechanisms of immune dysregulation. Dr Huang hopes this research will benefit patients in a wide range of viral infection induced immune complications and identifying novel treatments that improve patient outcome in the long-term.