Clinical Neuroimmunology

Lead by Professor Russell Dale, the Clinical Neuroimmunology group is a team of clinicians, scientists, and bioinformaticians aiming to understand how children develop neurodevelopmental disorders (NDDs). By understanding how these disorders start in the brain, we can develop specialised treatment strategies that optimise brain development and improve the lives of children with NDDs.

NDDs, such as autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), and tic disorders, including Tourette syndrome (TS), affect 1 in 10 children, and this prevalence is rising rapidly. A limited understanding of these NDDs has meant that there are no disease-modifying treatments available. This means that alongside long waiting times for diagnosis assessments, parents are presented with treatments that only target the symptoms of these disorders, rather than the underlying mechanisms. Our team want to change this.

Our work uses a range of techniques, including transcriptomics, proteomics, metabolomics, functional immune assays, and bioinformatics to help us understand how NDDs occur in children and the mechanisms by which common therapeutics may be modifying the pathophysiology of these disorders.

 Objectives

  • Improve how we assess family history, infection and immune history, and current neurodevelopmental and behavioural symptoms, through standardised digital tools.
  • Characterise the causes and triggers of NDDs, with a specific focus on environmental risk factors, such as infection and stress.
  • Explore disease mechanisms in the pathophysiology of NDDs, particularly immune and epigenetic processes.
  • Identify biomarkers and signatures of disease to enable earlier screening and detection of NDDs, and thereby earlier intervention to improve developmental outcomes in these children.
  • Investigate novel immunomodulatory treatments as therapeutic options to improve outcomes for children when conventional treatment fails.

Impact

  • We are developing resources for families and medical professionals to allow better management of children with NDDs, including an online assessment tool that supports preliminary diagnosis of potential NDDs.
  • We are analysing cerebrospinal fluid (CSF) metabolomics to help us not only understand pathological mechanisms, identify biomarkers, and develop therapeutic strategies for NDDs, but also to allow targeted monitoring of patient responses to certain therapeutics.
  • We have shown that immune system dysregulation can be modified through various immunomodulatory therapeutics, in paediatric acute neuropsychiatric syndrome (PANS) and autistic regression (a ‘flare’ of autism-like symptoms). By using techniques such as transcriptomics and proteomics, we are identifying other dysregulated mechanisms to improve clinical management of these disorders.
  • Knowing the importance of standardised, high-quality prenatal care and support, we are analysing how maternal inflammation disrupts foetal neurodevelopment during pregnancy to better understand how the immune system plays a role in NDD development.
  • We are using functional lab-based immune assays to observe the involvement of the immune system in those with NDDs compared to those without, in order to support the development of therapeutics that stabilise NDD symptoms.
  • We hope to reduce the time between research results and clinical implementation by investigating already existing anti-inflammatory therapies and drugs, with known safety profiles, to find potential treatments for NDDs. 
Prof Russell Dale

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Prof Russell Dale

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Biography
Paediatric Neurologist, Clinical Director of Kids Neuroscience Centre, and Head of the USYD CHW Clinical School. Prof Dale has helped improve recognition of several brain disorders. He is rated in the top 0.005% of neuroinflammatory experts in the world by Expertscape and is the most cited paediatric neuroinflammatory expert in the world.
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More team members

  • Dr Brooke Keating - Postdoctoral Research Scientist
  • Dr Emily Innes - Fellow and Masters Student
  • Erica Tsang – Ketogenic Dietitian and PhD Student
  • Dr Hiroya Nishida - Fellow and Postdoctoral Research Scientist
  • Dr Jingya (Jinni) Yan - Postdoctoral Research Scientist
  • Morgan Bucknor - PhD Student
  • Omar Hafed Shadid - PhD Student
  • Sarah Alshammery - PhD Student
  • Dr Shrujna Patel - Postdoctoral Research Scientist
  • Dr Velda Han - Fellow and PhD Student

Other collaborators include A/Prof Brian Gloss (WIMR), Dr Mark Graham (CMRI), Dr Igy Pang (CMRI), Dr Nader Aryamanesh (CMRI), A/Prof Markus Hofer (Charles Perkins Centre, USYD).