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Research project

Systemic inflammation and the blood-brain barrier in multiple sclerosis (SIBIMS)

Project overview

Systemic inflammation affects the natural history of long-term neurological conditions, such as multiple sclerosis (MS). Various possible mechanisms may underlie this phenomenon and precise identification may lead to new avenues of therapeutic intervention. One such mechanism is a change in blood-brain barrier (BBB) permeability related to the systemic inflammatory response. The BBB exists to protect the delicate brain, since neurones need a very stable environment to function and survive. We have previously shown that the BBB in disease states may be more susceptible to become leakier in the presence of systemic inflammation, compared to the healthy BBB.

This study aims to investigate BBB permeability during systemic inflammation in people with progressive MS and control individuals without neurological disease. are common and may trigger systemic inflammation. In this project we hypothesize that systemic infections, namely urinary tract infections are associated with a leakier BBB disruption, as measured with dynamic contrast-enhanced magnetic resonance imaging. We also hypothesize that the magnitude of BBB change is proportional to the systemic inflammatory response (as measured by urinary neopterin-to-creatinine ratio) and central nervous system symptoms, and more marked in people with MS than control individuals.


Lead researcher

Professor Ian Galea MD FRCP PhD

Prof (Clinical & Experimental Neurology)

Research interests

  • Brain haemorrhage: pathophysiology
  • Blood-brain barrier and immune-brain signalling
  • Neuroimmunology
Connect with Ian
Other researchers

Dr Aravinthan Varatharaj BMBCh MA(Oxon) PhD PGCME MRCP

Associate Professor in Neurology
Connect with Aravinthan

Research outputs

Charlotte M Stuart, Aravinthan Varatharaj, Martin E. Winberg, Pascale Galea, Henrik B.W. Larsson, Stig P. Cramer, Alessio Fasano, Zaynah Maherally, Geoffrey J. Pilkington, Åsa V Keita & Ian Galea, 2022, Clinical and Translational Medicine, 12(7), e965
Type: article
Maria Højberg Knudsen, Ulrich Lindberg, Jette Lautrup Frederiksen, Mark Bitsch Vestergaard, Helle J. Simonsen, Aravinthan Varatharaj, Ian Galea, Morten Blinkenberg, Finn Sellebjerg, Henrik B.W. Larsson & Stig P. Cramer, 2022, Multiple Sclerosis and Related Disorders, 63
Type: article
Amy L Ross Russell, Marc Hardwick, Athavan Jeyanantham, Laura M White, Saumitro Deb, Girvan Burnside, Harriet Joy, Craig J Smith, Thomas A Pollak, Timothy R Nicholson, Nicholas WS Davies, Hadi Manji, Ava Easton, Stephen Ray, Michael S Zandi, Jonathan P. Coles, David K. Menon, Aravinthan Varatharaj, Beth Mccausland, Mark A Ellul, Naomi Thomas, Gerome Breen, Stephen Keddie, Michael P Lunn, John PS Burn, Graziella Quattrocchi, Luke Dixon, Claire M Rice, George Pengas, Rustam Al-Shahi Salman, Alan Carson, Eileen M. Joyce, Martin R Turner, Laura A Benjamin, Tom Solomon, Rachel Kneen, Sarah Pett, Rhys H Thomas, Benedict D Michael & Ian Galea, 2021, Brain Communications, 3(3), fcab168
Type: article