I am currently a Hepatology training registrar currently on out-of-programme placement to undertake an MRC clinical research training fellowship evaluating the impact of the gut microbiota in cirrhosis in driving mucosal and systemic immune dysfunction. I have a particular research interest in uncoupling microbiota interactions with unconventional T cell populations and advancing manipulation of the gut microbiome as a therapeutic strategy in advanced chronic liver disease.

Patients with cirrhosis are predisposed to developing infection which is frequently a precipitant of multiorgan failure and death. With poor outcomes following sepsis, the propagation of multidrug-resistant bacterial species and increasing waiting list mortality for liver transplantation, there is an urgent need for novel approaches to reducing the rate of infection. Paradoxically, these patients are characterised by heightened immune activity and rigorous inflammatory processes and are unable to contend with infection, suggesting that whilst these immune effectors are primed, their antibacterial effector functions are switched off. The precise mechanisms responsible for this phenomenon remain unknown but are suggestive of a skewed homeostatic balance between protective anti-pathogen immunity and host-induced immunopathology. The aims of my research are to characterise the cellular and molecular mechanisms governing this predisposition to infection focusing on the intimate relationship between innate immune dysfunction and the gut-liver-brain axis

My research interest is in exploring how changes in commensal bacteria control circulating mucosa-associated invariant T cell frequency, phenotype, and T-cell receptor repertoire stability in longitudinal ex vivo models of dysbiosis before and after manipulation of the enteric microbiome.