Uveitis, an umbrella term for inflammation of the eye, can lead to severe vision loss if not promptly treated. It leads to 15% of all registered blindness in the UK. The condition is usually idiopathic meaning it has no known cause but can sometimes be associated with systemic autoimmune disease or infections. Many cases however are never fully identified which can lead to barriers to finding effective treatments.
Dr Chu and his team will work towards bringing a new diagnostic test for uveitis into routine hospital care. It is a collaboration with Dr Jullianne Brown and Prof Judith Breuer at the Great Ormond Street Hospital (GOSH) Clinical Metagenomics Facility. The facility provides this cutting-edge genomic sequencing technique that allows for the identification of bacteria, viruses, fungi and other types of infections directly from patient samples. Metagenomics is untargeted, meaning it can look for all types of infections, rather than looking for specific infections as is done in standard hospital care.
Dr Chu said:
“This research project will help us to bring metagenomic sequencing to a wider range of patients with uveitis, that could provide new diagnoses and treatment options, alongside increasing our fundamental understanding of inflammation in the eye.”
The metagenomics facility is the result of 10 years of research and development work between clinicians at GOSH, Guy’s and St Thomas NHS Foundation Trust (GSTT) and clinicians at other UK institutions and is made possible with ongoing support from the National Institute for Health and Care Research at UCLH and GOSH Biomedical Research Centres and partnered with UCL. The technology and skills are being rolled out across 30 centres nationally to speed up diagnosis of previously evasive infections.
Dr. Chu’s grant aims to utilise this advanced technique to identify previously undetected causes of uveitis, revolutionising how this condition is diagnosed and managed. The facility at GOSH has only now started performing metagenomics on ocular samples, in collaboration with Dr Chu and the Uveitis Service at Moorfields Eye Hospital led by Prof Carlos Pavesio.
A recent example of metagenomics in action involves Moorfields Eye Hospital and GOSH. Dr. Ellie Irwin, a 29-year-old doctor from Bristol had an undiagnosable and sight threatening uveitis in her eye for five years. The team caring for her at Moorfields sent a sample of fluid from behind her eye, the type of sterile site the metagenomics test is useful for, to the unit at GOSH for analysis. Their analysis pinpointed a rare bacterial infection found to have been picked up on a holiday in the Amazon. This led to a simple course of targeted antibiotics which has restored Dr. Irwin’s vision, saved her eye, allowing her to continue her career and to be healthy in time to enjoy her wedding.
Dr. Chu’s research is not limited to uveitis. His lab is also involved in studying immune responses to retinal gene therapy, Glaucoma and is developing new imaging techniques to study the retina.