Our research
Clinical trials
We have broad ranging experience in both commercial and investigator lead clinical trials in uveitis.
Uveitis
Uveitis is the most common extra-articular manifestation of JIA. Our work harnesses the leading ocular immunology and clinical trial expertise in Bristol to understand more about this debilitating condition, and how to risk stratify patients and optimise therapy. Our uveitis research also sits within the award winning combined paediatric rheumatology and ophthalmology clinical service at Bristol Children’s Hospital.
CRMO
Bristol is a centre of excellence for chronic recurrent multifocal osteomyelitis (CRMO). We have one of the largest cohorts of CRMO patients in Europe and run a monthly dedicated clinic for CRMO patients. We have published more than 11 papers in the last 10 years including the "Bristol diagnostic criteria" for CRMO which is widely used. The team is leading efforts for trials of novel biologics in CRMO. We have also done work on using "AI" in interpretation of WB-MRI in collaboration with Stanford University.
Translational medicine
We are currently exploring the role of epigenetic phenotypes in JIA uveitis and their potential use as biomarkers of uveitis.
We are keen to promote bench to bedside research to improve the lives of our patients. Current projects include:
- Identification of environmental factors which may predispose to JIA risk, such as the human gut microbiome.
- Exploring the role of epigenetic phenotypes in JIA uveitis
- Uveitis biomarker discovery work as part of the UK Wide JIA CLUSTER Consortium workstream 2.
We have recently completed work examining the environmental risk factors associated with JIA uveitis onset, which suggests a potential role for vitamin D and seasonality in disease onset. We have ongoing collaboration with the world-leading MRC Integrative Epidemiology Unit at the University of Bristol.
Paediatric Rheumatology research in Bristol benefits from the world-leading expertise in observation and molecular epidemiology at the MRC Integrative Epidemiology Unit.
Our recent work includes examining the environmental risk factor associated with JIA and JIA uveitis. Mendelian Randomisation is a method of causal inference which has frequently been applied in adult rheumatology. We are pioneering the use of this method in paediatric rheumatology to explore causal relationships between environmental exposures and JIA, and health outcomes resulting from JIA.
CLUSTER
Prof Ramanan co-leads the uveitis workstream for the UK wide JIA CLUSTER Consortium.