Roslyn Kemp

Understanding how Treg cells control immunity will contribute to treatment of Crohn’s Disease.

Just how important is “Treg”, and what does that have to do with the Otago Medical Research Foundation?

Tregs are regulatory cells known to have a role in human immunity.  Immune responses, along with genes, environment and malfunctioning intestinal lining, are the factors causing Inflammatory Bowel Diseases (IBD). 

So, understanding how Treg cells control immunity and what effect they have on people with chronic intestinal inflammation such as Crohn’s Disease will contribute to treatment.

The reality is that disease is very different in humans, and therefore so is their response to immune cells. A major health challenge then is predicting an individual’s response, given that not all treatments work for all patients.

A study by Professor Roslyn Kemp and her team at the University of Otago has been bringing together gut, immune cells from patients at Dunedin Hospital, and bacteria into a study aimed at pinpointing the underlying mechanisms at play.

They studied the differences in T cell populations between healthy people and those with Crohn’s Disease, and what effect the T cells had on the lining of the intestine.

The team are doing something novel by using an organoid – that is gut cells taken from a patient and developed into a monolayer model in the lab – basically a fake gut. They then layer on immune cells and bacteria to replicate the gut lining barrier, immune response and gut microbes from individual patients.

The ultimate aim is to understand all of the interactions going on, rather than a select few.  Then, by seeing the reaction of one patient’s immune cells in this model, they should be able test its reaction to treatment.  And based on that reaction, they hope eventually an “immune signature” can predict the best course of treatment – in gut issues and even in immune responses in tumours.

There is a long way to go - IBD is massively complex and developing targeted individual treatments is enormously challenging. This is precision medicine in its infancy and it’s an exciting place to be.

The Otago Medical Research Foundation study is a fundamental building block.  “It’s taking a hard fundamental experiment with a small question and expanding it into answers and bigger questions.”

Roslyn finds it’s fun to do the hard experiments.  “To make the really big advances, we have to look at the bigger picture, at all of the interactions, and we need collaboration across different fields of research.

“I’m inspired by the researchers whose attitudes are to do it differently, finding ways to overcome the barrier that has taken a line of research as far as it can go.”

“Also, it’s great that we can make this Otago medicine – involving Dunedin Hospital patients and University of Otago researchers and students.”