Professor Diana Lockwood
Diana's work focuses on improving the outcome of leprosy patients with nerve damage. Her research programme has six main areas: understanding the pathogenesis of leprosy reactions, looking at the molecular effects of treatment on inflammation in reactional lesions, improving treatment for reactions, looking at risk factors for nerve damage, using strain typing of M. leprae to understand the epidemiology of leprosy, and studies on the interaction between HIV and M. leprae.
She has also led work on developing new immunosuppressant treatments for reactions with randomised controlled trials. A multi-centre randomised controlled trial of azathioprine in the treatment for reactions is in progress in India; a study using cyclosporine to treat leprosy reactions in Ethiopian patients is fully developed and about to start; a Phase 2 study on using methylprednisolone in the early treatment of reactions has concluded in Nepal.
She has also started work on identifying second line drugs for the management of Erythema Nodosum Leprosum (ENL). A study in Ethiopia has been funded and I am collaborating with colleagues in The Philippines and India on proposals. Measuring the severity of reactions and documenting improvement is critical to all these clinical studies. My team are working on developing, analysing and refining severity scales for Type and ENL reactions. Trial studies involve developing methodologies for measuring nerve function improvements that can be used in resource poor settings. This year I have been a co-author on two published Cochrane reviews.
Her group, with Brazilian and Ethiopian collaborators is leading the analysis of the effect of HIV infection on leprosy and they have accumulating data showing that both immune reconstitution syndrome and upregulation occurs in patients with co-infection.
She has important overseas collaborations, most notably with the MRC/Lepra funded Blue Peter Research Centre in Hyderabad, India. She has been associated with this centre for over 15 years and much of my work arises from collaborations with this centre. Another important collaboration has been with the INFIR study, the biggest prospective cohort study of new leprosy patients at four centres in India linking together nerve function studies and immunology to identify risk factors for leprosy reactions. She is also closely associated with the IDEAL consortium which is developing new diagnostic tools for leprosy.