Utilising TCR sequencing as a prognostic marker to direct intervention in Immune Thrombocytopenia

Abstract:

Immune thrombocytopenia (ITP) is an autoimmune disorder characterised by low platelet counts, leading to increased risks of bleeding, fatigue, and complications from treatment. Despite advances in therapies that improve outcomes for many patients, a subset remains refractory, failing to respond to available treatments. These patients often experience worsening disease, treatment-induced toxicities, and a significant reduction in quality of life.

Currently, there is a lack of diagnostic and prognostic markers to guide treatment decisions, and the heterogeneity of responses further complicates management. Our research focuses on understanding the mechanisms underlying refractory ITP, aiming to identify early markers of disease progression, uncover immune profiles linked to treatment resistance, and explore novel therapeutic targets.

Our recent study highlighted expanded, long-lived T cell clones, specifically cytotoxic effector memory CD8+ T cells (TEMRA) in patients with refractory ITP. These findings suggest that clonal T cells play a key role in disease pathology.

We propose to use advanced immune profiling techniques, including single-cell RNA and TCR sequencing to study clonal evolution over time and assess their potential as therapeutic targets. By intervening earlier in disease progression and exploring pathways like SYK inhibition, we aim to improve outcomes for patients with refractory ITP.
 

Short Biography:

Michelle Tan May Hung is a dedicated researcher with expertise in immunology and autoimmune diseases. She holds an MSc in Molecular Medicine (Distinction) from Imperial College London and a BSc in Biomedical Science from the University of Sussex. She is currently pursuing her PhD in Prof. Nichola Cooper’s lab at Imperial, focusing on understanding the role of T cells in immune thrombocytopenia (ITP) and leveraging T cell receptor (TCR) sequencing to predict disease progression and inform targeted therapies.

Michelle has extensive experience in cutting-edge techniques, including multi-colour flow cytometry, single-cell RNA sequencing, and bioinformatics. She has contributed to several high-impact publications, such as studies on the modulation of T cells in ITP and transcriptional reprogramming during immune responses.

In addition to her research, Michelle actively participates in scientific communication, presenting her findings at international conferences and engaging in patient education. Her work aims to improve diagnostic tools, uncover novel therapeutic targets, and enhance the management of refractory ITP. She is passionate about applying her expertise to develop precision medicine approaches that address unmet clinical needs in autoimmune diseases.