The Gunaratnam Lab

 

Dr. Lakshman Gunaratnam, M.D., M.Sc.

Assistant Professor of Medicine and Microbiology & Immunology

Consultant Transplant Nephrologist

London Health Sciences Centre-University Hospital

Centre for Human Immunology

The University of Western Ontario

Research Focus:


Kidney transplantation remains the treatment of choice for patients with kidney failure. Unfortunately, the lifespan of transplanted kidneys has not changed over the years despite the advent of modern immunosupprerssive therapies. Significant barriers to long-term survival of kidney transplants are chronic immunologic rejection and long-term kidney toxicity from medications, both of which are limitations of current immunosuppressive therapies. The ability to reduce the incidence of acute and chronic rejection, and at the same time limit the use of toxic medications, is the ultimate goal of transplantation.


A major contributor to rejection and poor long-term outcome is ischemia reperfusion injury, an inevitable form of early tissue injury that occurs during organ harvesting and transplant surgery. New evidence suggests that “danger” signals released by injured or dying kidney epithelial cells (from the transplant) enhance the immunogenicity of the transplanted kidney by triggering a potent innate immune response.

            

The laboratory of Dr. Gunaratnam is studying the potential role of kidney injury molecule-1, a protein that is expressed by the kidney tubular epithelial cells soon after injury, in regulating the innate immune response and in preventing rejection. By uncovering the detailed mechanisms that enable kidney epithelial cells to control early inflammation following transplant surgery, we hope to identify specific therapeutic strategies to increase the lifespan of transplanted kidneys.