MBBS

Centre for Advanced Neurological Research

Centre for Advanced Neurological Research

Dr Lekha Pandit is the Principal Investigator of this center , located at KS Hegde Medical Academy. Its strength and uniqueness comes from the fact that it is a clinician driven research center which focuses on translational research in autoimmune central nervous system disorders. Its broad goals are to utilize clinical longitudinal data derived from its large patient registry to ask basic research questions that have translational potential through identification of biomarkers, immunological targets that facilitate management algorithms and the development of cost effective bioassays. These include a number of autoimmune disorders with special emphasis on multiple sclerosis (MS), Neuromyelitis optica spectrum disorders(NMOSD) and a variety of atypical non MS demyelinating diseases.

Current Areas of Research

This unique centre devoted to clinical and basic research in the field of Neurology came into existence in 2006. The initial funding for starting the lab was brought in by Dr. LekhaPandit and a memorandum of understanding was signed with Nitte Education Trust on 15.07.2005. Subsequent funding came from the generous support of the Nitte Trust and Governmental funding agencies such as DRDO, DST ICMR& DBT and international agencies such as Multiple Sclerosis Society of Great Britain.

Clinical Research:
Mangalore Demyelinating Disease Registry: The growing number of patients with demyelinating central nervous system disorders seen at the Department of Neurology at K S Hegde Hospital led to the formation of a patient registry exclusively for the enrollment, assessment, subsidized treatment and dedicated long term followup of patients with Multiple sclerosis, Neuromyelitisoptica and other atypical demyelinating central nervous system (CNS) disorders. The Mangalore demyelination disease Registry, run by Dr Lekha Pandit was started in 2007 with a purpose to establish a database of CNS demyelinating disorders. Patients within a radius of 250 km from Mangalore are referred for specialist consultation and treatment. This registry has more than 1500 patients on its rolls. Nearly 2/3rd are followed long-term with dedicated treatment protocols and subsidized medications. Data from this registry has led to many original contributions that help to understand autoimmune neurological disorders in the Indian context.

Laboratory Research:
  • Development of in-house cell based assay for the detection of AQP4 and MOGIgG antibody using Indirect Immunofluorescence technique for the sensitive diagnosis of Neuromyelitis Optica Spectrum Disorders (NMOSD).
  • Evaluation of the genetic susceptibility and environmental factors associated with Multiple sclerosis and Neuromyelitisoptica spectrum disorders.
  • Biomarker development for the detection of unknown antibodies associated with seronegative NMOSD.
  • Role of gut microbiome in central nervous system autoimmune disorders
Extra mural and intra mural Research Projects:
Identifying and characterizing Aquaporin -4 specific T cells in Neuromyelitis optica spectrum disorders Nitte (Deemed to be University)
2020-2021
Rs 1,99,948
Development of a sensitive cell based assay for the detection of a diagnostic biomarker (Myelin oligodendrocyte glycoprotein antibody) in Neuromyelitis optica spectrum disorders ICMR
(2020-2023)
Rs 30,72,528
Indian Multiple Sclerosis and Allied Demyelinating Disorders Registry and Research Network ICMR
(2020-2025)
Rs 32,29,000
Use of Wistar rat brain sections in Immunohistochemistry studies for characterization of seronegative Neuromyelitis optica spectrum disorders-A pilot study Nitte (Deemed to be University)
2019-2020
Rs 1,40,000
Evaluation of AQP4-IgG administration with human complement for developing Neuromyelitis optica spectrum disorder (NMOSD) rodent mouse model - A pilot study Nitte (Deemed to be University)
2019-2020
Rs 1,25,000
"Development of a cost effective cell based assay for the diagnosis of Neuromyelitis optica spectrum disorders in India" DBT-BIRAC
(2019-2021)
Rs 40,93,000
Neuromyelitis optica Biomarker assay development – Phase1 (Culture & Maintenance of Human Embryonic Kidney cell lines for development of cell based biomarker assay for sensitive diagnosis of Neuromyelitis optica spectrum disorders.) Nitte University
(2015-2016)
Rs 1,20,000
Understanding the role of herpes viruses and human endogenous retrovirus in MS pathogenesis Dept of Biotechnology
(2014-2017)
Rs 65,00,000
Environmental & genetic risk factors for MS in Indian population Dept of Science & Technology, Govt of India
(2011-2014)
Rs 58,01,282
Study of European risk variants in MS in Indian population MS society of Great Britain (2013-2014) Rs 15,00,000
Association of H pylori with NMO and NMO spectrum disorders among Indian population Nitte University
(2014-2015)
Rs 1,33,900
Association of HLA Class I (A&C) Alleles in Multiple Sclerosis among Indian population- a pilot study Nitte University
(2013-2014)
Rs 2,05,375
Study of patterns and prevalence of demyelinating disorders in urban Mangalore Indian council of medical research
(2010-2013)
Rs 35,80,000
Evaluation of Anti Aquaporin Antibody in Indan Demyelinating disorders (collaboration with Professor Weinshenker, Mayoclinic, Minnesotta, USA) Intramural funding
(2007-2008)
Rs 1,00,000
A longitudinal study to determine the clinical and radiological predictors for ADEM and MS and to evaluate underlying genetic susceptibility. Indian council of Medical research
(2007-2010)
Rs 12,50,000
Molecular genetics & genetic epi demiology of some common triplet repeat disorders in Coastal Karnataka Dept.of Science & Technology, (DST,Govt of India)
(2006-2009)
Rs19,00,000
Molecular Characterization of Campylo- bacter jejuni infection associated with Guillane –Barre syndrome Life Science research Board (DRDO,Govt of India)
(2005-2007)
Rs10,80,000
Evaluation of Fragile X syndrome as cause of mental retardation Indian council of medical of research (ICMR) & Nitte Educational Trust
(2002-2003)
Rs 25,000
Use of universal primers in the diagnosis Of culture negative meningitis Use of semi nested PCR in diagnosis of Culture negative meningitis Rhodes Scholar Mridula Shastri memorial post-doctoral scholarship (2001-2002) Rs 1,00,000


International collaborative projects:
Title Collaborators
Optic neuritis classification study - An international collaborative study (2018-2021) Lead collaborator- Dr Axel Petzold, UCL Institute of Neurology, Queen square, London, United Kingdom
International Panel for classification of Myelin Oligodendrocyte Glycoprotein Antibody Diseases (MOGAD) (2020-2021) Brain Group: Kazuo Fujihara (Japan) Romain Marignier ( France) Albert Saiz (Spain) Lekha Pandit (India) Brenda Banwell (US) Cheryl Hemingway (UK)

Spinal Cord Group: Jackie Palace ( UK) Ho Jin Kim ( S Korea) Eoin Flanagan (US) Douglas Sato ( Brazil)Rinze Neuteboom (Netherlands), Silvia Tenenbaum (Argentina)

Optic Nerve Group: Friedemann Paul (Germany) Jeff Bennett ( US), Alexander Brandt ( US/GER), Sudarshini Ramanathan ( AUS) Kevin Rostasy (Austria/ Germany) Jennifer Graves ( US)

Serology Group: Sean Pittock ( US) Paddy Waters (UK) Markus Reindl (Austria) Fabienne Brilot-Turville (Australia) Tanuja Chitnis (US), Kumaran Deiva (France)
Delphi Consensus Panel- Treatment choices in NMOSD (2020-2021) Chair : Dr Friedemann Paul (Germany International Panel: Dr Jacqueline Palace(US),Dr Romain Marignier(France), Dr Sudarshini Ramanathan ( AUS), Dr Marco Lana Peixoto (Brazil), Dr Douglas Sato(Brazil), Dr Nasrin Asgari(Denmark)Dr Ho Jin Kim (Republic of Korea),Dr Lekha Pandit(India), Dr Sean Pittock (USA),Dr Jeff Bennett(USA), Dr Isabel Leite(UK), Dr Saif Huda(UK), Dr Mar Tintore(Spain), Dr Albert Saiz (Spain), Dr Najib Kissani (Morocco), Kuzuo Fujihara (Japan), Dr Satoshi Kuwabara(Japan), Dr Adi Vaknin- Dembinsky (Israel).
Role of gut microbiome in central nervous system autoimmune disorders-A comparative study of patients of Indian origin with white Americans (2018-2019) FULLBRIGHT RESEARCH PROJECT- NITTE/HARVARD UNIVERSITY Fullbright fellowship program, Brigham & Women’s hospital, Harvard medical school (host University) Amount:15,000USD
An international retrospective multi-center study of retinal optical coherence tomography in patients with neuromyelitis optica spectrum disorders (2017-2019) The Collaborative Retrospective Study on retinal OCT in Neuromyelitis Optica (CROCTINO) / Parallel Study on MRI in Neuromyelitis Optica (PAMRINO) project-The Data Coordination Center (DCC) of the University of Utah,USA, Charité – Universitäts medizin Berlin-Germany, Guthy-Jackson Charitable Foundation, USA
Comparative study of severity of Neuromyelitis Optica Spectrum Disorder world wide (2017-2019) Dr Jacqueline Palace Nuffield Department of Clinical Neurosciences, Oxford University. Dr Ho Jin Kim National Cancer Center Korea, (Goyang-si South Korea)
An International survey on treatment of MOG-IgG associated demyelination (2018-2019) Lead collaborator- Dr Anu Jacob, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom

Facilities

Equipments
Make
Cell culture Equipments:
  • Fluorescent Microscope
  • Class 2 Biological safety cabinet
  • CO2 Incubator
  • Flow cytometer
  • Cell counter-Countess II FL
  • Immunowash Microplate Washer and iMark Microplate Absorbance Reader
  • Direct8-Milli Q- Water purification unit
  • Ice machine

 

Nikon
Thermo Fisher scientific (USA)
Thermo Fisher scientific (USA)
BD-Facsverse
Thermo Fisher scientific (USA)
Bio-Rad (USA)
 
Merck Millipore
Labman(India)
PCR and Electrophoresis equipments:
  • Real time PCR
  • Thermal cycler-PTC220 Dyad
  • Thermal cycler- S1000
  • Nanodrop-2000 Spectrophotometer
  • Gel Documentation unit
  • HYDRASYS 2 Iso Focusing unit - Automated Agarose gel Electrophoresis System
  • PROTEAN® i12TM IEF System and SDS PAGE unit
  • Electrophoresis System (Horizontal)
  • Electrophoresis System (Vertical)

7500 Applied Biosystems (USA)
Bio-Rad (USA)
Bio-Rad (USA)
Thermo Fisher scientific (USA)
VilberLourmat (France)
Sebia (France)
 
Bio-Rad (USA)

Bangalore Genei
Bangalore Genei
Centrifuges:
  • Sorvall ST 8R Centrifuge
  • Revolutionary Laboratory Centrifuge R-8C
  • Plate Centrifuge PR-23
  • Refrigerated centrifuge CPR 24
  • Non Refrigerated High SpeedCentrifuge
  • Refrigerated Centrifuge 5702R

Thermo Fisher scientific (USA)
Remi (India)
Remi (India)
Remi (India)
Eppendorf (Germany)
Eppendorf (Germany)
Freezers and refrigerators:
  • -80°c Deep Freezer-3 Nos

  • -20°c Deep Freezer-Horizontal -1 No
  • -20°c Scientific Deep Freezer Vertical -2Nos

  • Refrigerator (150ltr)
  • Refrigerator (350ltr)
  • LN2 container - 2 Nos (50ltr)

New Brunswick Scientific-U570 (USA)& Thermofisher Scientific
Blue Star (India)
Vest frost (Germany) & Panasonic (Japan)
Whirlpool
LG
Thermo Fisher scientific (USA)
Pipettes:
  • Serological pipette
  • Calibrated Micro Pipettes-6 sets (10µl, 20µl, 100µl & 1000µl)
  • Calibrated Multi Channel Pipette(10µl)
  • E4 XLS Electronic Multichannel Pipette

Eppendorf
Eppendorf
 
Nichipet-7000 (Japan)
Rainin
 
Others:
  • Digital PH meter
  • Bar coding system-DATAMAX E 4204
  • Hybridization Oven
  • Laminar Flow Units (2 Nos)
  • Incubator
  • Dry Bath
  • Water Bath-2Nos
  • Precision Weighing Scale
  • Cyclo Mixer (3 Nos)
  • Autoclave Unit (Vertical)- 2 Nos
  • Microwave –oven
 

HANNA
Bartech systems and automations
Thermo Fisher scientific
Lab Line( India)
Kemi ( India)
Remi ( India)
Kemi ( India)
Citizen
Remi ( India)
Lab Line and REMI( India)
IFB
 

Services

Special immunodiagnostic tests are offered at Centre for Advanced Neurological Research
  • NMO/MOG IgG test by Indirect immunofluorescence(IIFT)
  • Autoimmune Encephalitis Mosaic1 IIFT test
  • CSF Oligoclonal Band test
  • Paraneoplastic Neurologic Syndrome test
  • ANA Global test
  • Granulocyte Mosaic13-ANCA test
  • Paraprotein Detection
  • Anti-thyroid antibody detection
  • CD19 and CD27 count by flow cytometry
  • Stem cell enumeration-viable CD34 count by flow cytometry

Ongoing clinical drug trials
  • COMB157G2399- : An open label, single arm, multi centre extension study evaluating long- term safety, tolerability of Ofatumumab in subjects with relapsing multiple sclerosis. Study sponsor: Novartis healthcare private Ltd Year: 2019-2022.
  • PERSEUS/EFC16035- : A phase 3, randomized, double-blind, efficacy and safety study comparing SAR442168 to placebo in participants with primary progressive multiple sclerosis. Study sponsor: Sanofi Healthcare India Private Ltd Year: 2021-2024.
  • PERSEUS/EFC166455- : A phase 3, randomized, double-blind, efficacy and safety study comparing SAR442168 to placebo in participants with non-relapsing secondary progressive multiple sclerosis. Study sponsor: Sanofi Healthcare India Private Ltd Year: 2021-2024.

Achievements

Dr Lekha Pandit
  • Fulbright Nehru scholar (Academic & Professional Excellence)- 2018-2019 Visiting Professor of Neurology, Harvard Medical School, Boston, USA - 2018- 2019)
  • Member (Invited), International clinical consortium ,Guthy Jackson Neuromyelitis Optica foundation, USA- 2011- current
  • Member (nominated), Central organizing committee . Pan Asian committee for Treatment a& research in MS (PACTRIMS)- 2013- current.
  • Member (nominated), Medical Board, Multiple sclerosis International federation (MSIF),UK. Federation( MSIF)- 2011-2019.
  1. Dr Lekha Pandit was interviewed by Professor Wijeratne on behalf of the World Federation of Neurology (WFN) Chair for world brain day. World brain day celebration of 2021 has adopted Multiple sclerosis as the theme for focus. In this connection prominent neurological experts from different regions of the world were interviewed. From India. Dr Lekha Pandit addressed the challenges faced in the diagnosis and the management of these patients from a developing country perspective. She spoke about the Mangalore demyelinating disease registry (MANDDIR), established since 2007, at Nitte (deemed to be university), centre for advanced neurological research. She highlighted that this registry manages more than 1500 patients with demyelinating disorders from all over India with many patient friendly initiatives supported by Nitte. Dr Lekha Pandit spoke at length about her experience using of-label therapies and generics in controlling Mutliple Sclerosis and the need to have regional guidelines for therapy in the developing world.
    https://youtu.be/NYcm9omE9Tw
  2. NEW PROJECT: International MOGAD diagnostic criteria project Dr Lekha Pandit has been invited to be a member of the International Panel for classification of Myelin Oligodendrocyte Glycoprotein Antibody Diseases (MOGAD)
  3. The Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) has initiated a collaborative effort to update recommendations for clinical approaches to the differential diagnosis of MS. On behalf of the steering committee of the international MS Differential Diagnosis Consortium, Dr Lekha Pandit is invited to participate in the working group to produce a paper for the topic titled Differential Diagnosis Considerations in Non- Western Geographic Regions.
Invited lectures:
  • Dr Lekha Pandit delivered an invited lecture titled "Serological diagnosis of NMOSD and MOGAD: Practical considerations and limitations" at IAN CON 2021 held in Hybrid mode on 14-11-2021.
  • Dr Lekha Pandit was invited to speak at the 13th Pan Asian Committee for Treatment and Research in Multiple Sclerosis (PACTRIMS) Congress 2021 program on “The Gut environmental factors and MS and NMO” which was held in digital mode from 26th to 28th November 2021.
  • Dr Lekha Pandit was invited as speaker on A WEBINAR ON MULTIPLE SCLEROSIS-PANEL DISCUSSION. A public awareness and education programme and advice by experts on different aspects of multiple sclerosis conducted by Indian Academy of Neurology on WORLD BRAIN DAY on 22-07-2021
  • Dr Lekha Pandit was invited to speak at the 8th European committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Focused Workshop 2021 on “The Risk of Infections for MS Disease Modifying Treatments (DMTs)” which was held fully digital on 14 and 21 April 2021
  • Dr Lekha Pandit, was invited as speaker at Pan-Asian Committee for Treatment and Research in Multiple Sclerosis (PACTRIMS) inaugural educational webinar PACTMAN series 01 held Virtual on 29-04-2021
New publications:
  • Pandit L. Managing Multiple sclerosis and allied disorders during COVID-19 pandemic. In P N Sylaja (eds). Reviews in Neurology, New Delhi:Wolters Kluwer(India), Indian Academy of Neurology CME Publication; 2021: 49-56
  • Lu A, Zimmermann HG, Specovius S, Motamedi S, Chien C, Bereuter C, Lana-Peixoto MA, Fontenelle MA, Ashtari F, Kafieh R, Dehghani A, Pourazizi M, Pandit L, D'Cunha A, Kim HJ, Hyun JW, Jung SK, Leocani L, Pisa M, Radaelli M, Siritho S, May EF, Tongco C, De Sèze J, Senger T, Palace J, Roca-Fernández A, Leite MI, Sharma SM, Stiebel-Kalish H, Asgari N, Soelberg KK, Martinez-Lapiscina EH, Havla J, Mao-Draayer Y, Rimler Z, Reid A, Marignier R, Cobo-Calvo A, Altintas A, Tanriverdi U, Yildirim R, Aktas O, Ringelstein M, Albrecht P, Tavares IM, Bichuetti DB, Jacob A, Huda S, Soto de Castillo I, Petzold A, Green AJ, Yeaman MR, Smith TJ, Cook L, Paul F, Brandt AU, Oertel FC; GJCF International Clinical Consortium for NMOSD. Astrocytic outer retinal layer thinning is not a feature in AQP4-IgG seropositive neuromyelitis optica spectrum disorders. J Neurol Neurosurg Psychiatry. 2021 Oct 28:jnnp-2021-327412. doi: 10.1136/jnnp-2021-327412
  • Oertel FC, Specovius S, Zimmermann HG, Chien C, Motamedi S, Bereuter C, Cook L, Lana Peixoto MA, Fontanelle MA, Kim HJ, Hyun JW, Palace J, Roca-Fernandez A, Leite MI, Sharma S, Ashtari F, Kafieh R, Dehghani A, Pourazizi M, Pandit L, D'Cunha A, Aktas O, Ringelstein M, Albrecht P, May E, Tongco C, Leocani L, Pisa M, Radaelli M, Martinez-Lapiscina EH, Stiebel-Kalish H, Siritho S, de Seze J, Senger T, Havla J, Marignier R, Calvo AC, Bichuetti D, Tavares IM, Asgari N, Soelberg K, Altintas A, Yildirim R, Tanriverdi U, Jacob A, Huda S, Rimler Z, Reid A, Mao-Draayer Y, Soto de Castillo I, Petzold A, Green AJ, Yeaman MR, Smith T, Brandt AU, Paul F. Retinal Optical Coherence Tomography in Neuromyelitis Optica. Neurol Neuroimmunol Neuroinflamm. 2021;8(6):e1068. doi: 10.1212/NXI.0000000000001068
  • Pandit L, Malli C, D’Cunha A, Sudhir A. Overcoming the challenges in diagnosis of AQP4-IgG positive neuromyelitis optica spectrum disorders in resource poor settings using an indigenized and cost effective cell based assay . Journal of Neuroimmunology 2021 360:577706. doi: 10.1016/j.jneuroim.2021.577706
  • Pandit L, Malli C, D'Cunha A, Sudhir A. Overcoming the challenges in diagnosis of AQP4-IgG positive neuromyelitis optica spectrum disorders in resource poor settings using an indigenized and cost effective cell based assay. J Neuroimmunol. 2021;360:577706. doi: 10.1016/j.jneuroim.2021.577706
  • Pandit L. Fair and equitable treatment for multiple sclerosis in resource-poor regions: The need for off-label therapies and regional treatment guidelines. Mult Scler 2021; 27(9):1320-1322. doi: 10.1177/13524585211028806
  • Malli C, Pandit L, D’Cunha A, Sudhir A . Coexistence of autoantibodies and other autoimmune diseases with Multiple Sclerosis and related disorders – Experience from the Mangalore Demyelinating Disease Registry (MANDDIR). Ann Indian Acad Neurol 2021 DOI: 10.4103/aian.AIAN_170_21
  • Pandit L, Malli C, D’Cunha A, Sudhir A. Role of Viral Infections in Multiple Sclerosis pathogenesis among Indian Population. Neurol India2021;69:681-5
  • Malli C, Pandit L, D’Cunha A, Sudhir A . Coexistence of autoantibodies and other autoimmune diseases with Multiple Sclerosis and related disorders – Experience from the Mangalore Demyelinating Disease Registry (MANDDIR). Ann Indian Acad Neurol 2021 DOI:10.4103/aian.AIAN_170_21
  • Soares-dos-Reis R , Li Tsz-Ching J , Kim S H, Jacob A , Whittam D , Berthelot E , Paul F,Nakashima I , Noi Tye JS, De Seze J, Jitprapaikulsan J , Tan K , Yang L , Elsone L , IsabelLeite M , Mealy M A , Levy M , Fan M , Siebert N , Asgari N , Cabre P , Siritho S , Pittock S J, Wing-Ho SC , Senger T , Yeo T, Takai Y , Pandit L , Kim H J , Palace J , The Asian and African/Caribbean AQP4-NMOSD patient outcomes according to self-identified race and place of residence, Mult Scler Relat Disord 2021, doi: https://doi.org/10.1016/j.msard.2021.103080
  • Pandit L, Mustafa S. Epidemiology and clinical features of demyelinating disorders in India.Neurology and Clinical Neuroscience 2021: https://doi.org/10.1111/ncn3.12488
  • D’Cunha A, Pandit L, Malli C, Sudhir A. Evaluating the role of HLA DRB1 alleles and oligoclonal bands in influencing clinical course of Multiple Sclerosis– A study from the Mangalore demyelinating disease registry. Ann Indian Acad Neurol 2021:DOI:10.4103/aian.AIAN_508_20
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