He is living in Oxford and working in London, but flying in and out of Sri Lanka often – in fact, he is here at least 8-10 days every month. This is what is intriguing and when asked, 53-year-old Prof. Suranjith Seneviratne says that he is now holding a joint appointment at the Royal Free [...]

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Armed with expertise in immunology and allergy he wants to spread the word here

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He is living in Oxford and working in London, but flying in and out of Sri Lanka often – in fact, he is here at least 8-10 days every month.

Prof. Suranjith Seneviratne in Colombo. Pic by M.A. Pushpa Kumara

This is what is intriguing and when asked, 53-year-old Prof. Suranjith Seneviratne says that he is now holding a joint appointment at the Royal Free Hospital and University College London, United Kingdom (UK) and the Department of Surgery of the Faculty of Medicine, University of Colombo, which brings him back home.

He is attached to the Institute of Immunity and Transplantation, Royal Free Hospital and University College London, while being a Visiting Professor at the Colombo Medical Faculty.

“If we can arrange for someone to cover up our work at the Royal Free Hospital, then we can travel the world,” says Prof. Seneviratne who prefers to come back to his motherland, mostly with grant support to engage in research here. When he goes back to the UK, he has to do a lot of clinics, he smiles.

The main aim now, says Prof. Seneviratne, is to bring what he learned in the UK back to Sri Lanka as he is an expert in allergic/mast cell disorders, immuno-deficiency, auto-immune disorders and immuno-genetics. Prof. Seneviratne is the Director of the Centre for Mast Cell Disorders, UK and the President of the UK-Sri Lanka Immunology Foundation, which he explains is an organization that contributes to immunology, allergy and immuno-genetics education in Sri Lanka.

While numerous research papers in esteemed medical journals have his name, in recent times he has been billed to speak at many local doctor-events including the Sri Lanka Medical Association (SLMA), the Ceylon College of Physicians (CCP) and the microbiology, rheumatology and gastro sessions.

Clinical immunology and allergy are his specialities and Prof. Seneviratne explains how his research involves four strands. They are:

 

  •  Immune mechanisms in infectious diseases such as dengue and leptospirosis.
  •  Gastro-intestinal research in auto-immune conditions such as Inflammatory Bowel Disease, allergic manifestations and malignancies such as colorectal cancer.
  •  Immuno-deficiency studies.
  •  Immuno-genetic studies.

 

When asked what immunity is, Prof. Seneviratne compares immunity to the defence system of a country which will include the Army, the Navy, the Air Force and the Police. If the country is under attack, the first responders will be the Army and if the attack persists the second responders such as the other forces will join in.

“Our immune system is similar. It is the body’s defence system against infection and illness. If there is an assault by a bug, the first responders will be the innate immune system. If they can get rid of the bug, that’s wonderful. If they can’t, they need the second or main part of the immune system which then creates antibodies, proteins and cells in response to the war being waged against the outsiders. The complement system is the final component which helps both other systems function better,” he explains, drawing structures on a piece of paper for better clarity.

Going down memory lane how he got into medicine, he reminisces that cricket was an all-consuming passion when he was at St. Peter’s College, Colombo 4, where he played for the First Eleven. Studies took second place. The cricket attraction came from his Dad who was a teacher but better known as a cricket coach, “mad on cricket, whose life was all about cricket”. It was when Suranjith was about 18 years old that he decided to concentrate on his studies. “Suddenly, I was determined to try and do medicine but I was getting really low marks.”

The push towards medicine came from some childhood memories………a fascination with the work of General Practitioner (GP) Dr. Walter Jayasinghe at the Dehiwela Medical Centre to whom he had been taken for this or that at the tender age of 5.

From wielding the willow, Suranjith in his late teens changed tack to poring over his books, entering the Colombo Medical Faculty in 1985.

Leaving the portals of the hallowed Faculty of Medicine with First Class Honours, eight distinctions and 10 Gold medals and topping his batch that year, he completed his MD in Internal Medicine and trained in Clinical Immunology and Allergy at the John Radcliffe Hospital in Oxford. He also pursued a Doctor of Philosophy in Molecular Medicine at the Weatherall Institute of Molecular Medicine, University of Oxford, as a Commonwealth Scholar.

By then, he was married to Nilmini, a teacher and they made themselves a home in Oxford for their daughter Natasha, who is now 22, and son Ryan, 16.

Molecular medicine and genetics, not just as a researcher but to use as a clinician was his aim and “now when I see a patient, I always want to see how these techniques will be able to further clinical medicine and patient care. The ultimate goal is to treat patients and make them better”.

Later he took up duties at Imperial College-St. Mary’s Hospital in London around 2006, crossing over to the Royal Free and University College London (the Royal Free & University College Medical School – RFUCMS), on the other side of the city in 2011.

Prof. Seneviratne takes a look at the ground-level reality in Sri Lanka and says that as heart disease, joint disease or lung disease has been there for a long time, many doctors have specialized in these spheres. With such specializations have come the tests required to diagnose these diseases. However, when it comes to genetics and immunology and the combination of immuno-genetics, Sri Lanka has some way to go.

“Earlier, there were communicable diseases (CDs) and then non-communicable diseases (NCDs). Now we have moved to the next stage such as allergies, auto-immunity and malignancies. We had malignancies but with personalized sort of care coming in, now we are looking at malignancies in a different way,” he points out.

Underscoring that if people get heart disease, they will get the care they need which is similar to what they can expect from any part of the world because medical practitioners have trained in those fields, he says that if you have an immune or genetic problem, the care regrettably is not at the level it should be.

“This is the reason I am being invited to speak all the time, just to tell medical professionals what we are doing over there (in the UK) and how to bring certain techniques into Sri Lanka,” he says, citing the basic technology being used to measure antibodies and proteins; the number and function of cells or antibodies; and complement proteins.

When asked whether Sri Lanka does not have such facilities, Prof. Seneviratne says there is only a “limited repertoire” available here. It is through collaborations that they are getting the samples analysed. “Let me put it in a positive way – the testing and management of immuno-genetic and auto-immune conditions can be improved.”

With regard to the prevalence of immuno-genetic diseases in Sri Lanka, he says that there is an ongoing study.

Food allergies seem to be another pet subject as Prof. Seneviratne points out that they are an adverse immune response to food proteins. They have shown rapid increases in prevalence in several regions of the world, with around 8% of children and 1-2% of adults in western countries having some type of food allergy.

“Many food allergens have been characterized at a molecular level. This knowledge, combined with an increasing appreciation of the nature of the immune responses resulting in allergy or tolerance, is leading to novel therapeutic approaches,” he says, adding that recent advances in the diagnosis and management of food allergies can lead to the prevention of risk factors of severe or fatal anaphylaxis (a serious life-threatening allergic response).

Meanwhile, Prof. Seneviratne has been or is part of many research studies. About 20 are in the pipeline from the UK and about 12 from Sri Lanka currently.

He has authored 214 journal publications and has had his research published in journals such as ‘Science’, ‘Nature Medicine’, ‘Blood’, ‘American Journal of Medical Genetics’, ‘American Journal of Human Genetics’, ‘Journal of Experimental Medicine’ and ‘Journal of Allergy and Clinical Immunology’.

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