Professor Mohini Gray
I allocate my time between roles as an NHS consultant rheumatologist, an immunologist, a teacher, and as the lead for Equality, Diversity, and Inclusion (EDI) at the Edinburgh Medical School.
Professor Mohini Gray
Professor of Rheumatology
Address
- Street
Institute for Regeneration & Repair,
The University of Edinburgh,
Edinburgh BioQuarter
4-5 Little France Drive,
Edinburgh, EH16 4UU,
Scotland
AND
Western General Hospital
Dept of Rheumatic Diseases,
Crewe Road,
Edinburgh EH4 2XU
Group Members
- Becca Belmonte (Post-doctoral scientist)
- Catherine Sutherland - PhD student (co-supervisor)
- Elinor Wing - PhD student
My group's research is focused on understanding the pathogenesis of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). I'm currently building an interdisciplinary team of clinicians, bioinformaticians and data scientists to develop a clearer understanding of the Chronic Autoimmune Inflammatory Network (CAIN) that drives human autoimmunity.
Background
Autoimmune diseases arise from the failure of immune regulation towards self-proteins, culminating in chronic inflammation and the unwarranted destruction of healthy tissues and organs. Despite escalating to epidemic levels, these conditions persist as incurable sources of widespread suffering. Notable examples encompass rheumatic diseases like rheumatoid arthritis and SLE, as well as multiple sclerosis, type-I diabetes, inflammatory bowel disease, and psoriasis. Our research is focused on determining how B cells drive autoimmunity with the aim of forging new insights and potential therapeutic interventions.
Research Overview
I completed my PhD at Imperial College London, focusing on the biochemistry of MHC class II processing, under the guidance of Sir Mark Walport, Professor Marina Botto, and Professor Daniel Altman. As a Principal Investigator (PI), my research effectively bridges clinical medicine and fundamental immunology. Our lab strives to enhance understanding of immune processes, autoimmunity, and autoimmune disease pathogenesis, with the potential to open new therapeutic pathways and positively impact patient care.
We made pioneering discoveries about self-reactive B1a B cells' novel role in immune tolerance toward dying cells, challenging established notions. We also revealed an unconventional anti-inflammatory role for alpha defensins released from necrotic neutrophils, challenging traditional ideas that necrotic cells always act as danger signals.
We have now shifted our focus to comprehend autoimmune rheumatic disease pathogenesis, particularly systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). A significant breakthrough came when we identified a doubling of circulating class-switched double-negative 2 (DN2) B cells in newly diagnosed and untreated RA patients. These DN2 B cells, with minimal B cell receptor mutations, indicated generation outside the germinal centre response. We confirmed DN2 B cells as immediate precursors to pathogenic antibody-secreting cells (ASCs) in the inflamed synovium, the target tissue. Our ongoing research delves into the antibody specificity of DN2 B cells and the underlying dysfunction triggering rapid class switching and activation, employing single-cell sequencing and epigenomic techniques. We're also developing strategies to modulate DN2 B cell function. Grounded in human immune studies, we're also using classical immunological tools to gain mechanistic insights.
Consultant Rheumatologist:
With over two decades of service in Edinburgh, I've significantly contributed to the growth and improvement of the department, the largest in Scotland. My efforts have refined clinical services, including leadership roles in developing the transitional service for teenagers, overseeing the Connective Tissue Disease (CTD) clinic, and steering the early rheumatoid arthritis (ERA) service. Additionally, I conceived and developed EdRheum.org (https://www.edrheum.org/), a vital resource for patients seeking information and support. My dedication to patient care remains steadfast, demonstrated through ongoing practice and participation in on-call duties.
Equality, Diversity and Inclusion:
I am an active member of the University Race Equality and Anti-Racist (REAR) subcommittee, committed to addressing disparities in the student experience within our university. Acknowledging the concerning lower degree attainment rates among Black and Minority Ethnic (BaME) students compared to their white counterparts, I took the lead in assembling a team of social scientists to conduct research aimed at gaining a comprehensive understanding of the underlying causes. This effort will culminate in the development of recommendations that will contribute to the University of Edinburgh's Anti-Racism Action Plan.
Within the university, my involvement extends to the Sense of Belonging task group, where I played a role in crafting a guide aimed at nurturing a sense of belonging for all students (https://www.ed.ac.uk/files/atoms/files/belongingguide.pdf ). This aligns with the overarching strategic vision for the university as set for 2025.
In my capacity as the lead for Equality, Diversity, and Inclusion (EDI) at Edinburgh Medical School (EMS), I've effectively executed an action plan to address the BMA Race Charter by 2023 (https://www.bma.org.uk/media/6264/bma-racial-harassment-charter-review-oct-2022.pdf). Going forward, I'm embarking on a comprehensive review of EDI practices within EMS. This initiative will encompass all stages of the medical students' journey toward becoming doctors, ensuring that EDI principles are seamlessly integrated at every level.
The following PDF provides a brief visual summary of this group’s current research.
You can view a full catalogue of graphical research summaries for each group in the Centre for Inflammation Research by visiting our Research page.
Biographical Profile
- 1984-1987 BSc (Hons) First Class (Basic Medical Sciences/Immunology) University of London
- 1987-1990 MBBS University of London (King’s College Medical School) UK (Distinction in Surgery)
- 1993 MRCP (UK), Royal College of Physicians, London
- 1996-1999 PhD, Immunology, University of London, UK
- 2002 CCST (UK), Royal College of Physicians
Honours and Awards
- 2023 CMVM Staff Recognition Award
- Career Development Fellowship 2007-2009
- ARC Clinician Scientist Fellowship 2002-2007
- ARC Clinical Training Fellowship 1996-1999
Other Responsibilities
EDI Focus: I am also passionate about ensuring that Black and Minority Ethnic (BAME) staff and students are supported to reach their full potential at Edinburgh University. I am currently undertaking qualitative research into the factors that affect the BAME attainment gap within Edinburgh University. I also chair the Medical School Anti-Racism Action Group. I am the CMVM lead for BAME issues on the EDI committee as well as sitting on the University EDI-Race Subcommittee. I represent Edinburgh Medical School on the national Medical Schools Council.
I am the chair for the Board of Examiners for Year 5 of the undergraduate MBBS programme.
I have developed a website (EdRheum) to provide information and education for patients that attend the Rheumatology Unit in Lothian.
Alumni
- Jonathan Heaney (Consultant Rheumatologist)
- Victor Casanova (Postdoctoral Fellow)
- Kanchan Phadwal (Postdoctoral Fellow)
- Gareth Tomlinson (PhD student)
- Zaneta Sibinska (RA)
- Kamya Choudhury - PTAS Intern Qualitative Researcher
- Sarah Shemery- PTAS Intern Qualitative Researcher
- Jonanthan Costello - MSc student
- Katherine Miles - Research Assistant & lab manager
Collaborators
- Dr Graeme Cowan (Edinburgh University)
- Dr Thomas Otto (Glasgow University)
- Prof Carl Goodyear (Glasgow University)
- Prof Nagasuma Chandra (Department of Biochemistry, Indian Institute of Science, Bangalore - 560 012, India)
Sources of Funding
- Medical Research Council
- Wellcome Trust
- Arthritis Research UK
- Principal's Teaching Award
More information on funding at Mohini Gray's Research Explorer profile.