Professor Alasdair Coles

Alasdair Coles

University position


Professor Alasdair Coles is pleased to consider applications from prospective PhD students.


Department of Clinical Neurosciences


Neurology Unit


Home page (personal home page)

Research Theme

Clinical and Veterinary Neuroscience


We study people with immunological illnesses of the brain, especially multiple sclerosis.

Our most important work to date has been on alemtuzumab (Campath-1H), a humanised monoclonal antibody made originally in Cambridge. We started using it to treat multiple sclerosis in1991. In September 2013, alemtuzumab received its European license and in 2014 it was approved by the FDA and by NICE.

The principal adverse effect of alemtuzumab is autoimmunity, which arises when reconstitution of the immune repertoire after alemtuzumab occurs by homeostatic expansion of residual lymphocytes. Therefore we are now testing the ability of keratinocyte growth factor to promote thymic lymphopoiesis and so prevent autoimmunity after alemtuzumab, in a MRC-funded clinical trial.

We are also doing a trial of a potential remyelinating therapy in multiple sclerosis, and doing a pilot study of immunotherapy in people with psychosis associated with anti-neuronal antibodies.

The 3 year result of a trial comparing alemtuzumab (Campath-1H) and interferon in the treatment of multiple sclerosis
The 3 year result of a trial comparing alemtuzumab (Campath-1H) and interferon in the treatment of multiple sclerosis
Click image to view full-size

Research Focus


Multiple sclerosis

monoclonal antibodies




Clinical conditions

Multiple sclerosis


Cell culture

Randomised control trials



Roger Barker

Alastair Compston

Robin Franklin

Steve Sawcer

United Kingdom

Geoff Hale Web:

David Miller Web:

Herman Waldmann Web:

Associated News Items

Key publications

Jones JL, Thompson SA, Loh P, Davies JL, Tuohy OC, Curry AJ, Azzopardi L, Hill-Cawthorne G, Fahey MT, Compston A, Coles AJ (2013), “Human autoimmunity after lymphocyte depletion is caused by homeostatic T-cell proliferation.” Proc Natl Acad Sci U S A 110(50):20200-5 Details

McCarthy CL, Tuohy O, Compston DA, Kumararatne DS, Coles AJ, Jones JL (2013), “Immune competence after alemtuzumab treatment of multiple sclerosis.” Neurology 81(10):872-6 PDF Details

Cohen JA, Coles AJ, Arnold DL, Confavreux C, Fox EJ, Hartung HP, Havrdova E, Selmaj KW, Weiner HL, Fisher E, Brinar VV, Giovannoni G, Stojanovic M, Ertik BI, Lake SL, Margolin DH, Panzara MA, Compston DA, CARE-MS I investigators (2012), “Alemtuzumab versus interferon beta 1a as first-line treatment for patients with relapsing-remitting multiple sclerosis: a randomised controlled phase 3 trial.” Lancet 380(9856):1819-28 PDF Details

Coles AJ, Twyman CL, Arnold DL, Cohen JA, Confavreux C, Fox EJ, Hartung HP, Havrdova E, Selmaj KW, Weiner HL, Miller T, Fisher E, Sandbrink R, Lake SL, Margolin DH, Oyuela P, Panzara MA, Compston DA, CARE-MS II investigators (2012), “Alemtuzumab for patients with relapsing multiple sclerosis after disease-modifying therapy: a randomised controlled phase 3 trial.” Lancet 380(9856):1829-39 PDF Details

Jones JL, Anderson JM, Phuah CL, Fox EJ, Selmaj K, Margolin D, Lake SL, Palmer J, Thompson SJ, Wilkins A, Webber DJ, Compston DA, Coles AJ (2010), “Improvement in disability after alemtuzumab treatment of multiple sclerosis is associated with neuroprotective autoimmunity.” Brain 133(Pt 8):2232-47 PDF Details

Somerfield J, Hill-Cawthorne GA, Lin A, Zandi MS, McCarthy C, Jones JL, Willcox M, Shaw D, Thompson SA, Compston AS, Hale G, Waldmann H, Coles AJ (2010), “A novel strategy to reduce the immunogenicity of biological therapies.” J Immunol 185(1):763-8 PDF Details

Thompson SA, Jones JL, Cox AL, Compston DA, Coles AJ (2010), “B-cell reconstitution and BAFF after alemtuzumab (Campath-1H) treatment of multiple sclerosis.” J Clin Immunol 30(1):99-105 Details

Jones JL, Phuah CL, Cox AL, Thompson SA, Ban M, Shawcross J, Walton A, Sawcer SJ, Compston A, Coles AJ (2009), “IL-21 drives secondary autoimmunity in patients with multiple sclerosis, following therapeutic lymphocyte depletion with alemtuzumab (Campath-1H).” J Clin Invest 119(7):2052-61 PDF Details

CAMMS223 Trial Investigators, Coles AJ, Compston DA, Selmaj KW, Lake SL, Moran S, Margolin DH, Norris K, Tandon PK (2008), “Alemtuzumab vs. Interferon beta-1a in early multiple sclerosis.” N Engl J Med 359(17):1786-801 PDF Details

Compston DAS, Coles AJ (2008), “Multiple Sclerosis” Lancet 372: 1502-1517

Coles AJ, Cox A, Le Page E, Jones J, Trip SA, Deans J, Seaman S, Miller DH, Hale G, Waldmann H, Compston DA (2006), “The window of therapeutic opportunity in multiple sclerosis: evidence from monoclonal antibody therapy.” J Neurol 253(1):98-108 Details

Coles AJ, Thompson S, Cox AL, Curran S, Gurnell EM, Chatterjee VK (2005), “Dehydroepiandrosterone replacement in patients with Addison's disease has a bimodal effect on regulatory (CD4+CD25hi and CD4+FoxP3+) T cells” Eur J Immunol 35(12):3694-703 Details

Cox AL, Thompson SA, Jones JL, Robertson VH, Hale G, Waldmann H, Compston DA, Coles AJ (2005), “Lymphocyte homeostasis following therapeutic lymphocyte depletion in multiple sclerosis” Eur J Immunol 35(11):3332-42 Details

Coles AJ, Wing M, Smith S, Coraddu F, Greer S, Taylor C, Weetman A, Hale G, Chatterjee VK, Waldmann H, Compston A (1999), “Pulsed monoclonal antibody treatment and autoimmune thyroid disease in multiple sclerosis.” Lancet 354(9191):1691-5 Details

Coles AJ, Wing MG, Molyneux P, Paolillo A, Davie CM, Hale G, Miller D, Waldmann H, Compston A (1999), “Monoclonal antibody treatment exposes three mechanisms underlying the clinical course of multiple sclerosis.” Ann Neurol 46(3):296-304 Details



Azzopardi L, Thompson SA, Harding KE, Cossburn M, Robertson N, Compston A, Coles AJ, Jones JL (2014), “Predicting autoimmunity after alemtuzumab treatment of multiple sclerosis.” J Neurol Neurosurg Psychiatry 85(7):795-8 Details

Brown JW, Martin PJ, Thorpe JW, Michell AW, Coles AJ, Cox AL, Vincent A, Zandi MS (2014), “Long-term remission with rituximab in refractory leucine-rich glioma inactivated 1 antibody encephalitis.” J Neuroimmunol 271(1-2):66-8 Details

Coles AJ, Compston A, 70 signatories (2014), “Product licences for alemtuzumab and multiple sclerosis.” Lancet 383(9920):867-8 Details

Jones JL, Coles AJ (2014), “Mode of action and clinical studies with alemtuzumab.” Exp Neurol Details


Abrahamsson SV, Angelini DF, Dubinsky AN, Morel E, Oh U, Jones JL, Carassiti D, Reynolds R, Salvetti M, Calabresi PA, Coles AJ, Battistini L, Martin R, Burt RK, Muraro PA (2013), “Non-myeloablative autologous haematopoietic stem cell transplantation expands regulatory cells and depletes IL-17 producing mucosal-associated invariant T cells in multiple sclerosis.” Brain 136(Pt 9):2888-903 Details

Brown J, Coles A, Jones J (2013), “First use of alemtuzumab in Balo's concentric sclerosis: a case report.” Mult Scler Details

Brown JW, Coles AJ (2013), “Alemtuzumab: evidence for its potential in relapsing-remitting multiple sclerosis.” Drug Des Devel Ther 7:131-8 Details

Coles AJ (2013), “Alemtuzumab treatment of multiple sclerosis.” Semin Neurol 33(1):66-73 Details

Coles AJ (2013), “Alemtuzumab therapy for multiple sclerosis.” Neurotherapeutics 10(1):29-33 Details

Kousin-Ezewu O, Coles A (2013), “Alemtuzumab in multiple sclerosis: latest evidence and clinical prospects.” Ther Adv Chronic Dis 4(3):97-103 Details

Williams T, Coles A, Azzopardi L (2013), “The outlook for alemtuzumab in multiple sclerosis.” BioDrugs 27(3):181-9 Details


Button T, Altmann D, Tozer D, Dalton C, Hunter K, Compston A, Coles A, Miller D (2012), “Magnetization transfer imaging in multiple sclerosis treated with alemtuzumab.” Mult Scler Details

Coles A (2012), “We are about to cure MS in the next 10 years, even though we do not know its cause: no.” Mult Scler 18(6):784-5 Details

Coles AJ, Fox E, Vladic A, Gazda SK, Brinar V, Selmaj KW, Skoromets A, Stolyarov I, Bass A, Sullivan H, Margolin DH, Lake SL, Moran S, Palmer J, Smith MS, Compston DA (2012), “Alemtuzumab more effective than interferon β-1a at 5-year follow-up of CAMMS223 Clinical Trial.” Neurology 78(14):1069-78 Details

Costelloe L, Jones J, Coles A (2012), “Secondary autoimmune diseases following alemtuzumab therapy for multiple sclerosis.” Expert Rev Neurother 12(3):335-41 Details

Hill-Cawthorne GA, Button T, Tuohy O, Jones JL, May K, Somerfield J, Green A, Giovannoni G, Compston DA, Fahey MT, Coles AJ (2012), “Long term lymphocyte reconstitution after alemtuzumab treatment of multiple sclerosis.” J Neurol Neurosurg Psychiatry 83(3):298-304 Details

Lennox BR, Coles AJ, Vincent A (2012), “Antibody-mediated encephalitis: a treatable cause of schizophrenia.” Br J Psychiatry 200:92-4 Details

Rieckmann P, Boyko A, Centonze D, Coles A, Elovaara I, Havrdová E, Hommes O, Lelorier J, Morrow SA, Oreja-Guevara C, Rijke N, Schippling S (2012), “Future MS care: a consensus statement of the MS in the 21st Century Steering Group.” J Neurol Details


Coles AJ, Fox E, Vladic A, Gazda SK, Brinar V, Selmaj KW, Bass AD, Wynn DR, Margolin DH, Lake SL, Moran S, Palmer J, Smith MS, Compston DA (2011), “Alemtuzumab versus interferon beta-1a in early relapsing-remitting multiple sclerosis: post-hoc and subset analyses of clinical efficacy outcomes.” Lancet Neurol 10(4):338-48 Details

Cossburn M, Pace AA, Jones J, Ali R, Ingram G, Baker K, Hirst C, Zajicek J, Scolding N, Boggild M, Pickersgill T, Ben-Shlomo Y, Coles A, Robertson NP (2011), “Autoimmune disease after alemtuzumab treatment for multiple sclerosis in a multicenter cohort.” Neurology 77(6):573-9 Details

Cuker A, Coles AJ, Sullivan H, Fox E, Goldberg M, Oyuela P, Purvis A, Beardsley DS, Margolin DH (2011), “A distinctive form of immune thrombocytopenia in a phase 2 study of alemtuzumab for the treatment of relapsing-remitting multiple sclerosis.” Blood 118(24):6299-305 Details

Jones JL, Dean AF, Antoun N, Scoffings DJ, Burnet NG, Coles AJ (2011), “'Radiologically compatible CLIPPERS' may conceal a number of pathologies.” Brain 134(Pt 8):e187 Details

Laguna Goya R, Busch R, Mathur R, Coles AJ, Barker RA (2011), “Human fetal neural precursor cells can up-regulate MHC class I and class II expression and elicit CD4 and CD8 T cell proliferation.” Neurobiol Dis 41(2):407-14 Details

Shah AJ, Breen DP, Thomas D, Cross J, Coles A, Molyneux P (2011), “An evolving case of headaches and strokes.” Pract Neurol 11(2):113-7 Details


Jones JL, Coles AJ (2010), “New treatment strategies in multiple sclerosis.” Exp Neurol 225(1):34-9 Details

Marsh EA, Hirst CL, Llewelyn JG, Cossburn MD, Reilly MM, Krishnan A, Doran M, Ryan AM, Coles AJ, Jones JL, Robertson NP (2010), “Alemtuzumab in the treatment of IVIG-dependent chronic inflammatory demyelinating polyneuropathy.” J Neurol Details

Schoenmakers E, Agostini M, Mitchell C, Schoenmakers N, Papp L, Rajanayagam O, Padidela R, Ceron-Gutierrez L, Doffinger R, Prevosto C, Luan J, Montano S, Lu J, Castanet M, Clemons N, Groeneveld M, Castets P, Karbaschi M, Aitken S, Dixon A, Williams J, Campi I, Blount M, Burton H, Muntoni F, O'Donovan D, Dean A, Warren A, Brierley C, Baguley D, Guicheney P, Fitzgerald R, Coles A, Gaston H, Todd P, Holmgren A, Khanna KK, Cooke M, Semple R, Halsall D, Wareham N, Schwabe J, Grasso L, Beck-Peccoz P, Ogunko A, Dattani M, Gurnell M, Chatterjee K (2010), “Mutations in the selenocysteine insertion sequence-binding protein 2 gene lead to a multisystem selenoprotein deficiency disorder in humans.” J Clin Invest 120(12):4220-35 Details

Zandi MS, Irani SR, Lang B, Waters P, Jones PB, McKenna P, Coles AJ, Vincent A, Lennox BR (2010), “Disease-relevant autoantibodies in first episode schizophrenia.” J Neurol Details


Coles A (2009), “Trials of diminishing relapses for diminishing returns.” Lancet Neurol 8(10):870-1 Details

Coles A (2009), “Multiple sclerosis.” Pract Neurol 9(2):118-26 Details

Jones J, Coles A (2009), “Spotlight on alemtuzumab.” Int MS J 16(3):77-81 Details


Compston A, Coles A (2008), “Multiple sclerosis.” Lancet 372(9648):1502-17 Details

Jones JL, Coles AJ (2008), “Campath-1H treatment of multiple sclerosis.” Neurodegener Dis 5(1):27-31 Details


Coles A (2007), “The fragile benefit of BENEFIT.” Lancet Neurol 6(9):753-4 Details

Coles, A. and Compston, A (2007), “Antibody Therapy of Multiple Sclerosis” in Waldmann, H. (ed.), Monoclonal Antibodies as Therapeutic Agents: Fundamentals, Therapeutic Applications and Latest Advances, The Biomedical & Life Sciences Collection, Henry Stewart Talks Ltd, London

Simpson BS, Coles AJ (2007), “Rationale for cytotoxic monoclonal antibodies in MS.” Int MS J 14(2):48-56 Details

Zandi MS, Coles AJ (2007), “Notes on the kidney and its diseases for the neurologist.” J Neurol Neurosurg Psychiatry 78(5):444-9 Details


Coles A (2006), “The curious incident of disability in multiple sclerosis trials.” Lancet Neurol 5(11):899-900 Details

Cox AL, Coles AJ, Nortje J, Bradley PG, Chatfield DA, Thompson SJ, Menon DK (2006), “An investigation of auto-reactivity after head injury.” J Neuroimmunol 174(1-2):180-6 Details


Coles A, Dick D (2004), “Unilateral calf hypertrophy.” J Neurol Neurosurg Psychiatry 75(11):1606 Details

Harkness KA, Coles A, Pohl U, Xuereb JH, Baron JC, Lennox GG (2004), “Rapidly reversible dementia in cerebral amyloid inflammatory vasculopathy.” Eur J Neurol 11(1):59-62 Details


Coles A, Mukherjee M, Compston A (2003), “Case reports in The Lancet.” Lancet 361(9364):1230 Details

Golde S, Coles A, Lindquist JA, Compston A (2003), “Decreased iNOS synthesis mediates dexamethasone-induced protection of neurons from inflammatory injury in vitro.” Eur J Neurosci 18(9):2527-37 Details


Coles AJ (2002), “Neutralising antibodies to the beta interferons.” J Neurol Neurosurg Psychiatry 73(2):110-1 Details


Broadley SA, Sawcer SJ, Chataway SJ, Coraddu F, Coles A, Gray J, Roxburgh R, Clayton D, Compston DA (2001), “No association between multiple sclerosis and the Notch3 gene responsible for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL).” J Neurol Neurosurg Psychiatry 71(1):97-9 Details

Coles A, Barker R (2001), “A case of stiff limb syndrome responsive to plasma exchange.” J Neurol Neurosurg Psychiatry 70(3):407-8 Details

Coles A, Deans J, Compston A (2001), “Multiple sclerosis treatment trial precipitates divorce.” J Neurol Neurosurg Psychiatry 70(1):135 Details


Coles A (2000), “Neurologic complications in organ transplant recipients” J Neurol Neurosurg Psychiatry 68(1):123C Details


Coles A (1999), “Hospitalist neurology. Blue books of practical neurology” J Neurol Neurosurg Psychiatry 67(5):699F Details

Coles A (1999), “Systemic diseases, part II” J Neurol Neurosurg Psychiatry 67(5):699D Details

Paolillo A, Coles AJ, Molyneux PD, Gawne-Cain M, MacManus D, Barker GJ, Compston DA, Miller DH (1999), “Quantitative MRI in patients with secondary progressive MS treated with monoclonal antibody Campath 1H.” Neurology 53(4):751-7 Details


Coles AJ, Wing MG, Compston DA (1998), “Disease activity and the immune set in multiple sclerosis: blood markers for immunotherapy.” Mult Scler 4(3):232-8 Details

Gawne-Cain ML, O'Riordan JI, Coles A, Newell B, Thompson AJ, Miller DH (1998), “MRI lesion volume measurement in multiple sclerosis and its correlation with disability: a comparison of fast fluid attenuated inversion recovery (fFLAIR) and spin echo sequences.” J Neurol Neurosurg Psychiatry 64(2):197-203 Details

Tubridy N, Coles AJ, Molyneux P, Compston DA, Barkhof F, Thompson AJ, McDonald WI, Miller DH (1998), “Secondary progressive multiple sclerosis: the relationship between short-term MRI activity and clinical features.” Brain 121 ( Pt 2):225-31 Details


Moreau T, Coles A, Wing M, Isaacs J, Hale G, Waldmann H, Compston A (1996), “Transient increase in symptoms associated with cytokine release in patients with multiple sclerosis.” Brain 119 ( Pt 1):225-37 Details

Moreau T, Coles A, Wing M, Thorpe J, Miller D, Moseley I, Issacs J, Hale G, Clayton D, Scolding N, Waldmann H, Compston A (1996), “CAMPATH-IH in multiple sclerosis.” Mult Scler 1(6):357-65 Details