The CRE recently celebrated the graduation of Dr Raquel Cameron, who completed her PhD titled “Colonic Diverticular Disease and the Role of Inflammation” for the degree of Doctor of Philosophy (Anatomical Pathology) in the School of Biomedical Sciences.
Colonic diverticular disease is a commonly observed condition, yet most people with colonic diverticulosis do not realise they have diverticulae. This is because only about 4% of people with the condition develop diverticulitis and exhibit symptomatic disease.
Dr Cameron made landmark discoveries in her research – including that colonic diverticular disease may be both a mucosal and submucosal eosinophilic intestinal disease. She shares that “This observation represents a novel and clinically significant finding, as eosinophils, typically associated with allergic and immune responses, were identified in elevated numbers in the mucosa and submucosa surrounding the colonic diverticula. This challenges the traditional view of colonic diverticular disease as a non-inflammatory condition and introduces the possibility of an underappreciated immunological component in its pathogenesis.” The presence of eosinophils in the mucosa and submucosa of colonic diverticula may suggest an eosinophil-associated inflammatory response, potentially indicative of a secondary eosinophilic colitis. While eosinophilic colitis is typically a primary idiopathic condition, its occurrence in the context of colonic diverticular disease raises the possibility of a localised immune-mediated process. This finding could inform novel diagnostic criteria and therapeutic strategies targeting the immune component of colonic diverticular disease.
In 2022 Raquel hoped to “provide a potential mechanistic understanding of what occurs in the colon for people to develop diverticulosis and diverticular disease… the hope is that it will be a forward step in managing disease outcomes through understanding and potential treatment or lifestyle routes for further study.” Upon completion in 2025, the thesis has made a significant contribution toward the understanding of the link between inflammation and mortality risk in colonic diverticular disease. Her research shows that “histological evidence of inflammation in colonic diverticular disease—particularly mucosal inflammation—was identified as a strong predictor of increased mortality, particularly in the first-year post-diagnosis…Notably, even patients with colonic diverticular disease who exhibit histologically normal mucosa demonstrate a statistically significant elevation in mortality risk, albeit to a lesser extent than those with documented inflammatory changes.”
Dr Cameron initially planned to compare microbiome findings with histopathology to determine if there was a correlation. “To date, microbiome within the colonic diverticulae has not been researched.” Raquel shared in 2022. Ultimately, the thesis body of work did not establish a direct correlation between microbiome composition and histopathological inflammation. However, Raquel did identify important gaps and future directions, such as “developing better sampling methods for intra-diverticular microbiota and investigating microbial metabolites (like SCFAs) and their influence on immune cell behaviour.”
For future research, Dr Cameron said she ” would cherish the opportunity to continue advancing the thesis body of work to completion. This will involve detailed characterization of eosinophil subtypes and their underlying mechanisms, as well as the integration of histological inflammation markers to inform personalized therapeutic strategies. Furthermore, the identification of patients at elevated risk of mortality based on histopathological features may enable earlier and more targeted clinical interventions.”
The CRE would like to congratulate Dr Cameron again on her achievements and acknowledge Distinguished Laureate Professor Nick Talley and Dr Kerith Duncanson as extremely proud supervisors, and a huge contribution by the late but great Professor Marjorie Walker who would have been delighted to share this celebration with us.