Dr Malcolm Starkey is the Laboratory Head and Senior Research Fellow, Urinary Tract Immunology & Microbiology Research Group in the Department of Immunology at the Central Clinical School at Monash University. He is also the Founding Director of the Bladder and Kidney Health Discovery Program that unites the departments of Immunology, Renal Medicine, Infectious Diseases, Sexual Health, Urology and Diabetes within Monash’s Central Clinical School, Alfred Health, and Monash Health. This discovery program provides a multidisciplinary platform to address the challenge of urinary tract infection and other debilitating urinary tract conditions.

Dr Starkey's group studies the immune system in the urinary tract, focusing on urinary tract infection and stone formation. The primary interest of his research group is how microbial challenges predispose to chronic diseases with a specific focus on mucosal cytokines and type 2 immunity, including group 2 innate lymphoid cells.

Dr Starkey completed his PhD in Immunology and Microbiology at The University of Newcastle, Australia. He then undertook post-doctoral training at the National Heart and Lung Institute, Imperial College, London, before returning to Australia as a National Health Medical Research Council (2014-17) and Australian Research Council (2018-20) fellow investigating type 2 immunity in respiratory diseases. 

Immunotherapies for urinary tract infection
Urinary tract infections are a common cause of bacterial infection, especially in females. These infections are often chronic or recurrent and can cause long-term damage to the urinary tract, especially in children. In some cases, the bacteria can ascend to the kidney and cause kidney scarring, a pivotal precursor to the development of chronic kidney disease, which predisposes to systemic health complications, including cardiovascular disease and diabetes.

Impact of traumatic brain injury on bladder immunity
Traumatic brain injury is a serious global health issue and one of the largest causes of global neurological disability. Traumatic brain injury alters the immune response in a way that renders patients more vulnerable to infections. Such infections pose an additional challenge to the patient, increasing the rates of mortality and morbidity, and worsening neurological outcomes. Urinary tract infection is common bacterial infection following traumatic brain injury. However, the impact of injury on bladder immunity remains to be elucidated.

Novel treatments for the rare kidney stone disease cystinuria
Kidney stones are a common urinary tract problem that disproportionally affects men. Stones can cause obstructions in the urinary system and are a significant risk factor for the development of chronic kidney disease. Current treatments for stones focus on removing the stones, often with multiple invasive procedures. There is a lack of understanding of why stones reoccur and why individuals with stones are at increased risk of developing chronic disease. Therefore, there is a clear need for novel approaches to prevent stone recurrence and its harmful consequences.

Predicting the risk of infection post renal transplantation for individualised treatment (PREDICT-IT)
This is an interdisciplinary project run between the Department of Immunology and the Department of Renal Medicine in collaboration with the Bladder and Kidney Health Discovery Program. We hypothesise that detailed immune profiling can predict the risk of infection and rejection following kidney transplantation.

Targeting type 2 immunity in the battle against chronic urinary tract infection
The bladder is a unique and often forgotten mucosal site. When the bladder is exposed to bacterial pathogens it sheds superficial epithelial cells to eliminate the invading bacteria. The bladder epithelium has to rapidly repair itself to maintain epithelial integrity to prevent exposure to toxins in the urine. If this repair response is insufficient it may leave the host susceptible to infection. If the repair response is exaggerated it may lead to remodelling and fibrosis of the tissue.

Understanding how group 2 innate lymphoid cells in early life regulate postnatal lung development and susceptibility to chronic respiratory diseases
The neonatal lung is constantly exposed to countless environmental challenges, including respiratory pathogens. The lung has evolved a local immune system that protects it against these challenges. However, these protective immune responses may also have unwanted deleterious effects on lung structure and function. This is particularly important in early life when the lung is still developing. This project aims to define novel immunological processes that are involved in postnatal lung development and their roles in underpinning the development of chronic respiratory diseases.

- Member of the Department of Immunology executive committee and Central Clinical School research implementation committee providing advice on the function and research vision of the department and school

- Department coordinator for the Winter/Summer Vacation Scholarship Program