Investigating associations between environmental factors and cystic fibrosis disease progression

The Cystic Fibrosis Trust (https://www.cysticfibrosis.org.uk/) and Imperial’s MRC Doctoral Training Programme (DTP, https://www.imperial.ac.uk/mrc-dtp-studentships) are co-funding a PhD studentship on cystic fibrosis and environmental factors to be hosted at the Small Area Health Statistics Unit (SAHSU, http://www.sahsu.org/), within the MRC-PHE Centre for Environment & Health (http://www.environment-health.ac.uk/) at Imperial College London.

Project summary

The project will focus on analyses of the CF Registry data in relation to environmental factors, including air pollution, to rigorously quantify possible causative interactions, with a particular focus on respiratory disease. As for many projects conducted within SAHSU, this will require the use of detailed geographical information (i.e. address or postcode level) to enable accurate exposure assignment for all patients in order to conduct detailed small-area epidemiological analyses and estimate each patient’s individual exposure to a range of environmental factors known or suspected to influence disease progression.

This project will complement another ongoing PhD project on a similar topic, and other epidemiological studies on CF (e.g. EpiNet). It will involve conducting a systematic review and meta-analysis as well as using specific epidemiological tools for small-area studies and environmental exposure analyses, such as time-series analyses, geographical information systems (GIS) and statistical methods. The projects will be conducted in close collaboration with the UK CF Trust and the successful candidates will be encouraged to build on preliminary collaborations established in the UK and internationally.

Expected outcomes

The successful candidate will be expected to produce excellent academic research to be presented at national and international conferences, and published in peer-reviewed journals (preferentially in open-access). They will actively engage with the community of scientists and clinicians involved but also, importantly, with the Cystic Fibrosis Trust and the community of patients and their relatives, including through active participation at the Annual Meeting of the CF Trust. Translating research results into useful advice for individuals with CF will be the ultimate outcome of this project.

Background

Cystic fibrosis (CF) is a life-limiting inherited condition caused by a faulty gene that controls the movement of salt and water in and out of cells. It causes mucus to gather in the lungs and digestive system and creates a range of challenging symptoms including problems with lung function, which can drop to less than 20% of the value expected in someone with fully functioning lungs; with the digestive system, including failure of the pancreas; and chronic bacterial infections. Estimates of disease incidence are around 1 in 3,000 live births in persons of northern European descent, with Ireland having the highest incidence at 1 in 1,400 live births. Incidence varies according to race and ethnicity; only 1 in 4,000 to 10,000 Latin Americans and 1 in 15,000 to 20,000 African Americans have cystic fibrosis, with even lower incidence rates in people of Asian background. In addition, millions of asymptomatic people carry the faulty gene (2.5 million in the UK, corresponding to 1 in 25 individuals). Each week five babies are born with cystic fibrosis, and two CF patients die.

More than half of the CF population in the UK will now live past 41 – compared to a life expectancy at birth of about 80 years for normal individuals. Improved care and treatments continue to improve the survival and quality of life of CF patients. There is currently no cure for cystic fibrosis but many treatments are available to manage it, including physiotherapy, exercise, medication and nutrition. Marked variations still exist in CF health outcomes. The clinical course of CF for any individual with CF is determined by the interaction of genetic factors (including CFTR and modifier genes) and non-genetic factors. The latter include the physical environment (e.g. environmental tobacco smoke, outdoor pollution, and pathogenic microorganisms), the sociodemographic, cultural, and family context (which mediates stress, social support, and disease self-management skills), and variations in delivery and acceptance of healthcare treatments. Ongoing efforts are currently focusing on genetic factors influencing disease progression. Although a better understanding of non-genetic factors could provide a more immediate way of improving disease outcomes, this area of research is currently neglected.
Further background information can be found at: https://www.cysticfibrosis.org.uk/news/environment-and-cf

How to apply

To be considered, candidates need to submit an application form and a personal statement (maximum one page) detailing their interest for this particular project. All completed applications forms must be submitted by the application deadline to be considered. The application form should be completed and e-mailed to [Email Address Removed]. Incomplete applications will not be considered.

Eligibility

The eligibility criteria below match those of the Medical Research Council (MRC) and MRC-DTP (http://www.imperial.ac.uk/mrc-dtp-studentships/eligibility-criteria/).

Applicants are expected to hold a first class or upper second class Honours degree (or its equivalent) in an appropriate science subject from a recognised university with a strong quantitative/ computational background in biostatistics, epidemiology, data sciences, bioinformatics or mathematics and also have a Masters degree (with minimum merit pass or equivalent) or equivalent research experience by the start of their PhD.

To be eligible for fully funded PhD Studentships, applicants must meet the following residency criteria:
1) UK residency status, or
2) been ‘ordinarily resident’ in the UK for three years prior to the start of the studentship. This means you must normally have been residing in the UK (apart from temporary or occasional absences).

If neither of the residency criteria apply to you, but you are an EU resident, you may apply for a fees-only studentship. Non-EU international students will not be eligible.

Please note that your residency selections will be verified as part of the application process. For queries regarding your eligibility, please contact Liz Hayes ([Email Address Removed]).