PhD Study : Is chronic back pain a low grade infection?

Summary

Degenerative disc disease (DDD) is one of the most common causes of chronic low back pain (CLBP), an often debilitating condition that is the leading cause of visits to the doctor and hospital admissions [1]. DDD is associated with cellular, extracellular and inflammatory changes in the intervertebral disc (IVD). Although various factors contribute to DDD, including trauma and biomechanical factors, persistant low-grade IVD infection with the anaerobic, low-virulent bacterium Cutibacterium acnes may also play an important role [2].

Evidence to support a role for C. acnes in DDD has come from observations of the organism as a biofilm in IVD tissue from patients who have undergone microdiscectomy surgery, as well as the demonstration that symptoms of CLBP can be successfully alleviated with a prolonged course of antibiotics [3,4]. While there is a growing body of evidence supporting the involvement of C. acnesin DDD, a definitive causal role will take time to prove since the bacterium comprises part of the normal human microbiota. Acceptance of C. acnes infection as a factor in DDD will require further epidemiological and clinical-trial investigations, as well as animal- and cell culture-based infection studies.

Confirmation that the bacterium is indeed a cause of DDD in a subset of patients would be very exciting and a paradigm shift in our understanding of the underlying pathophysiology of the condition, providing opportunities for new personalised medicine approaches in the treatment and management of CLBP.

Against this background, the objectives of this exciting and highly topical PhD project will be:

1. Metagenomic profiling and immunohistochemical analysis of diseased IVDs.
2. Phylogenetic and phenotypic analyses of C. acnes isolates from diseased IVDs; in particular, we will investigate biofilm formation on biotic surfaces that mimic the IVD environment.
3. Investigation of host-pathogen interactions in vitro.

AccessNI clearance required

Please note, the successful candidate will be required to obtain AccessNI clearance prior to registration due to the nature of the project.

Essential criteria

Applicants should hold, or expect to obtain, a First or Upper Second Class Honours Degree in a subject relevant to the proposed area of study.

We may also consider applications from those who hold equivalent qualifications, for example, a Lower Second Class Honours Degree plus a Master’s Degree with Distinction.

In exceptional circumstances, the University may consider a portfolio of evidence from applicants who have appropriate professional experience which is equivalent to the learning outcomes of an Honours degree in lieu of academic qualifications.

• Sound understanding of subject area as evidenced by a comprehensive research proposal
• Clearly defined research proposal detailing background, research questions, aims and methodology

Desirable Criteria

If the University receives a large number of applicants for the project, the following desirable criteria may be applied to shortlist applicants for interview.

• Completion of Masters at a level equivalent to commendation or distinction at Ulster
• Experience using research methods or other approaches relevant to the subject domain
• Sound understanding of subject area as evidenced by a comprehensive research proposal
• Work experience relevant to the proposed project
• Publications record appropriate to career stage
• Experience of presentation of research findings
• A comprehensive and articulate personal statement
• Relevant professional qualification and/or a Degree in a Health or Health related area

Funding and eligibility

The University offers the following levels of support:

Vice Chancellors Research Studentship (VCRS)

The following scholarship options are available to applicants worldwide:

• Full Award: (full-time tuition fees + £19,000 (tbc))
• Part Award: (full-time tuition fees + £9,500)
• Fees Only Award: (full-time tuition fees)

These scholarships will cover full-time PhD tuition fees for three years (subject to satisfactory academic performance) and will provide a £900 per annum research training support grant (RTSG) to help support the PhD researcher.

Applicants who already hold a doctoral degree or who have been registered on a programme of research leading to the award of a doctoral degree on a full-time basis for more than one year (or part-time equivalent) are NOT eligible to apply for an award.

Please note: you will automatically be entered into the competition for the Full Award, unless you state otherwise in your application.

Department for the Economy (DFE)

The scholarship will cover tuition fees at the Home rate and a maintenance allowance of £19,000 (tbc) per annum for three years (subject to satisfactory academic performance).

This scholarship also comes with £900 per annum for three years as a research training support grant (RTSG) allocation to help support the PhD researcher.

• Candidates with pre-settled or settled status under the EU Settlement Scheme, who also satisfy a three year residency requirement in the UK prior to the start of the course for which a Studentship is held MAY receive a Studentship covering fees and maintenance.
• Republic of Ireland (ROI) nationals who satisfy three years’ residency in the UK prior to the start of the course MAY receive a Studentship covering fees and maintenance (ROI nationals don’t need to have pre-settled or settled status under the EU Settlement Scheme to qualify).
• Other non-ROI EU applicants are ‘International’ are not eligible for this source of funding.
• Applicants who already hold a doctoral degree or who have been registered on a programme of research leading to the award of a doctoral degree on a full-time basis for more than one year (or part-time equivalent) are NOT eligible to apply for an award.

Due consideration should be given to financing your studies. Further information on cost of living