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Stephanie Ling

Dr Stephanie Ling is a Clinician Scientist Fellows collaborating with industry partner Astra Zeneca (AZ). Her project will focus on better undertanding differenet types of rheumatoid arthritis in order to prescribe medication more effectively.

When did your Fellowship start and how long will it last?

My Fellowship is due to start in autumn 2025 and it will last for five years.

What were you doing prior to your Fellowship?

I am currently working as an NIHR Academic Clinical Lecturer in Rheumatology. This involves carrying out my research that aims to improve the lives of people with rheumatoid arthritis (RA), as well as working as a clinical rheumatologist.

Why did you choose this Fellowship Programme?

Ever since I was a medical student, I knew that I wanted a career in medical research so that I could directly use science to improve the lives of my patients. The integration between working in both a university and with a drug company means that my findings can be more focussed towards improving current treatments for people with RA, and even developing new ones. I have previously only worked within a university/healthcare setting, so this is an exciting step for me to take and a really big factor affecting my choice of this particular programme.

What is the aim of your research?

RA is a common autoimmune arthritis that affects around 18 million people worldwide and symptoms often begin in people of working age, so it has a significant societal impact. It is a lifelong disease that causes inflammation in the joints, causing pain, stiffness, swelling and fatigue. RA also affects other parts of the body, beyond the joints.

No one person with RA has the same symptoms as another.

We decide how active a person’s RA is by using a combination of measurements reported by both patients and their healthcare professionals. We call the combined measurements disease activity scores. We can measure inflammation in joints with images made using technology such as ultrasound and magnetic resonance imaging (MRI) scans. We can measure inflammation in the body using blood tests.

However, sometimes we cannot detect inflammation, but a person’s RA is still active because of ongoing symptoms (like pain and fatigue). When this happens, we call this discordant RA. I estimate this affects 30-45% of people with RA, based on our previous research.

There is little research on what causes discordant RA. Distinct types of discordant RA exist. Each type has different markers in the blood. If we can identify each type and understand what causes each, we can recommend which medicines will help.

I plan to find markers in the blood to identify and understand each type of discordant RA. Finding markers in the blood will help design new:

  • Medicines to help people with discordant RA with symptoms that do not improve with currently-available treatments.
  • Blood tests to identify groups of people with RA who might benefit from different types of treatment.

If I can identify the most promising medicines and blood markers, people with RA will feel better quicker. There will be less time lost to feeling unwell from their RA, and more time spent doing things important to people with RA.

What inspired you to look at this field?

I have been researching outcomes and response to treatment in people with RA since my Master’s degree in 2010-11. When I started developing this proposal, I ran a focus group of people with and carers of people with bone and joint conditions. We identified that the lack of drug treatment options for people with discordant RA was an important area for development. Focus group members were particularly keen for this aspect of research to be developed, because there is a huge unmet need to improve the lives of people with discordant RA.

I have also worked with a patient research partner for the past few years, and she explained her lived experience of persistent RA symptoms like fatigue, which can be an aspect of active discordant RA. It was really important to her that this research should be carried out.

Since the overarching aim of my research has always been to improve the lives of people with RA, I was inspired to design a research project specifically looking at people with discordant RA and what measures could be taken to improve their clinical care and control of symptoms.

Which industry partner are you working with and how will they support you in achieving your goals? What will your partner gain from working with you?

I am working with AstraZeneca, who are based at the Discovery Centre in Cambridge. You might know them from their rapid COVID-19 vaccine development programme. AstraZeneca are very much aligned with my passion to improve the lives of people with RA and are even in the process of developing promising new drugs for the treatment of RA.

AstraZeneca will support me in a number of ways:

  • Some of the datasets that I will be analysing were collected by AstraZeneca, who will be giving me access to these important collections to help advance my research.
  • AstraZeneca will give me training in cutting-edge analytical methods to add to my current skillset.
  • I will work with AstraZeneca to understand how my research findings can be used to develop new drugs and whether the drugs currently being developed by them can be used in people with discordant RA.

 

In return, AstraZeneca will learn from my findings from other studies that I have access to, including my new study where I will be recruiting current rheumatology patients in Greater Manchester. My extensive training in rheumatology and general internal medicine, as well as my experience with public and patient involvement and engagement, mean that I will be able to ask targeted research questions to help my patients and provide current NHS clinical expertise to enable my industry partner to interpret our findings.

Why did you choose the University of Manchester as your HEI partner?

I have worked at the University of Manchester since 2013, when I first joined as an NIHR Academic Clinical Fellow in Rheumatology. I completed my PhD there in 2022 (also funded by NIHR), before taking up my current post as an NIHR Academic Clinical Lecturer in Rheumatology.

My department, the Centre for Musculoskeletal Research, has an internationally-recognised track record in carrying out leading rheumatology research in diverse fields such as epidemiology, genetics, machine learning (a form of artificial intelligence analysis) and clinical trials. Staying at the Centre, with our expert researchers and both national and international collaborations, mean that I will be in the ideal setting to carry out my planned research programme.

What do you plan to do when you have completed your Fellowship?

I plan to stay in clinical research, which has always been my ultimate career goal. I want to lead my own research group as a clinical bioinformatician, focussing on data-driven identification of targets for new drug treatments and diagnostic tests, with the aim of improving the lives of people with RA.

In the future, I hope to carry out more cross-disease work, expanding my knowledge, skills and experience beyond a single disease of study. I would also like to expand my research to a life-course approach, incorporating children and young people into future studies, as this is another unmet need in research.