COPD and Response to Traffic Related Particles

描述（由申请人提供）：慢性阻塞性肺疾病（COPD）是一种常见疾病，导致相当高的发病率和死亡率。流行病学研究表明，慢性阻塞性肺病患者特别容易受到与交通有关的颗粒物的影响。迄今为止，我们关于这些影响的知识主要来自基于社区的流行病学研究，使用行政数据库和人口暴露。流行病学观察表明，在COPD患者中尚未证实在大人群样本中有效果，疾病机制仍不确定。以往研究空气污染对慢性阻塞性肺病患者健康影响的努力受到样本量不足、个人暴露评估不足以及缺乏合适队列的限制。我们已经解决了这些局限性，并将研究交通相关污染对300名中重度COPD患者的影响，这些患者从VA Boston接受临床治疗的患者中招募。我们假设，在一年多的评估中，暴露于交通相关的黑碳颗粒会导致COPD加重，肺功能下降，全身性炎症增加，并以剂量相关的方式增加全身性氧化应激。通过波士顿地区黑碳时空土地利用回归模型评估暴露，并通过家庭监测验证模型。本研究项目获得的信息将定义交通相关颗粒与慢性阻塞性肺病患者对空气污染的临床、肺部和全身反应之间的暴露反应关系。

DESCRIPTION (provided by applicant): Chronic obstructive pulmonary disease (COPD) is a common disease that results in considerable morbidity and mortality. Epidemiological studies indicate that persons with COPD are particularly susceptible to the effects of traffic related particles. To date, our knowledge regarding these effects is mostly derived from community-based epidemiologic studies using administrative databases and population exposures. Epidemiological observations indicating effects in large population samples have not yet been demonstrated in patients with COPD and the mechanisms of disease remain uncertain. Previous efforts to study the health effects of air pollution in patients with COPD have been limited by inadequate sample size, an inadequate assessment of personal exposure, and lack of a suitable cohort. We have addressed these limitations and will study the effects of traffic-related pollution in 300 persons with moderate to severe COPD recruited from patients receiving clinical care at VA Boston. We hypothesize that when assessed over one year, exposure to traffic-related particles as measured by black carbon will result in exacerbations of COPD, a reduction in pulmonary function, an increase in measures of systemic inflammation, and an increase in systemic oxidative stress in a dose-related manner. Exposure will be assessed by a Boston-area black carbon spatio-temporal land use regression model with model validation by in-home monitoring The information obtained from this research project will define the exposure response relationships between traffic-related particles and the clinical, pulmonary, and systemic responses to air pollution in patients with COPD. PUBLIC HEALTH RELEVANCE: COPD is a common disease that results in considerable morbidity and mortality. Epidemiologic studies have identified these patients as a group susceptible to the adverse effects of traffic related air pollution. We will examine the dose response relationship between traffic related air pollution exposures with exacerbations, change in pulmonary function, and systemic response in patients with COPD.