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，可导致相当高的发病率和死亡率。流行病学研究表明，COPD患者特别容易受到交通相关颗粒物的影响。迄今为止，我们对这些影响的了解主要来自于使用行政数据库和人群暴露的社区流行病学研究。流行病学观察结果表明，尚未在COPD患者中证实大人群样本中的效果，疾病机制仍不确定。以前研究空气污染对COPD患者健康影响的努力受到样本量不足、个人暴露评估不足和缺乏合适队列的限制。我们已经解决了这些局限性，并将研究交通相关的污染的影响，在300人的中度至重度慢性阻塞性肺疾病患者在VA波士顿接受临床治疗招募。我们假设，当评估超过一年时，暴露于交通相关颗粒物（通过炭黑测量）将导致COPD加重、肺功能降低、全身炎症指标增加以及全身氧化应激增加（呈剂量相关方式）。暴露将通过波士顿地区黑碳时空土地利用回归模型进行评估，并通过家庭监测进行模型验证。从本研究项目获得的信息将定义交通相关颗粒物与COPD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.