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The Changing Epidemiology of Lung Health: Opportunities for Research on Cannabis and HIV Disease (The ORCHID Study)

肺部健康流行病学的变化：大麻和艾滋病毒研究的机会（ORCHID 研究）

基本信息

批准号：
10650755
负责人：
Richard Jin-yuan Wang
金额：
$ 20.12万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-07-01 至 2027-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10650755
关键词：
Acute Address Adult Affect American Area Biochemical Biological Biological Markers California Cannabis Chronic Chronic lung disease Cohort Studies Complex Consequences of HIV Consumption Data Data Reporting Disease Disease Progression Engineering Environment Environmental Exposure Epidemiology Exposure to Funding Future Goals HIV HIV Infections Health High Prevalence Human Immune Impairment Industry Interdisciplinary Study Link Long-Term Effects Longitudinal cohort Lung Marijuana Smoking Measurement Measures Medical Marijuana Medicine Mentored Patient-Oriented Research Career Development Award Mentors Methods Modeling National Heart, Lung, and Blood Institute Oils Onset of illness Outcome Participant Patient Self-Report Persons Population Prevalence Prevention Public Health Recreation Reporting Research Research Personnel Respiratory Signs and Symptoms Risk Sampling San Francisco Scoring Method Statistical Methods Surveys Training United States United States National Academy of Sciences Universities Urine Vulnerable Populations Waxes career career development cigarette smoking clinical investigation clinical research site cohort evidence base exposure to cigarette smoke health difference human disease improved injured airway innovation insight instrument lung health marijuana legalization marijuana use marijuana user novel permissiveness professor pulmonary function respiratory health social trend vaping welfare

项目摘要

Project Summary / Abstract Consumption of cannabis products is increasing in the United States. The prevalence of past month use among adults has grown from 5.8% in 2007 to 11.5% in 2019. Causes of this increase include an evolving regulatory environment, product innovations by the cannabis industry, and cultural trends towards greater permissiveness. The effect of exposure to cannabis products on lung health are not fully understood, so the public health impact of increased cannabis consumption cannot be fully appreciated. In a recent report, the National Academy of Science, Engineering, and Medicine highlighted the critical need for more research to determine whether long term exposure to cannabis leads to chronic lung disease. The overall objective of this proposal is to examine the effects of cannabis exposure on lung health. This proposal leverages a longstanding, NHLBI-funded multi-center cohort of adults living with or at risk for HIV infection—the MACS/WIHS Combined Cohort Study—in which the lifetime prevalence of cannabis exposure exceeds 70%. The specific aims of the proposal are to: (1) measure the association of self-reported cumulative exposure to cannabis with lung function in persons living with or without HIV; (2) measure the effect of biochemically- verified cannabis exposure on the change in lung function in persons living with and without HIV; and (3) pilot a novel instrument for measuring exposure to different cannabis products among persons living with and without HIV. The objective and aims of this proposal are in line with the NHLBI’s Strategic Goal to “reduce human disease” through “clinical investigations that advance the prediction, prevention, preemption, treatment, and cures of human [lung] diseases.” In particular, this proposal is responsive to Compelling Question 2.CQ.03, “What biomarkers of… environmental exposure are predictive of disease onset or progression?” and Critical Challenge 3.CC.04, “Advances in methods and models for assessing and characterizing exposures are needed to understand differences in health among populations.” The benefits of the proposed research are expected to accrue broadly to the public health and welfare of current and future Americans. This K23 award supports mentored career development for Richard Wang, MD MAS, Assistant Professor of Medicine at the University of California San Francisco (UCSF). Dr. Wang’s long-term career goal is to become an independent clinician investigator focused on improving the respiratory health of vulnerable populations, including persons with HIV. His short-term goal is to better understand the risks to respiratory health posed by the rapidly changing prevalence and practices of cannabis consumption among the American public. This K23 award supports Dr. Wang to develop expertise in: statistical methods for causal inference from complex observational data; the biochemical measurement of cannabis metabolites in biological samples; and the measurement of cannabis use with survey instruments. Dr. Wang benefits from a superb mentoring team with complementary scientific expertise and a vibrant scientific milieu at UCSF for rigorous multi-disciplinary research and training.

项目概要/摘要美国大麻产品的消费量正在增加。过去一个月的使用率成年人的死亡率从 2007 年的 5.8% 增长到 2019 年的 11.5%。这种增长的原因包括不断变化的监管环境、大麻行业的产品创新以及更广泛的文化趋势宽容。接触大麻产品对肺部健康的影响尚不完全清楚，因此大麻消费增加对公共健康的影响尚未得到充分认识。在最近的一份报告中，美国国家科学、工程和医学院强调迫切需要进行更多研究确定长期接触大麻是否会导致慢性肺部疾病。本次活动的总体目标提案旨在研究大麻暴露对肺部健康的影响。该提案利用了由 NHLBI 资助的长期、多中心的艾滋病毒感染者或有感染风险的成年人队列—— MACS/WIHS 联合队列研究——终生接触大麻的患病率超过 70%。该提案的具体目标是：（1）衡量自我报告的累积暴露与大麻对感染或未感染艾滋病毒的人具有肺功能； (2) 测量生化效果- 核实大麻暴露对艾滋病毒感染者和未感染者肺功能变化的影响； (3) 试点用于测量吸食和不吸食大麻的人接触不同大麻产品的新型仪器艾滋病病毒。该提案的目的和宗旨与 NHLBI 的战略目标“减少人力通过“临床研究推进预测、预防、抢占、治疗和预防疾病” 治愈人类[肺部]疾病。”特别是，该提案是对引人注目的问题 2.CQ.03 的回应， “环境暴露的哪些生物标志物可以预测疾病的发作或进展？”和关键挑战 3.CC.04，“评估和表征暴露的方法和模型的进步需要了解人群之间健康状况的差异。”拟议研究的好处是预计将广泛促进当前和未来美国人的公共健康和福利。此次K23奖支持理查德·王 (Richard Wang) 的职业发展，他是医学博士、医学博士、医学助理教授加州大学旧金山分校 (UCSF)。王博士的长期职业目标是成为一名独立的临床研究者专注于改善弱势群体的呼吸健康，包括个人患有艾滋病毒。他的短期目标是更好地了解快速传播的病毒对呼吸系统健康造成的风险。改变美国公众大麻消费的流行率和做法。此次K23奖支持王博士发展以下方面的专业知识：从复杂的观察中进行因果推断的统计方法数据;生物样品中大麻代谢物的生化测量；和测量大麻与调查仪器的使用。王博士受益于优秀的导师团队，互补性强加州大学旧金山分校拥有科学专业知识和充满活力的科学环境，可进行严格的多学科研究和培训。