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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.

项目总结/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比例从2007年的5.8%上升到2019年的11.5%。这种增长的原因包括不断发展的监管环境、大麻业的产品创新以及大麻生产的文化趋势，宽容暴露于大麻产品对肺部健康的影响尚未完全了解，因此，大麻消费量增加对公共卫生的影响无法得到充分认识。在最近的一份报告中美国国家科学、工程和医学院强调，迫切需要进行更多的研究，确定长期接触大麻是否会导致慢性肺病。本报告的总体目标该提案旨在研究大麻暴露对肺部健康的影响。该提案利用了长期以来，NHLBI资助的多中心队列的成年人生活或艾滋病毒感染的风险， MACS/WIHS联合队列研究-大麻暴露的终生患病率超过70%。该提案的具体目标是：（1）测量自我报告的累积暴露与大麻与肺功能的人生活或没有艾滋病毒;（2）测量生物化学的影响- 经核实的大麻暴露对艾滋病毒感染者和非艾滋病毒感染者肺功能变化的影响;以及（3）试点用于测量有和没有大麻的人接触不同大麻产品的新仪器艾滋病。该提案的目标和宗旨符合NHLBI的战略目标，即“减少人类死亡”。疾病”通过“临床研究，推进预测，预防，先发制人，治疗，治人之病”。特别是，本提案对强制性问题2.CQ.03做出了回应， “环境暴露的哪些生物标志物可预测疾病的发作或进展？”和关键挑战3.CC.04，“评估和描述暴露的方法和模型的进展，需要了解不同人群的健康差异。”拟议研究的好处是预计将对当前和未来美国人的公共健康和福利产生广泛影响。K23奖项支持理查德王，医学博士MAS，医学助理教授在指导职业发展加州旧金山弗朗西斯科大学（UCSF）。王博士的长期职业目标是成为一名独立的临床研究人员专注于改善弱势群体的呼吸系统健康，包括感染了艾滋病毒他的短期目标是更好地了解快速呼吸道疾病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程度和做法。K23奖项支持王博士发展以下方面的专业知识：从复杂的观察数据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物化学测量;以及使用调查工具。王博士受益于一个优秀的指导团队，科学专业知识和UCSF充满活力的科学环境，进行严格的多学科研究和培训。