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）

• 批准号: 10403339
• 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
• 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/10403339
• 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 diseases; 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; Reporting; Research; Research Personnel; Research Training; Respiratory Signs and Symptoms; Risk; Sampling; San Francisco; Scoring Method; Statistical Methods; Surveys; 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; preempt; professor; pulmonary function; respiratory health; social; trend; vaping; welfare

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.

项目摘要 /摘要 在美国，大麻产品的消费量正在增加。过去一个月的流行率 在2007年的成年人中，成年人已从5.8％增长到2019年的11.5％。这一增加的原因包括不断发展 监管环境，大麻行业的产品创新以及更大的文化趋势 允许。暴露于大麻产品对肺部健康的影响尚不完全了解，因此 大麻消费量增加的公共卫生影响无法完全理解。在最近的报告中 国家科学，工程和医学学院强调了对更多研究的关键需求 确定长期暴露于大麻会导致慢性肺部疾病。总体目标 建议是检查大麻暴露对肺部健康的影响。该建议利用 长期以来，NHLBI资助的多中心队列的成年人伴有或有艾滋病毒感染风险 - MAC/WIHS组合队列研究 - 大麻暴露的寿命流行率超过70％。 该提案的具体目的是：（1）衡量自我报告的累积暴露与 在患有或没有艾滋病毒的人中，有肺部功能的大麻； （2）测量生化的影响 对患有和没有艾滋病毒的人的肺功能变化的验证大麻暴露； （3）飞行员A 在与与众不同的人中衡量暴露于不同大麻产品的新型工具 艾滋病病毒。该提案的目标和目标符合NHLBI的战略目标，即减少人类 疾病”通过“推进预测，预防，预先待遇，治疗和 人类[肺]疾病的治疗方法。“特别是，该提议对引人入胜的问题2.CQ.03，响应敏感 “……环境暴露的哪些生物标志物可以预测疾病的发作或进展？”和批评 挑战3.CC.04，“评估和表征暴露的方法和模型的进步是 需要了解人群之间健康差异。”拟议研究的好处是 预计将广泛地占据当前和未来美国人的公共卫生和福利。这个K23奖 支持Richard Wang的指导职业发展，医学博士MAS，医学助理教授 加利福尼亚大学旧金山大学（UCSF）。王博士的长期职业目标是成为独立 临床研究人员致力于改善脆弱人群的呼吸健康，包括人 与艾滋病毒。他的短期目标是更好地了解迅速提出的呼吸健康风险 改变美国公众大麻消费的患病率和实践。这个K23奖 支持Wang博士开发专业知识：复杂观察性的因果推断的统计方法 数据;生物学样品中大麻代谢产物的生化测量；和测量 大麻与调查工具一起使用。 Wang博士从一支完善的精神团队中受益 UCSF的科学专业知识和充满活力的科学环境，用于严格的多学科研究和培训。