Case-Control Study of Methamphetamine in Pulmonary Arterial Hypertension

本申请的长期目标是建立以下疾病之间的流行病学关联： 甲基苯丙胺使用和肺动脉高压。甲基安非他明和其他兴奋剂滥用 在美国和全世界都在增加，并伴有几种已知的并发症。肺 动脉高血压被怀疑是后遗症，然而这从未在临床上进行过研究。 严格的多中心流行病学研究。初步研究结果表明，羧酸酯酶1（CES 1） 可能是一个重要的遗传修饰剂在设置甲基苯丙胺使用导致肺动脉 高血压具体目的是：1）确定甲基苯丙胺的使用是否与PAH相关， 病例对照研究，以及这种关联是否被CES 1中的遗传变异（或活性）修饰; 2） 确定甲基苯丙胺相关性肺结核患者临床恶化的风险因素 动脉高压与特发性肺动脉高压的前瞻性队列研究 研究;和3）了解CES 1活性的降低是否会导致人肺内皮细胞损伤， 甲基苯丙胺相关性肺动脉高压以患者为导向的研究将是 在一个多中心研究小组中进行，以解决这些流行病学问题。

The long-term objectives of this application are to establish the epidemiological association between methamphetamine use and pulmonary arterial hypertension. Methamphetamine and other stimulant abuse have been increasing across the United States and the world with several known complications. Pulmonary arterial hypertension has been suspected to occur as a sequela, however this has never been studied in a rigorous multicenter epidemiologic study. Preliminary findings have suggested that carboxylesterase 1 (CES1) may be an important genetic modifier in the setting of methamphetamine use leading to pulmonary arterial hypertension. The Specific Aims are 1) to determine whether methamphetamine use is associated with PAH in a case-control study and whether this association is modified by genetic variants in (or activity of) CES1; 2) to determine the risk factors for clinical worsening in patients with methamphetamine-associated pulmonary arterial hypertension in comparison with idiopathic pulmonary arterial hypertension in a prospective cohort study; and 3) to understand if reductions in CES1 activity result in human pulmonary endothelial cell damage in methamphetamine-associated pulmonary arterial hypertension. Patient-oriented research studies will be conducted in a multicenter study group to address these epidemiologic questions.