EFFECT OF CHRON MACROLIDE ADMIN ON FREQUENCY & SEVERITY OF COPD EXACERBATIONS

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 慢性阻塞性肺疾病(简称COPD)是一种影响许多吸烟者的肺部疾病。在这种慢性疾病的过程中，一些患者会出现一种或多种慢性阻塞性肺疾病“恶化”(即肺部症状的暂时恶化，可能需要住院治疗，并可能危及生命)。目前，慢性阻塞性肺病在美国影响着1240万至2400万人，是第四大死因。在世界范围内，慢性阻塞性肺病是第六大主要死因，也是前十大死因中唯一一种新诊断和死亡率增加的疾病。因此，重要的是找到一种治疗方法，可以防止COPD的恶化，减少发作的严重性，并降低这种疾病影响的患者的死亡率。 该项目实现了美国公共卫生服务报告《2010年健康人群：到2010年将慢性阻塞性肺病死亡人数从每1000人119人减少到每1000人60人》(目标24-10)。如果我们提出的干预措施降低了COPD的恶化速度或严重程度，则有望降低这些患者的死亡率。 这项研究分为三个不同的方案，大环内酯(亲本)方案、生物标记物和遗传子研究。所有研究方案都已合并到一份同意文件中。如果受试者决定不参与遗传子研究，他们将有机会继续参与大环内酯类和生物标记物研究。 大环内酯类(父母)协议的具体目的是确定在这些患者的日常护理之外，使用大环内酯类抗生素(特别是阿奇霉素)一年是否会降低COPD恶化的比率和严重程度。 Biomarker子研究：具体目标是确定血液中的某些生物标记物(化学物质)如何与呼吸状况相关。 遗传学亚研究：遗传学亚研究的具体目标是从这一患者群体中采集血液，用于未来对吸烟相关疾病的研究，包括慢性阻塞性肺疾病。 这项研究由美国国立卫生研究院资助，由密歇根大学的马丁内斯博士和来自美国其他九个研究机构的研究人员共同开展。我们计划在三年内在密歇根大学招收约110名患者，并在全国范围内招收超过1100名患者。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Chronic obstructive pulmonary disease (COPD in short) is a disease of the lungs that affects many smokers. During the course of this chronic condition, some patients develop one or more COPD "exacerbations" (that is, a temporary worsening of lung symptoms that may require hospitalization and could be life-threatening). Currently, COPD affects from 12.4 to 24 million people in the United States and is the fourth leading cause of death. Worldwide, COPD is the sixth leading cause of death and is the only condition in the top 10 causes of death that has an increasing of new diagnosis and death rates. It is therefore important to find a treatment that could prevent COPD exacerbations,reduce the severity of the episodes, and the mortality of the patients this disease affects. This project addresses an objective stated in the U.S. Public Health Service report "Healthy People 2010: Reduce deaths from COPD from 119 per 1000 people to 60 per 1000 people by 2010" (Objective 24-10). If the intervention that we propose reduces the rate or severity of COPD exacerbations it would be expected to reduce the rate of deaths of these patients. The study is broken down into three separate protocols, the Macrolide (parent) Protocol, the Biomarker and Genetic substudies. All study protocols have been incorporated into one consent document. Subjects will be given the opportunity to continue to participate in the Macrolide and Biomarker study, should they decide not to participate in the Genetic substudy. The Macrolide (parent) Protocol specific aim is to determine if the administration of a macrolide antibiotic (specifically Azithromycin) for one year will decrease the rate and the severity of COPD exacerbations when added to the usual care of these patients. The Biomarker Substudy: specific aims are to determine how certain biomarkers (chemicals) in the blood are related to respiratory conditions. The Genetic Substudy: specific aims of the genetic substudy are to collect blood from this patient population for future studies of smoking related diseases, including chronic obstructive pulmonary disease. The study is funded by the National Institutes of Health and is conducted by Dr. Martinez at the University of Michigan and researchers from nine other research institutions in the United States. We plan to enroll about 110 patients at the University of Michigan and over 1,100 patients nationally over a three year period of time.'