Metal Exposure and Subclinical Lung Disease in Adult E-cigarette Users

成人电子烟使用者的金属接触和亚临床肺病

• 批准号: 10352389
• 负责人: Elizabeth Oelsner
• 金额: $ 70.36万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-15 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10352389
• 关键词: Acute; Address; Adolescent and Young Adult; Adult; Age; Allergens; Ancillary Study; Animal Model; Area; Arsenic; Biological; Blood; Blood flow; Carbon Monoxide; Cardiopulmonary; Cardiovascular Diseases; Chromium; Chronic Obstructive Pulmonary Disease; Clinical; Cobalt; Cotinine; Development; Devices; Diffuse; Electronic cigarette; Endothelium; Functional Magnetic Resonance Imaging; General Population; Gold; Health; Health Campaign; Hospitalization; Image; Inhalation; Interstitial Lung Diseases; Knowledge; Lead; Link; Lung; Lung Capacity; Lung diseases; Magnetic Resonance Imaging; Measurement; Measures; Mediation; Metal exposure; Metals; Modification; Multi-Ethnic Study of Atherosclerosis; Multimodal Imaging; New York City; Nickel; Occupational Asthma; Parents; Participant; Public Health; Pulmonary Emphysema; Pulmonary Fibrosis; Regulation; Risk; Risk Factors; Role; Science; Smoker; Spirometry; Structure; System; Testing; Tetrahydrocannabinol; Thick; Tobacco smoke; Toxin; Urine; X-Ray Computed Tomography; aerosolized; attenuation; clinical predictors; cohort; e-cigarette aerosols; electronic cigarette use; electronic cigarette user; endothelial dysfunction; falls; follow-up; former smoker; improved; innovation; interstitial; low dose computed tomography; lung injury; magnetic resonance imaging biomarker; mortality; never smoker; pre-clinical; primary outcome; pulmonary function; quantitative imaging; recruit; respiratory; respiratory health; urinary; vape pens; vaper; vaping associated lung injury; ventilation; young adult

E-cigarette (e-cig) use is common, particularly among adolescents and young adults, and has been associated with E-cigarette and Vaping Associated Lung Injury (EVALI). To address major gaps in knowledge regarding the respiratory health risks of e-cig use, we propose an ancillary study to R01ES029967 (6th percentile, Fall 2019) to evaluate associations between e-cig use and subclinical lung injury, as well as the potential contribution of metals contained in e-cig aerosols. Risk of inhaling metals via e-cigs is poorly understood, although at least one EVALI case was linked to cobalt in a vape pen. Our team has shown that e-cig aerosols frequently contain potentially toxic levels of metals with established links to lung disease. Hence, we propose to study e-cig users for evidence of subclinical lung disease in the context of state-of-the-science metal measurements. Subclinical lung disease can be detected and characterized using quantitative imaging measures of lung structure and function that have been pioneered by our investigative group. We have shown that lung features on computed tomography (CT) and magnetic resonance imaging (MRI) predict incident clinical lung disease. We have also found that these imaging measures may detect e-cig and metal-related subclinical lung injury. This study will use imaging measures of subclinical lung disease to support inferences regarding the long-term clinical respiratory risks of e-cig use and e-cig-related metal exposure. Parent study R01ES029967 will examine the relationships between e-cig use, metals, and subclinical cardiovascular disease by recruiting 520 participants in New York City, ages 18-50 years old, including 130 current e-cig users (vapers) who never smoked tobacco, 130 current vapers/former smokers, 130 dual current vapers/current smokers, and 130 never vapers/never smokers. Measurements will include gold-standard quantification of metals in e-cig aerosols as well as in blood or urine, in addition to detailed assessments of endothelial health and preclinical cardiovascular disease. With this ancillary study, we propose to add innovative ultra-low dose CT (N=400 participants) and cardiopulmonary MRI (N=200 participants) – plus spirometry, DLCO, and relevant confounders – to test the following Aims: Aim 1: Determine the associations of e-cig use with imaging measures of subclinical lung disease. Aim 2: Determine the associations of metal exposures with imaging measures of subclinical lung disease. Exploratory Aim 3: Explore effect modification and mediation of Aim 1 associations by metal exposures. This study will address major gaps in knowledge regarding the respiratory health risks of e-cig use, which is increasingly common in young adults. It will test robust biological hypotheses regarding e-cigs and subclinical lung disease using innovative imaging measures developed and applied by the investigative team; moreover, it will examine the role of metal exposure, an established pulmonary toxin, in e-cig-related lung injury. The results will be suitable to help inform public health campaigns and regulation regarding e-cigarettes.

电子烟（电子烟）的使用很常见，尤其是在青少年和年轻人中，并且已经关联 带有电子烟和相关的肺损伤（evali）。解决有关知识的主要差距 E-CIG使用的呼吸健康风险，我们建议对R01ES029967进行辅助研究（第六个百分点，秋季 2019）评估电子烟的使用与亚临床肺损伤之间的关联以及潜力 E-cig气溶胶中包含的金属的贡献。通过电子烟吸入金属的风险知之甚少， 尽管至少有一个评估案件与vape笔相连。我们的团队表明E-cig气溶胶 经常包含具有与肺部疾病的已建立联系的潜在有毒金属水平。因此，我们提出了 在最先进的情况下，研究电子烟的使用者是否有亚临床肺部疾病的证据 金属测量。可以使用定量成像检测和表征亚临床肺疾病 我们的调查组率先开创了肺结构和功能的度量。我们已经显示了 该肺在计算机断层扫描（CT）和磁共振成像（MRI）预测事件上的特征 临床肺病。我们还发现，这些成像措施可能检测到电子烟和金属相关的措施 亚临床肺损伤。这项研究将使用亚临床肺疾病的成像测量来支持 关于电子烟的长期临床呼吸道风险和与电子烟有关的金属的推论 接触。家长研究R01ES029967将检查电子烟的使用，金属和 亚临床心血管疾病通过招募520名年龄在18-50岁的纽约市的参与者 包括130名当前的电子烟使用者（VAPER） 130双电流蒸气/当前吸烟者，130个从不蒸气/从未吸烟。测量将包括 除了细节外 内皮健康和临床前心血管疾病的评估。通过这项辅助研究，我们 提议增加创新的超低剂量CT（n = 400名参与者）和心肺MRI（n = 200 参与者） - 加上肺活量测定法，DLCO和相关的混杂因素 - 测试以下目的： 目标1：确定E-CIG使用的关联与亚临床肺疾病的成像测量。 目标2：确定金属暴露与亚临床肺部疾病的成像测量的关联。 探索目的3：通过金属暴露探索目标1关联的效果修改和调解。 这项研究将解决有关E-CIG使用的呼吸健康风险知识的主要差距，这是 在年轻人中越来越普遍。它将测试有关电子烟和亚临床的强大生物学假设 使用调查团队制定和应用创新成像措施的肺部疾病；而且，它 将检查金属暴露（一种已建立的肺毒素）在与电子烟有关的肺损伤中的作用。 结果将适合为公共卫生运动和有关电子烟的法规提供信息。