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: 10570960
• 负责人: Elizabeth Oelsner
• 金额: $ 69.28万
• 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/10570960
• 关键词: Acute; Address; Adolescent and Young Adult; Adult; Age; Allergens; Ancillary Study; Animal Model; Area; Arsenic; Biological; Blood; Blood Vessels; Blood flow; Carbon Monoxide; Cardiopulmonary; Cardiovascular Diseases; Chromium; Chronic Obstructive Pulmonary Disease; Clinical; Cobalt; Cotinine; Development; Devices; Diffusion; Electronic cigarette; Endothelium; Functional Magnetic Resonance Imaging; General Population; 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（e-cig）的使用很常见，特别是在青少年和年轻人中，并且与 与电子烟和电子烟相关的肺损伤 (EVALI) 解决有关知识的主要空白。 为了了解电子烟使用的呼吸系统健康风险，我们建议对 R01ES029967 进行一项辅助研究（第 6 个百分位，秋季 2019）评估电子烟使用与亚临床肺损伤之间的关联，以及潜在的 人们对电子烟气溶胶中所含金属的影响知之甚少。 尽管至少有一个 EVALI 案例与电子烟笔中的钴有关。 经常含有潜在有毒水平的金属，已确定与肺部疾病有关。 在最新科学水平的背景下研究电子烟使用者，寻找亚临床肺病的证据 金属测量可以使用定量成像来检测和表征。 我们的研究小组首创了肺结构和功能的测量方法。 计算机断层扫描 (CT) 和磁共振成像 (MRI) 的肺部特征可预测事件 我们还发现这些成像措施可以检测与电子烟和金属相关的疾病。 本研究将使用亚临床肺疾病的影像学测量来支持。 关于电子烟使用和电子烟相关金属的长期临床呼吸风险的推论 家长研究 R01ES029967 将研究电子烟的使用、金属和电子烟之间的关系。 亚临床心血管疾病招募了纽约市 520 名年龄 18-50 岁的参与者， 包括 130 名从未吸过烟草的当前电子烟用户（电子烟用户）、130 名当前电子烟用户/曾经吸烟者， 测量将包括 130 名当前吸烟者/当前吸烟者和 130 名从不吸烟者/从不吸烟者。 除了详细的数据外，还对电子烟气溶胶以及血液或尿液中的金属进行金标准定量 通过这项辅助研究，我们评估了内皮健康和临床前心血管疾病。 建议增加创新的超低剂量 CT（N=400 名参与者）和心肺 MRI（N=200 名参与者） 参与者）——加上肺活量测定法、DLCO 和相关混杂因素——测试以下目标： 目标 1：确定电子烟使用与亚临床肺部疾病影像学测量的关联。 目标 2：确定金属暴露与亚临床肺病影像学测量的关联。 探索性目标 3：探索金属暴露对目标 1 关联的影响修改和调节。 这项研究将解决有关电子烟使用呼吸系统健康风险的主要知识空白，即 它将检验有关电子烟和亚临床的强有力的生物学假设。 此外，使用研究团队开发和应用的创新成像措施来诊断肺部疾病； 将研究金属暴露（一种已确定的肺毒素）在电子烟相关肺损伤中的作用。 结果将有助于为公共卫生运动和有关电子烟的监管提供信息。