Molecular Profiles of Smokers with Subclinical Interstitial Lung Disease
Abstract
Pulmonary fibrosis is a disease that affects genetically susceptible individuals with a history of smoking. It is estimated that approximately 200,000 adults in the United States suffer from idiopathic pulmonary fibrosis (IPF), a progressive disease with limited therapies. Recent groundbreaking clinical trials have identified antifibrotic therapies that attenuate the rate of loss of lung function. Several studies from our group and others suggest that a spectrum of lung scarring affects a high number of smokers. Early-stage lung scarring often goes unrecognized, highlighting the need for tools that help doctors identify lung involvement at an earlier stage when it may be more treatable. Previous studies have shown that older age, male gender, and a history of smoking are commonly observed in patients with lung scarring. Additionally, increased levels of select blood proteins can be found in these patients. Our research group has shown that these proteins in combination with clinical factors can be used to identify early-stage lung scarring. These findings are of great importance, as this information could be used in the doctor’s office to identify lung scarring at an early stage, which in turn creates an opportunity to modify and direct treatment towards the lung that otherwise may be ignored. This early intervention could potentially lead to decrease rates of fibrotic lung disease and death related to this common complication. Based on the above findings, we believe that in smokers, a combination of blood markers and clinical factors can identify the presence of lung scarring. Furthermore, some of these protein and clinical markers could help predict those whose lung scarring will most likely progress. We will address these research questions by completing the following specific aims. In Specific Aim 1, we will determine the prevalence of lung scarring in smokers, their clinical implications, and factors that may predict their presence. In Specific Aim 2, we will demonstrate that the addition of blood markers to the clinical factors identified in Specific Aim 1 can increase the ability to detect lung scarring. Finally, in Specific Aim 3, we will demonstrate that blood markers that predict disease progression patients can also predict the development of lung fibrosis in smokers. Importantly, these studies will be performed in a large cohort of smokers presently enrolled in a longitudinal observational study at the University of Pittsburgh. The successful completion of the proposed studies will allow doctors to identify early-stage lung scarring and patients most at risk of progressive lung scarring. This potentially could help doctors provide timely treatment at an earlier stage, which in turn could lead to better quality of care and reduction in deaths due to interstitial lung disease.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1810772
Entities
People
- Ivan O Rosas
Organizations
- United States Army