Project Summary/Abstract The overall scientific goal of this proposal is to further understand the clinical and genetic epidemiology of smokers with heavy cigarette smoke exposure who do not have smoking related pulmonary or cardiovascular disease. Chronic obstructive pulmonary disease (COPD), the most frequently recognized smoking related lung disease, is extremely common with a prevalence of over 11 million people in the United States though millions more may have the disease without a diagnosis. COPD is characterized by chronic airflow obstruction that interferes with normal breathing and is not reversible by bronchodilator. Cigarette smoking is the most significant risk factor for developing COPD, though it has been shown that the amount of cigarette smoke exposure is not directly associated with the likelihood of developing COPD or the severity of disease. While COPD is the most well defined and recognized form of smoking related lung disease, recent data confirms long standing clinical observation that it is just one of the manifestations of smoking related lung damage with others including emphysema and chronic cough. Additionally, some cigarette smokers with many pack-years of exposure do not develop smoking related lung disease, and the reason for this is not understood. Just as smoking related lung disease is not limited to COPD, the effects of cigarette damage on the body are not limited to the lung. Cigarette smoke exposure is also a major risk factor for development of coronary artery disease. Many cigarette smokers develop concomitant coronary artery disease, though it is not yet known whether people who do not develop pulmonary manifestations of cigarette smoking despite heavy cigarette smoke exposure are also less susceptible to coronary artery disease. This project will examine genetic resistance to the adverse pulmonary effects of smoking and whether there are common antecedents to both smoking related pulmonary and cardiac disease. Training received during this project along with coursework and focused mentorship will enhance my knowledge and skills in clinical and genetic epidemiology of chronic lung disease.

F32HL146017

2019-07-01

2020-06-30