The Johns Hopkins Obstructive Lung Disease Section has a diverse portfolio of research activities. These include engagement in team science at the national level through multicenter studies and locally through transdisciplinary work across the University and through community-based research. Johns Hopkins has been a part of American Lung Association Airways Clinical Research Centers for many years and currently serves a as the data coordinating center. JHU is a site for the Genetic Epidemiology of COPD Program (COPD Gene) and the SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) program, as well as the NHLBI's Precision Interventions for Severe and/or Exacerbation Prone Asthma (PrecISE) Network. The Division participates in industry-sponsored multicenter clinical trials that are available to eligible patients. There is a strong history of investigation of environmental influences on obstructive lung disease and this work is based in the BREATHE Center (Bridging Research, Lung Health, and the Environment). The Breathe Center serves as a home for a multidisciplinary group of investigators that include adult and pediatric pulmonologists, as well as biostatisticians, environmental scientists, and behavioral scientists. The BREATHE Center has been supported by NIH and EPA funding and includes the Center for Childhood Asthma in the Urban Environment and the CURE COPD Programs. The clinical research programs are synergistic with the basic science and translational work and provide a platform for training the next generation of scientists. Examples of recent and ongoing research programs are listed below.
GlaxoSmithKline Liu (PI) 9/01/14 – 08/31/19
Boehringer Ingelheim Pharmaceutical Liu (PI) 03/01/2016- 02/28/2018
The Coordinating Center provides infrastructure support for the American Lung Association Airways Clinical Research Centers. Current studies are listed: https://www.lung.org/our-initiatives/research/airways-clinical-research-centers/
Funding: (Wise) 07/1/16-06/31/21
The goal of this project is to evaluate the impact of indoor and outdoor air quality on student achievement, student health and overall school climate and to document the impact of changes in indoor air quality associated with modernization of school facilities in Baltimore City.
Environmental Protection Agency 83563901 (McCormack) 11/01/2014 – 12/17/2019
The goal of this study is to determine the association between in-home particulate matter concentrations and cardiovascular outcomes among participants with COPD and to determine the effect of an air purifier intervention that reduces indoor PM on these outcomes.
Team: Meredith McCormack, Nadia Hansel, Niru Putcha, Emily Brigham
Funding: NIEHS R21ES025840 (McCormack) 08/01/2015 – 07/31/2018
This clinical trials network will study novel therapies for severe asthma and test biomarkers that define responsive sub-populations of severe disease.
(Liu) 09/2017 – 08/2022
The goal of this study is to determine the efficacy of air cleaners to improve indoor air quality and health in former smokers with moderate to severe COPD.
Team: Nadia Hansel, Niru Putcha, Meredith McCormack, Gregory Diette
Funding: NIEHS R01ES022607 (Hansel) 08/07/2013 – 04/30/2019
The goal of this project is to compare the effectiveness of a physician-centered compared to a peer-centered self-management program to improve health status and reduce healthcare utilization in patients with COPD.
PCORI (Aboumatar) 07/01/16 -06/30/19
The aim of our Center, Comparing Urban and Rural Effects of poverty on COPD (CURE COPD), is to understand the interactive effects of indoor air pollution, obesity and pro-inflammatory diets on COPD in both urban (Project 1) and rural (Project 2) low income communities, both of which suffer disproportionate prevalence and morbidity from COPD.
Team: Nadia Hansel, Gregory Diette, Meredith McCormack, Niru Putcha
Funding: EPA 83615001 NIH/NIMHD P50MD010431 (Hansel) 07/01/2015 – 06/30/2020
The objective is to conduct a multicenter trial to determine whether the angiotensin receptor antagonist losartan is effective in reducing the progression of emphysema in patients with COPD. The trial is conducted by the ALA-ACRC and the NIH-Pulmonary Trials Cooperative.
U01HL128951 NIH/NHLBI (Wise) 08/01/15 – 07/31/19
The objective of this research is to characterize patients with COPD enrolled in COPD Gene so that genetic determinants of susceptibility to this disease can be established using full genome genotyping. This renewal will conduct 10-year follow-up studies of the cohort at the Johns Hopkins site.
NIH/NHLBI (Wise) 08/01/17-7/31/22
Current active smokers represent the largest subset of COPD patients. We propose a randomized controlled trial to test a home based intervention (air cleaner placement and motivational interviewing for smoking cessation and secondhand smoke reduction) to improve health in smokers with COPD.
Team: Nadia Hansel, Michelle Eakin, Niru Putcha, Meredith McCormack
1R01ES029512 NIH/NIEHS(Hansel). 09/15/2018– 05/31/2023
OBesity Enhances Susceptibility to Pollutant Effects in Asthma (OBESE ASTHMA), will study mechanisms by which obesity leads to enhanced susceptibility to pollutants (particulate matter with aerodynamic diameter < 2.5 µm (PM2.5) and ultrafine particles (UFP)) leading to increased asthma morbidity in children.
Team: Nadia Hansel, Gregory Diette, Meredith McCormack, Emily Brigham
Funding: NIEHS P50ES018176/EPA (Hansel) 09/01/15 – 08/31/19
This is a pilot study to determine the feasibility and to inform the design of a clinical trial of Zinc supplementation for treatment of chronic refractory cough.
R34HL132369 NIH/NHLBI (Wise) 04/01/16 – 03/31/19
The goal of this project is to measure the concentrations of ultrafine particles (the smallest form of particulate air pollution) in the home, understand the respiratory and systemic health effects experienced by children with asthma linked to these levels, and explore potential metabolic susceptibility factors that may be targeted in future studies to mitigate the effects of ultrafine particle exposure on health.
K23ES029105 NIEHS (Brigham) 01/01/19-12/31/22
The objective of this project is to plan for a multisite pragmatic comparative effectiveness trial to compare roflumilast to azithromycin for prevention of hospitalization and death in patients with COPD who have been hospitalized for exacerbations. See: https://www.copdfoundation.org/Research/Other-Studies/Reliance.aspx
The lung epithelium is the site of initial contact with inhaled agents and establishes a protective barrier limit contact between what we breath in and the external environment and subepithelial tissues, however we know that this barrier is breached with repetitive exposure to cigarette smoke or air pollution and patients with COPD have a disrupted barrier as well. We are interested in studying basic mechanisms of how this barrier is disrupted and patient based susceptibility to these insults. Furthermore, we are investigating ways to rectify the barrier and assess improvement in lung function using basic and patient based translational strategies.
Using in vitro and animal models to test the effects of exposures, including cigarette smoke, environmental particulate matter, E-cigarettes and other environmental exposures we seek to identify changes in epithelial plasticity that lead to worsened lung function.
Team: Ramana Sidhaye, Shyam Biswal, Nadia Hansel, Joe Katz, Kirsten Kohler, Rasika Mathais, Doug Robinson, Niru Putcha, Bob Wise
Funding: NIH NHLBI HL124099 (Sidhaye), HL151107 (Sidhaye), GOMRI DROPPS III (Katz, Kohler, Sidhaye)
The purpose of the OMEGA COPD Trial is to look at the effects of diet on COPD health outcomes. The study hopes to determine whether increasing dietary Omega-3 intake and improving indoor air quality can improve health outcomes in COPD patients. Eligible participants will be assigned randomly to one of two groups. Both groups will receive a voucher for $50 of food delivery every week for 12 weeks. One group will receive personalized dietary coaching, encouraging OMEGA-3 rich foods, and the other group will receive more general guideline-based dietary coaching. Participants will be followed for 6 months and will receive clinic visits, home visits and a series of phone calls. Participants can receive up to $880. If you are interested in learning more about the study, or to find out if you are eligible, please call our research staff at 410-550-9527.
Team: Nadia Hansel, Michelle Eakin, Kirsten Koehler, Edgar Miller
Funding: NHLBI 1R01 HL158615 (Hansel)