# Long Term Outcomes and Macrophage Biology in Patients with EVALI

> **NIH NIH U01** · IHC HEALTH SERVICES, INC. · 2020 · $314,409

## Abstract

PROJECT ABSTRACT
E-cigarette, or vaping, associated lung injury (EVALI) is a new, serious respiratory disease of uncertain cause,
treatment, and clinical outcome. Despite progress in case identification and characterization of the early
course, there are key questions related to the longer-term consequences for individuals with EVALI and the
pathobiologic mechanisms that lead to acute respiratory failure. Intermountain Healthcare and the University of
Utah have been actively engaged in studies of EVALI from the early stages of this outbreak, and together we
are well-positioned to address both of these important questions. We have established a cohort of over 140
EVALI patients and have described the case presentation and response to therapy. We have provided initial
information concerning the distinct appearance of alveolar macrophages (AM) in these individuals. We now
propose to address clinical and pathobiologic questions concerning EVALI in experiments with two Specific
Aims. In Specific Aim 1, we will leverage our research infrastructure, experience in short- and long-term clinical
studies of acute respiratory distress syndrome (ARDS) as part of the PETAL network, and experience with
EVALI to assess the long-term clinical outcomes of patients with EVALI. We will use electronic health record
queries to assess changes in healthcare use and respiratory illnesses in the year before vs. after an EVALI
diagnosis in the entire cohort of over 140 patients and how those may be influenced by comorbidities. Using
validated instrument batteries, we will assess 80 individuals at 3 and 12 months after initial hospitalization for
EVALI to determine: (a) the presence and persistence of respiratory impairment at 12 months after EVALI, (b)
whether residual respiratory symptoms evolve between 3 and 12 months after EVALI, (c) the distribution of
recurrent vaping among EVALI survivors, including changes in devices or cartridges and implications of
baseline mental illness, (d) the association of recurrent vaping with respiratory impairment, and (e) changes in
healthcare use and respiratory illnesses in the year before vs. after an EVALI diagnosis.
Multiple characteristics of the acute illness suggest that AM inflammatory responses play an important role in
the pathogenesis of EVALI. In Specific Aim 2, we will compare bronchoalveolar lavage (BAL) samples from 10
patients with EVALI to those in 10 “healthy” vapers. Using RNA-seq we will identify pathways in differentially
activated EVALI subjects compared to individuals who vape without evidence of EVALI. We will also use flow
cytometry to determine the ontogeny and additional activation features of AM in these two groups, and will
determine the extent of alveolar epithelial cell injury in analysis of the cell-free supernatant from BAL samples.
This proposed work aims to answer the crucial, complementary questions to shed further insight into the
pathophysiology and outcomes of EVALI. Furthermore, insights from this...

## Key facts

- **NIH application ID:** 10080334
- **Project number:** 3U01HL123018-06S1
- **Recipient organization:** IHC HEALTH SERVICES, INC.
- **Principal Investigator:** Joseph R Bledsoe
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $314,409
- **Award type:** 3
- **Project period:** 2020-04-10 → 2022-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10080334

## Citation

> US National Institutes of Health, RePORTER application 10080334, Long Term Outcomes and Macrophage Biology in Patients with EVALI (3U01HL123018-06S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10080334. Licensed CC0.

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