# The influence of air pollution on lung health among people living with HIV.

> **NIH NIH K23** · MASSACHUSETTS GENERAL HOSPITAL · 2020 · $199,168

## Abstract

PROJECT SUMMARY/ABSTRACT
Background: One in four people living with COPD – 96 million people worldwide – have never smoked. Most
COPD mortality occurs in regions of the world where smoking is uncommon, like sub-Saharan Africa, where HIV
and air pollution may be driving COPD mortality among the estimated 26 million Africans with COPD. People
living with HIV (PLWH) experience persistent systemic inflammation and increased risk of chronic lung disease.
Like HIV, air pollution – the leading environmental cause of death globally – causes systemic inflammation and
significantly worsens lung health. HIV and air pollution operate through similar inflammatory pathways that are
destructive to lung tissues. Thus, PLWH who are exposed to air pollution may face particularly high risk of lung
disease. If shared inflammatory pathways accentuate lung disease risk among PLWH exposed to air pollution,
then targeting these pathways could have outsized clinical impact. The hypothesis of this project is that PLWH
experience greater air pollution-associated lung inflammation and lung dysfunction than HIV-uninfected people.
I helped establish a four-year collaboration between Massachusetts General Hospital, Mbarara University of
Science and Technology, and Harvard T.H. Chan School of Public Health that has enabled air quality monitoring
in southwestern Uganda and is poised to investigate this novel area of research. Candidate: Dr. North's
overarching career goal is to become an independent investigator focused on environmental exposures and lung
health among PLWH. Her clinical work caring for patients with chronic lung disease and leading research
investigating the epidemiology of chronic lung disease in Uganda have inspired this career path. She is well-
prepared to undertake the scientific and training aims proposed here, having successfully published eight first-
author manuscripts, three middle-author manuscripts, and completed a 2016 pilot study of air quality in rural
Uganda. Mentoring: Dr. Mark Siedner (Primary mentor) is an NIH-funded investigator who has successfully
mentored 4 NIH K awardees. Drs. Petros Koutrakis (personal air pollution measurement), Bethany Hedt-Gauthier
(biostatistics), and Benjamin Medoff (immune-mediated lung injury), will provide additional focused mentoring to
ensure Dr. North's success. Research: Leveraging an ongoing, R01-funded cohort of 300 HIV-infected and 300
age- and sex-similar, HIV-uninfected participants, Dr. North will add personal air pollution monitoring and
research bronchoscopy to ongoing study procedures in order to characterize personal air pollution exposure and
examine relationships between air pollution, lung inflammation and lung function. Training: To achieve her aims
and become an independent researcher, Dr. North requires additional training in 1) personal air pollution
measurement, 2) advanced biostatistics including structural equation modeling, and 3) immune-mediated lung
injury. Based on her previous researc...

## Key facts

- **NIH application ID:** 10082599
- **Project number:** 1K23HL154863-01
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Crystal North
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $199,168
- **Award type:** 1
- **Project period:** 2020-09-05 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10082599

## Citation

> US National Institutes of Health, RePORTER application 10082599, The influence of air pollution on lung health among people living with HIV. (1K23HL154863-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10082599. Licensed CC0.

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