# The Pulmonary Vasculature and Platelets in Emphysema and COPD

> **NIH NIH K23** · BRIGHAM AND WOMEN'S HOSPITAL · 2022 · $196,313

## Abstract

Rationale: Chronic obstructive pulmonary disease (COPD) and emphysema are the major components of
chronic lower respiratory disease, the 4th leading cause of death in the United States and the world. Despite
this, there are no disease-modifying pharmacologic therapies for COPD. Thus, there are opportunities to
advance treatment of COPD by identifying and testing biological therapies that alter disease progression.
Candidate: As a pulmonary-critical care-trained physician and Instructor at Brigham and Women's Hospital
(BWH) and Harvard Medical School (HMS), the PI has conducted preliminary research identifying platelet
activation as a potential risk factor for COPD and emphysema. The PI's long term goal is to become an
independent clinical investigator with a focus on strategies that impact the development and progression of
emphysema and COPD. Career Development: The PI's short term goals are to complete a Master's Degree in
Epidemiology, to learn about imaging analysis, measures of platelet activation and clinical trial design and
operations, which she will do with the guidance of the assembled multi-disciplinary mentorship team.
Environment: BWH and HMS have a track-record of success in research career development and has
committed significant resources to support this proposal including use of the BWH Center for Clinical
Investigation. Research: The proposed research aims will evaluate the vascular hypothesis of emphysema and
a specific related biological pathway (platelet activation) in sequential steps. Aim 1 will assess the association
between pulmonary vascular morphology and the progression of percent emphysema on CT. Aim 2 will
measure urinary 11-dehydro-thromboxane B2, a measure of in vivo platelet activation, in a sample of 1,537
participants in the Subpopulations and Intermediate Outcomes Measured in COPD Study (SPIROMICS) to test
whether platelet activation is associated with emphysema and pulmonary vascular morphology in cross-
sectional analyses, and whether it predicts longitudinal progression of emphysema. Aim 3 will recruit 20 novel
participants with visual emphysema on CT and mild-moderate COPD for a crossover study to determine
whether dual antiplatelet therapy improves pulmonary microvascular perfusion on dual-energy CT scan
compared to placebo. Together, these aims link the pulmonary vasculature, platelet activation and emphysema
progression, and will test whether inhibiting platelet activation impacts our measures of microvascular
pulmonary perfusion. Improvement in pulmonary perfusion with dual antiplatelet therapy would suggest that
these therapies may impact long-term progression of emphysema, a hypothesis I would propose to test in a
future R01/phase IIb RCT. In completing these research objectives, the PI aims to identify a potential novel
pathway related to emphysema and COPD, and gain the expertise to establish an independent research
program that identifies and tests therapies that impact the progression of emphysem...

## Key facts

- **NIH application ID:** 10400029
- **Project number:** 5K23HL141651-04
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Carrie L Pistenmaa
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $196,313
- **Award type:** 5
- **Project period:** 2019-05-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10400029

## Citation

> US National Institutes of Health, RePORTER application 10400029, The Pulmonary Vasculature and Platelets in Emphysema and COPD (5K23HL141651-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10400029. Licensed CC0.

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