# Inflammation, Aging, Microbes, Obstructive Lung Disease, and Diffusion Abnormalities (I AM OLD-DA): Pulmonary function in females, evaluating the menopausal transition and immune activation (pFEMI).

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $159,182

## Abstract

Abstract
Women with HIV remain underrepresented in research despite possessing a higher risk for the development and
progression of HIV-associated comorbidities compared to men with HIV. Representing one of the major
contributors to global years of life lost and the second most common comorbidity in people with HIV (PWH),
obstructive lung disease (OLD) is an important health priority for PWH worldwide. OLD promises to increase in
importance as the HIV population ages and as OLD risk factors such as smoking and biomass fuel exposure
continue to collide with medical conditions such as tuberculosis. Women with HIV are particularly vulnerable to
OLD; not only have HIV seronegative women demonstrated increased susceptibility for the development of OLD,
but women with HIV have overall increased levels of immune activation markers, many of which have been
linked to pulmonary dysfunction. However, whether sex-based differences in OLD exist among PWH has not
been well characterized. To define sex-based differences in pulmonary dysfunction in PWH and to investigate
sex-specific mechanisms in OLD risk, we propose a supplement to the NHLBI funded Inflammation, Aging,
Microbes, Obstructive Lung Disease, and Diffusion Abnormalities (I AM OLD-DA) study. Under the current I AM
OLD-DA study, we are performing serial pulmonary function tests to measure spirometry and diffusing capacity
for carbon monoxide (DLco) over time as well as analyzing 12 inflammatory biomarkers in our established
cohorts in San Francisco, California and Kampala, Uganda to better characterize HIV-associated pulmonary
disease and to elucidate its underlying mechanisms. Thus far, we have found a distinct biomarker signature for
pulmonary dysfunction in PWH. Further, in our pilot data analysis, we found over a four-fold increase in odds of
OLD in women with HIV as compared to men with HIV, a disparity that was not seen between women and men
without HIV, indicating a potential HIV-specific sex-based difference that has important implications for our
understanding of OLD in persons with and without HIV. With this supplement, we will address whether there are
sex-specific drivers for pulmonary dysfunction in our Ugandan cohort through the addition of sex hormones and
sex-stratified biomarkers. This project would be the first of its kind in: (1) evaluating sex-based differences in
spirometry and DLco in PWH in an international setting (Aim 1); (2) comparing spirometry and DLco to sex-
stratified biomarkers (Aim 2); and (3) examining the role of sex and reproductive age on OLD through the
measurement of sex hormones (Aim 3). This supplement proposal addresses three of the ORWH Strategic
Goals (Strategic Goals 1, 2, and 4) through the addition of samples that focus on sex-based differences. Should
there be a relationship between certain biomarkers, reproductive age, and OLD in women with HIV, this could
provide key insights into underlying mechanisms in sex-based differences in pulmonary dysfunction...

## Key facts

- **NIH application ID:** 10556269
- **Project number:** 3R01HL128156-07S2
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** LAURENCE HUANG
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $159,182
- **Award type:** 3
- **Project period:** 2015-07-01 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10556269

## Citation

> US National Institutes of Health, RePORTER application 10556269, Inflammation, Aging, Microbes, Obstructive Lung Disease, and Diffusion Abnormalities (I AM OLD-DA): Pulmonary function in females, evaluating the menopausal transition and immune activation (pFEMI). (3R01HL128156-07S2). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10556269. Licensed CC0.

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