# Platelet Activation Pathways and Respiratory Morbidity in COPD

> **NIH NIH K23** · JOHNS HOPKINS UNIVERSITY · 2024 · $196,475

## Abstract

PROJECT SUMMARY / ABSTRACT
Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States.
Currently, the treatment of COPD relies on a stepwise algorithm of inhaler therapies without targeting systemic
processes. Mounting evidence suggests that activated platelets may play a role in COPD but the mechanisms
and impact of platelet activation on COPD outcomes are not known. Furthermore, it has been difficult to
differentiate respiratory events from cardiovascular symptoms since COPD and cardiovascular disease (CVD)
are highly comorbid. Understanding the role of platelets and potential for targeted antiplatelet therapy in COPD
patients without CVD could lead to novel therapeutic options. Prior studies demonstrating an association
between platelet activation and worse respiratory morbidity in COPD have employed non-specific surrogate
biomarkers. Likewise, prior studies showing an association of aspirin use with improved COPD morbidity and
mortality have been among prevalent users in observational cohorts susceptible to selection bias and
confounding by indication. In order to understand the potential role of specific platelet activation pathways on
respiratory morbidity in COPD, we propose directly measuring platelet activation and reactivity in a sample of
115 individuals with COPD without overt or subclinical CVD as determined by absence of coronary artery
calcification on computed tomography scan. Specifically, we will measure membrane receptors uniquely
expressed on activated platelets (CD62P/P-selectin, CD63, CD154/CD4L, and PAC1), platelet-leukocyte
conjugates (platelet-monocyte and platelet-neutrophil conjugates), and platelet response (i.e. change in
activation) to stimulation with three agonists (adenosine diphosphate, thromboxane, and serotonin). We
hypothesize that higher proportion of baseline circulating activated platelets, higher proportion of platelet-
leukocyte conjugates, and increased platelet reactivity in response to low doses of agonists will be associated
with higher baseline respiratory symptoms, worse quality of life and higher rate of acute exacerbations of COPD
over 1 year. Furthermore, we will conduct a randomized double-blinded sequential crossover study of three
aspirin doses in 48 individuals with COPD without CVD to determine the most effective aspirin dose for
suppression of platelet activation and reactivity in this population. Completion of the proposed aims will elucidate
the role of platelet activation and reactivity pathways on respiratory outcomes in COPD and inform the design of
a larger randomized controlled trial of antiplatelet therapy in COPD. We will recruit from the large pool of
participants in ongoing and completed COPD studies at Johns Hopkins supplemented by leveraging the
infrastructure of the Johns Hopkins COPD Precision Medicine Center of Excellence. My ultimate career goal is
to be an independent translational researcher focusing on identifying novel targets...

## Key facts

- **NIH application ID:** 10773102
- **Project number:** 5K23HL151758-04
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Ashraf Fawzy
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $196,475
- **Award type:** 5
- **Project period:** 2021-02-20 → 2026-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10773102

## Citation

> US National Institutes of Health, RePORTER application 10773102, Platelet Activation Pathways and Respiratory Morbidity in COPD (5K23HL151758-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10773102. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*
