# ASPIRE: Air Pollution: Strategies for Personalized Intervention to Reduce Exposure

> **NIH NIH R01** · CASE WESTERN RESERVE UNIVERSITY · 2020 · $251,065

## Abstract

ABSTRACT
Chronic cardiometabolic (CM) diseases such as hypertension and type 2 diabetes (T2DM) contribute
disproportionately to global morbidity and mortality, and are increasing believed to have multiple environmental
influences. In the previous 5 years of this competitive renewal (AIRCMD), we executed a multinational
collaborative in an environment with high levels of air pollution exposure and demonstrated that short-term
exposure to black carbon and PM2.5 results in elevations in blood pressure (BP) and insulin sensitivity through
sympathetic nervous system (SNS) mechanisms. Given the fact that improvements in air quality are decades
away in countries like China and India and that prevailing low levels of air pollution in the United States
preclude the ability of US based studies to demonstrate a meaningful effect, the efficacy of personal-
intervention is best performed in relevant countries (e.g., China) where ambient levels are high, and the public
is likely to derive benefit. In this competing renewal, we propose a high impact interventional study that will test
the efficacy of personal intervention strategies to mitigate PM2.5-induced adverse cardiometabolic effects in
environments with high levels of ambient exposures. The use of “simple” facemasks (N95) to reduce air
pollution exposure is widespread across regions experiencing high air pollution levels, and is commonly
adopted by visitors to these environments. In Aim 1, as part of a randomized crossover study of 100 adults with
metabolic syndrome, we will demonstrate the impact of a simple facemask (FM) intervention while outdoors on
cardio-metabolic outcomes (primary endpoints: 24-hour ambulatory systolic blood pressure [ASBP] and insulin
resistance (IR) by fasting homeostasis model assessment of insulin resistance [HOMA-IR]) compared to
control (no facemask). Secondary end-points will include automated resting SBP, SNS activity (time and
frequency domain heart rate variability [HRV]), and central aortic BP. In Aim 2, whether in-home air purifier
system with HEPA filters [APHF]) in conjunction with a FM compared to a sham filtration arm and no FM leads
to improvements in the same cardio-metabolic outcomes, in a double-blinded cross-over study will be carried
out. In an exploratory Aim 3 we will elucidate the potential pathways of benefit using circulating adipokines, oral
glucose tolerance testing with and without a safe stable isotope [13C-labeled oral glucose] to provide new
insights on pathways of benefit. Collectively, the results from this project are likely to provide critical new data
on protective effects of personal intervention strategies.

## Key facts

- **NIH application ID:** 9985121
- **Project number:** 5R01ES019616-09
- **Recipient organization:** CASE WESTERN RESERVE UNIVERSITY
- **Principal Investigator:** Robert Daniel Brook
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $251,065
- **Award type:** 5
- **Project period:** 2011-02-04 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9985121

## Citation

> US National Institutes of Health, RePORTER application 9985121, ASPIRE: Air Pollution: Strategies for Personalized Intervention to Reduce Exposure (5R01ES019616-09). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9985121. Licensed CC0.

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