The new Indo-U.S. Center of Excellence for Environmental Lung Diseases will be led by Shyam Biswal, PhD, professor in the Bloomberg School’s Department of Environmental Health Sciences; Sundeep Salvi, MD, PhD, FCCP, director of India’s Chest Research Foundation at Pune; and Anurag Agrawal, MD, of the Institute of Genomics and Integrative Biology, Council of Scientific and Industrial Research in Delhi. Research will focus on the large rural cohort of more than 80,000 individuals enrolled in the Health and Demographics Surveillance System at Vadu, Pune, led by Sanjay Juvekar, PhD.
The IUSSTF will include a multidisciplinary team from the Bloomberg School of Public Health and the Johns Hopkins School of Medicine, as well as collaborators from the National Institute of Environmental Health Sciences at the National Institutes of Health and the Institute of Genomics and Integrative Biology, Council of Scientific and Industrial Research in Delhi.
COPD is a major public health problem for both developed and developing countries. Characterized by chronic bronchitis and emphysema, there is no effective treatment. COPD contributes greatly to mortality, which makes chronic lower respiratory diseases the third-leading cause of mortality in the U.S. COPD affects 24 million Americans and 210 million worldwide. Recently, rural populations of India have seen a disproportionate increase in environmental lung diseases caused primarily by indoor cooking using biomass and other solid fuels, such as wood, coal and charcoal. It is estimated that more than 3 billion people worldwide are exposed to high levels of indoor air pollution from biomass and solid fuel burning, compared with 1.1 billion who smoke tobacco.
“We are beginning to appreciate the global problem of nonsmoker COPD but our understanding of pathobiology is unclear. This Center will attempt to bring together experts from both countries to face this public health challenge,” said Biswal. The initial efforts prior to the focus on health effects will focus on assessment of exposure to indoor air particles in the cohort and their characterization.
According to Patrick Breysse, PhD, professor in the Bloomberg School’s Department of Environmental Health Sciences and Center collaborator, “Indoor air pollution in homes cooking with biomass in India is hundreds of times higher than outdoor air pollution. Exposure assessment will be a key component of Center-supported research.” Genetic predisposition to environmental factors is an area of great interest to the Center.
“We are starting to identify genes that influence COPD in cigarette smokers, but we have little knowledge about genetic interactions with environmental exposures, such as biomass cooking fuel exposure in nonsmokers,” said Stephanie London, MD, DrPH, a genetic epidemiologist at NIEHS and a collaborator with the Center who will be investigating this challenging problem.
The initial focus of the IUSSTF will be to support exchanges between U.S. and Indian investigators and to lay the groundwork for large-scale public health research projects to study the exposure, pathobiology and gene-environment interaction for the susceptibility of the disease to develop novel prevention and treatment strategies in the affected population.