The primary goal of this proposal is to demonstrate the value of genetic testing in the diagnostic and prognostic evaluation of patients with, or in those at-risk for, idiopathic pulmonary fibrosis (IPF). Idiopathic pulmonary fibrosis (IPF), the most common and severe form of pulmonary fibrosis (PF) has a mortality rate comparable to that of many end-stage malignancies Although IPF has historically been unresponsive to pharmacotherapy, recent studies have finally demonstrated that medical therapy can reduce the rate of decline in lung function, particularly when started early in the course of disease. While these findings provide motivation to improve early detection of IPF, recent studies also demonstrate that genetic testing may be a critical factor that can help guide early detection. We hypothesize that specific, known genetic variants confer variable prognosis in patients with PF, and that targeted genetic testing will aid in patient counseling, early disease detection, and ultimately, earlier initiation of medical therapy. To assess these hypotheses we propose to address the following specific aims:
Aim 1) Does targeted genetic testing aid in the diagnostic and prognostic evaluation of patients with pulmonary fibrosis? Aim 2) Does targeted genetic testing aid in early detection, and prognostication of populations at-risk for pulmonary fibrosis? and Aim 3) We will assess the psychosocial impact of genetic testing groups at-risk for pulmonary fibrosis. Positive results from these studies will set the stage for subsequent trials that could prospectively evaluate the role of targeted genetic testing in determining the need for further screening, and in designing therapeutic trials in groups at-risk for IPF.

Public Health Relevance

Idiopathic pulmonary fibrosis (IPF) is a disorder characterized by lung scarring and has a prognosis worse than that of most cancers. Improving the management of, and early detection for, IPF are important public health priorities. By capitalizing on important genetic discoveries this proposal will examine the role that precision medicine can have in more precisely characterizing patient diagnosis and risk with the goal of ultimately tailoring treatment strategies. In addition, this proposal, for the first time, will demonstrate the role that genetics can have in early detection of this often fatal disease.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL130974-04
Application #
9615036
Study Section
Respiratory Integrative Biology and Translational Research Study Section (RIBT)
Program Officer
Vuga, Louis J
Project Start
2016-01-01
Project End
2019-12-31
Budget Start
2019-01-01
Budget End
2019-12-31
Support Year
4
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Brigham and Women's Hospital
Department
Type
DUNS #
030811269
City
Boston
State
MA
Country
United States
Zip Code
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