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Principal Investigator: Dionysios Kavalieratos
Organization: EMORY UNIVERSITY
Fiscal Year: 2024
Award: $590,820
Funding agency: National Heart Lung and Blood Institute
Project Summary
Therapeutic advances have doubled life expectancy for many people living with cystic fibrosis (PLWCF), yet
multisystem symptom burden (e.g., pain, dyspnea, fatigue) continues to impair quality of life. Evidence also
suggests that quality of life and mortality in CF are influenced by social determinants of health and race. The
goal of this observational study is to identify overlapping biopsychosocial drivers of symptom experience in
PLWCF. Specific Aim 1: We will use patient-reported outcomes to identify clusters of co-occurring, plausibly
interrelated symptoms in 140 adults with CF. We will also determine the extent to which social determinants of
health interrelate with symptom clusters to form clinically meaningful phenotypes of CF symptom experience.
Specific Aim 2: We will perform untargeted metabolomic analysis of plasma and exhaled breath condensate to
identify metabolic signatures (e.g. inflammation and oxidative stress) and clustering techniques to propose
metabolic endotypes and determine their relationships with symptom clusters and phenotypes. Specific Aim 3:
We will use sequential mixed methods incorporating surveys and interviews to identify PLWCF experience of
CF clinical care and relationships between symptom clusters, social determinants of health, and care
experience. Cumulatively, these complementary yet independent approaches will create a robust, person-
centered understanding of CF symptoms, their correlates and interactions, and their effect on quality of life.
The expected outcome of this research is identification of new, actionable targets for interventions to prevent or
reduce symptoms at the biological, clinical, and systems levels.
Terms: <21+ years old><Adult><Adult Human><Affect><Application Context><Asthma><Biologic Factor><Biological><Biological Factors><Biological Function><Biological Process><Blood Plasma><Body System><Breathlessness><Bronchial Asthma><COPD><Caring><Causality><Chronic Obstruction Pulmonary Disease><Chronic Obstructive Lung Disease><Chronic Obstructive Pulmonary Disease><Client satisfaction><Clinical><Cohort Studies><Concurrent Studies><Coughing><Cystic Fibrosis><Data><Disease><Disorder><Dyspnea><Effectiveness><Enrollment><Etiology><Exhalation><Exhaling><Exhibits><Fatigue><Goals><Grouping><Healthcare><Heart failure><Impairment><Impoverished><Individual><Inflammation><Inflammatory><Intervention><Intervention Strategies><Interview><Lack of Energy><Life Expectancy><Link><Managed Care><Mental Depression><Metabolic><Metabolic Pathway><Methods><Molecular><Mucoviscidosis><Observation research><Observation study><Observational Study><Observational research><Organ><Organ System><Outcomes Research><Oxidative Stress><Pain><Painful><Palliative Care><Palliative Therapy><Palliative Treatment><Pathogenesis><Patient Outcomes Assessments><Patient Reported Measures><Patient Reported Outcomes><Patient Satisfaction><Patients><Pattern><Persons><Phenotype><Physical condensation><Plasma><Plasma Serum><Poverty><QOL><Quality of life><Race><Races><Reporting><Research><Respiratory Expiration><Reticuloendothelial System, Serum, Plasma><Sampling><Severities><Site><Social Environment><Survey Instrument><Surveys><Symptom Burden><Symptoms><System><Techniques><Therapeutic><Therapeutic Intervention><Therapeutic Research><Work><adulthood><alleviate symptom><ameliorating symptom><associated symptom><biologic><biopsychosocial><burden of disease><burden of illness><cardiac failure><causation><chronic obstructive pulmonary disorder><clinical care><clinical relevance><clinically relevant><co-morbid symptom><co-occuring symptom><comfort care><comorbid symptom><concurrent symptom><condensation><contextual factors><cooccuring symptom><decrease symptom><demographics><depression><disease burden><disease causation><emotional symptom><enroll><experience><fewer symptoms><groupings><health care><improved><improved outcome><intervention therapy><interventional strategy><manage symptom><metabolism measurement><metabolomics><metabonomics><mortality><multi-site trial><multisite trial><novel><patient centered><patient oriented><person centered><physical symptom><prevent><preventing><racial><racial background><racial origin><reduce symptoms><relieves symptoms><respiratory><social><social climate><social context><social factors><social health determinants><social influence><socioenvironment><socioenvironmental><symptom alleviation><symptom association><symptom cluster><symptom comorbidity><symptom management><symptom reduction><symptom relief><symptom science>