Effect of Shisha Smoking on the Biology of the Airway Epithelium in Qatar

Study Overview
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Brief Summary
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The purpose of this study is to learn about the effects of smoking shisha on the lungs, when compared to the effects of smoking cigarettes or of not smoking. The investigators hope to learn more about how shisha smokers should be monitored and treated once diseased.

Detailed Description
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Traditional shisha smoking is practiced by  10% of the Qatari adult population. Although based on tobacco leaves, shisha smoking exposes the airway epithelium to a chemical insult of intensity and duration different from that of cigarette smoking. This study, a collaboration between WCMC-Qatar and WCMC-New York and the Hamad Medical Corporation (HMC), is focused on defining the biology of the airway epithelium of shisha smokers compared to non-smokers. Using approved protocols, bronchoscopy will be used to sample the airway epithelium, the site of the earliest changes associated with smoking. The transcriptome of the recovered epithelium will be assessed in the genomic core WCMC-Qatar for gene expression using microarrays and complete RNA sequencing using massive parallel sequencing.Based on this information, the epithelial DNA will be assessed for relevant SNPs, copy number variations and methylation status. Parallel studies will be carried out in cigarette smokers, providing a comprehensive catalog of shisha smoking-induced changes compared to cigarette smokers and non-smokers in this population.

Official Title
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Effect of Shisha Smoking on the Biology of the Airway Epithelium in Qatar

Conditions
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Smoking

Participation Criteria
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Eligibility Criteria
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Non-smoker Inclusion Criteria: Population living in Qatar Must provide informed consent Individuals must also have smoked less than 100 cigarettes and/or less than 10 shisha pipes in their lifetime Has normal pulmonary function test Has normal chest xray No signs of acute lung infection Exclusion Criteria: Medical history of significant illness or other significant medical issues Regular shisha smoker Regular cigarette smoker Simultaneous cigarette plus shisha smoking Shisha smoker Inclusion Criteria: Population living in Qatar Must provide informed consent Must have smoked 5 pipe-yr Must currently smoke 5 pipes/wk Has normal function tests Has normal chest xray No signs of acute lung infection Exclusion Criteria: Medical history of significant illness or other significant medical issues Regular cigarette smoker Simultaneous cigarette plus shisha smoking Cigarette smoker Inclusion Criteria: Population living in Qatar Must provide informed consent Confirmation of smoking status by urine testing Confirmation of smoking status by assessment of carboxyhemoglobin Has normal function tests Has normal chest xray No signs of acute lung infection Exclusion Criteria: Medical history of significant illness or other significant medical issues Regular shisha smoker Simultaneous cigarette plus shisha smoking

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Non-smoker<br>This group will include individuals without any history of lung disease, including asthma, and without recurrent or acute pulmonary disease. Individuals must also have smoked less than 100 cigarettes and/or less than 10 shisha pipes in their lifetime. | |
| Shisha smoker<br>This group will include individuals who have a shisha smoking history of more than 5 pipe-years and must currently smoke more than 5 pipes per week. Individuals must not show any signs of acute lung infection or have medical history of significant illness or other significant medical issues. | |
| Cigarette smoker<br>This group will include individuals who have a cigarette smoking history that will be confirmed by urine testing. Individuals must not show any signs of acute lung infection or have medical history of significant illness or other significant medical issues. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gene expression changes in the small airway epithelium (SAE) | We will measure the effect that shisha smoking has on the small airway epithelium (SAE) by measuring parameters such as the SAE gene expression in shisha smokers (i.e., non-cigarette smokers). We will compare these parameters to the same parameters measured in non-smokers and cigarette smokers. | 3 days |