Genetic and Environmental Factors in Adult Nonmalignant Respiratory Disease

我们建议在新加坡的一个超过50，000名华人老年人的队列中研究遗传因素、饮食和环境暴露在非恶性呼吸系统疾病风险中的作用。我们正在扩大为研究饮食与癌症之间的关系而建立的队列的范围。这项由NCI资助的研究（Yu博士获得的杰出研究者奖）包括详细的饮食信息，该信息使用了为新加坡华裔人群开发并验证的饮食工具。由NCI资助的后续行动包括电话采访，然后收集血液和尿液。 为了扩大队列研究慢性支气管炎和哮喘的能力，在随访中增加了问题，以确定慢性支气管炎、呼吸困难和哮喘的症状。此外，吸烟数据已扩大到包括早期和成年生活暴露于环境烟草烟雾和非日常主动吸烟的信息。在接下来的4年中，随着队列随访的完成，我们将能够进行流行病学分析，以检查可能影响成人非恶性呼吸道疾病风险的暴露，包括吸烟暴露和烹饪习惯，并检查饮食因素（如抗氧化剂和异硫氰酸酯）的可能保护作用。 这些条件的遗传多态性可以在巢式病例对照样本中进行检查。这一人群特别令人感兴趣，因为据报道，新加坡和其他地方的华人妇女在吸烟水平低的情况下患慢性支气管炎的比例很高。我们预见这项研究是在全球低风险和高风险人群中检查成人非恶性呼吸道疾病遗传和环境风险因素的第一步。受试者入组已开始。超过10，000名受试者接受了后续调查问卷，并正在收集生物样本。这是一项长期研究，需要几年时间才能完成。

We propose to examine the role of genetic factors, diet and environmental exposures in the risk of nonmalignant respiratory disease in a cohort of over 50,000 older adults of Chinese ethnicity in Singapore. We are expanding the scope of a cohort established to examine the relation between diet and cancer. This NCI funded study (an outstanding investigator award to Dr. Yu) includes detailed dietary information using a dietary instrument developed for and validated in this population of Singaporeans of Chinese ethnicity. Follow-up, funded by NCI, includes a telephone interview followed by collection of blood and urine. To expand the capability of the cohort to the study of chronic bronchitis and asthma, questions are being added to the follow-up to determine symptoms of chronic bronchitis, dyspnea and asthma. In addition, smoking data has been expanded to include early and adult life exposure to environmental tobacco smoke and information on nondaily active smoking. Over the next 4 years as follow-up of the cohort is completed, we will be able to conduct epidemiologic analyses to examine exposure that may influence the risk of nonmalignant respiratory disease in adults including tobacco smoking exposure and cooking practices and to examine the possible protective effect of a dietary factors such as antioxidants and isothiocyanates. Genetic polymorphisms for these conditions can be examined in nested case-control samples. This population is of particular interest because the Chinese women in Singapore and elsewhere have been reported to have high rates of chronic bronchitis in the face of low levels of smoking. We foresee this study as the first step in examining genetic and environmental risk factors for adult nonmalignant respiratory disease in low and high risk populations across the world. Enrollment of subjects has begun. Over 10,000 subjects have been administered a follow-up questionnaire and biologic samples are being collected. This is a long term study which will require several years to complete.