Noninvasive Measures in Wheezy Infants and Toddlers

描述（由申请人提供）： 反复喘息在幼儿期很常见，影响超过20%的儿童。婴幼儿缺乏诊断气流阻塞和气道炎症的非侵入性方法，这使得临床医生很难将儿童早期短暂性喘息与早期持续性哮喘分开。如果这种方法是可用的，他们将协助医疗保健提供者与哮喘的早期诊断，提供了一个合理的基础上开始每日吸入皮质类固醇，并可能减少早期下降的肺功能，通过及时的治疗干预。 本研究的总体目标是在一组有反复喘息病史的婴儿和年龄匹配的健康婴儿中描述气道炎症和气流阻塞的纵向无创测量。 Debley博士将评估呼出气中一氧化氮、呼出气冷凝液中半胱氨酰白三烯和胸廓指数（肺过度充气的人体测量）的纵向测量值与症状和使用升容快速胸部按压技术测量的婴儿肺功能的相关性。他还将比较反复喘息和无呼吸道症状的婴儿之间这些非侵入性测量的纵向值。 博士Debley的职业目标是成为儿科肺病学亚专业中反复喘息儿童研究的领导者，特别是在幼儿气流阻塞和气道炎症的非侵入性评估方面的专业知识。他提出了一个严格的5年职业发展计划，由四位杰出而经验丰富的导师监督，这将为他提供与他的研究计划和职业目标相关的几个新领域的增强技能和知识，包括：使用升容胸外按压技术进行婴儿肺功能的表现和解释，收集呼出气冷凝液并分析其成分，应用统计学方法分析纵向数据，全面了解一氧化氮生物学，包括幼儿呼出的一氧化氮分析，并详细了解哮喘中的炎症介质。

DESCRIPTION (provided by applicant): Recurrent wheezing is common in early childhood, affecting over 20% of children. Noninvasive methods to diagnosis airflow obstruction and airway inflammation are lacking in infants and toddlers, making it difficult for clinicians to separate transient wheezing of early childhood from early persistent asthma. If such methods were available they would assist medical care providers with the early diagnosis of asthma, provide a rationale basis for the initiation of daily inhaled corticosteroids, and perhaps reduce early decline in lung function through timely therapeutic intervention. The overall goal of this research is to characterize longitudinal noninvasive measures of airway inflammation and airflow obstruction in a cohort of infants with a history of recurrent wheezing/and age- matched healthy infants. Dr. Debley will assess the associations of longitudinal measurements of exhaled nitric oxide, cysteinyl leukotrienes in exhaled breath condensate, and the thoracic index (an anthropometric measure of pulmonary hyperinflation), with symptoms and infant pulmonary function measures using the raised-volume rapid thoracic compression technique. He will also compare longitudinal values of these noninvasive measures between infants with recurrent wheezing and infants without respiratory symptoms. Dr. Debley's career goal is to become a leader within the subspecialty of pediatric pulmonology in the study of children with recurrent wheezing, with particular expertise in the non-invasive assessment of airflow obstruction and airway inflammation in young children. He proposes a rigorous 5 year career development plan supervised by four outstanding and experienced mentors, which will provide him with enhanced skills and knowledge in several new areas relevant to his research plan and career goals, including: the performance and interpretation of infant lung function using the raised-volume thoracic compression technique, the collection of exhaled breath condensate and analysis of its constituents, the application of statistical methods used to analyze longitudinal data, a comprehensive understanding of nitric oxide biology including the analysis of exhaled nitric oxide in young children, and a detailed understanding of inflammatory mediators in asthma.