PREVENTION OF EARLY ASTHMA IN KIDS (PEAK)

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Long-term follow-up studies suggest that initiation of asthma-like symptoms before age 3 in children who will go on to develop asthma is associated with a worse prognosis and larger deficits in lung function later in life. It is likely that chronic airway inflammation and the consequent development of airway hyperresponsiveness may play a crucial role in the self-perpetuation of early-onset asthma. This suggests that the early institution of therapy directed at decreasing airway inflammation may alter the natural course of asthma. We propose a study aimed at the identification of a subgroup of children aged 2-4 years who have wheezed during early life and are at greatest risk for the subsequent development of asthma. After a one month run-in period, children will then be randomized into a double-blind placebo-controlled trial of inhaled corticosteroid (fluticasone proprionate) or matching placebo administered twice daily for two years. These children will then be observed off study medication for 1 year for the development of asthma symptoms.