ACUTE INTERVENTION MANAGEMENT STRATEGIES (AIMS)

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。临床经验表明，儿童，特别是6岁以下的儿童，可能患有间歇性哮喘（两次发作之间无症状），但在呼吸道病毒季节，往往会出现严重的哮喘，导致他们去医生办公室接受紧急护理、急诊治疗和住院。因此，有理由认为这些患者患有严重的间歇性哮喘。国家心肺和血液研究所（NHLBI）儿童哮喘研究和教育（CARE）网络开展了一项名为“急性干预管理策略（AIMS）”的试验，该试验将评估3种干预策略对12个月至59个月的儿童的效果，这些儿童患有严重程度足以导致之前在急诊室、住院、或者紧急去看医生（比如严重的间歇性哮喘）。我们将尝试回答以下问题：1。与常规治疗相比，早期吸入皮质类固醇或白三烯受体拮抗剂治疗是否能改变研究期间严重间歇性哮喘的病程？2. 对任何一种干预的反应是否与表型（嗜酸性粒细胞、IgE、鼻腔灌洗液中的cyyslt、哮喘预测指数阳性/阴性）或基因（如b2肾上腺素能受体或5-lioxygenase基因）特征有关？

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. Clinical experience demonstrates that children, especially those under the age of 6 years, may have asthma which is truly intermittent (asymptomatic between exacerbations) and yet experience exacerbations, particularly during the respiratory viral season, that often are severe leading to visits to physician offices for urgent care, emergency department treatment, and hospitalization. Thus, it is plausible to consider these patients to have severe intermittent asthma. The National Heart, Lung and Blood Institute (NHLBI) Childhood Asthma Research and Education (CARE) Network has developed a trial entitled "Acute Intervention Management Strategies (AIMS)", which will evaluate the effect of 3 intervention strategies in children age 12 months - 59 months with recurrent wheezing in the context of respiratory tract illnesses of sufficient severity to have resulted in previous treatment in the emergency unit, hospitalization, or urgent visit to a physician's office (i.e. severe intermittent asthma). We will attempt to answer the following questions: 1. Does early treatment with inhaled corticosteroid or leukotriene receptor antagonist change the course of severe intermittent asthma over the study period compared with conventional therapy? 2. Can the response to either intervention be related to either phenotypic (eosinophils, IgE, cysLT in nasal lavage, asthma predictive index positive/negative) or genotyic (such as B2-adrenergic receptor or 5-lioxygenase gene) features?